Why Diabetes Is So Dangerous

There’s a common saying in the diabetes community that diabetes won’t kill you, but it’s complications will.  Still, according to the American Diabetes Association, diabetes was the 7^th leading cause of death in the United States in 2010, with over 69,000 death certificates listing it as the underlying cause of death. [1]

Add to that the common complications, like cardiovascular disease, kidney disease, and infection, and you can multiply that number by 10!

Yet despite these eye-opening statistics, I still see far too many people not taking diabetes seriously. They approach it as something that’s a nuisance rather than something that can and does cause major health complications, and yes even death, if uncontrolled.

“Sometimes I pretend I’m not diabetic, but that’s a dangerous game.”

– Unknown

Diabetes is more dangerous than most people assume, and so it becomes easy for many people with diabetes to get lax in their efforts to manage the dysfunction.  A 2012 GAPP2 (Global Attitude of Patients and Physicians 2) survey found that 22% of insulin-using diabetic patients missed a basal insulin dose during a 30-day period. [2]

There are very real dangers diabetes poses if left unchecked or mismanaged, and one of my goals today is to motivate you into taking better care of yourself or helping a loved one manage the disease better.

Why is diabetes so dangerous? Because if not managed correctly, it can wreak havoc on just about every system and organ in the body. Let’s take a look at some of the biggest risks diabetic complications pose:

Diabetic Ketoacidosis

Diabetic Ketoacidosis is a very dangerous condition that can occur when patients neglect to take their insulin and have uncontrolled blood sugar. Since insulin is necessary to break down glucose as a source of energy, the body then turns to body fat as a fuel source.

While you may think that burning fat for fuel sounds like a great idea, it’s not in this case. This process of using fat and not glucose for fuel leads to an excessive and dangerous buildup of byproducts called ‘ketones’ making the blood very acidic.

This is not the same thing as nutritional ketosis, which is the presence of a small to moderate amount of ketones in the blood that occurs during fasting or with strategic low carbohydrate diets.  Nutritional ketosis is widely considered safe and even used therapeutically for people who suffer from seizures and other health considerations.

If left unchecked, however, diabetic ketoacidosis can lead to a diabetic coma and even death. The incidence of this complication is on the rise, with 80,000 hospitalizations reported in 1988 and 140,000 cases in 2009. [3] Symptoms of the condition include difficulty breathing, acute abdominal pain, dehydration, weakness and vomiting. If you or a loved one is diabetic and experiencing these symptoms, contact your primary care doctor immediately.

Diabetic Retinopathy

The retina is the innermost layer of the eye and it performs an incredibly important function. The retina receives light from our surroundings and converts that light into neural signals that are sent to the brain for recognition. Thanks to the retina we know if we are looking at a cat or scrambled eggs – a very important distinction at breakfast.

Because of the retina’s vital role in vision, any damage to it can cause permanent blindness. Diabetics are at risk of retinal damage because this sensitive eye tissue is affected by poor glucose control, which often causes tiny blood vessels in the retina to become damaged. Diabetics are also particularly at risk of developing cataracts and glaucoma.

Diabetic Nephropathy

Diabetic Nephropathy is a fancy term describing damage to the kidneys caused by diabetes. Your kidneys have tiny blood vessels that filter waste from your blood. In diabetics with constantly-high blood sugars, these blood vessels can be damaged or destroyed and, over time, the kidneys are not able to do their job. In some cases, the kidneys may fail completely.  If fact, diabetes is the leading cause of kidney failure in adults.

The number of patients being treated for end stage renal disease (ESRD-DM) has also increased over time. In 1980 the number of diabetes being treated for (ESRD-DM) was “only” 2,600, yet in 2008 that number climbed to 48,374. [4]

Heart Attacks and Stroke

Diabetics, especially those who smoke and have high blood pressure, or are overweight, have a greater risk of developing heart disease and strokes.  In fact, according to The American Heart Association:

• 74% of people over 65 with diabetes die of either heart attack or stoke
• Adults with diabetes are at a 200-400% increased risk for a heart attack or stroke than those without diabetes
• Diabetes is considered one of seven controlled risk factors for cardiovascular disease

According to Joslin Diabetes Center, diabetes is the “strongest” risk factor for cardiovascular disease due to its root metabolic imbalances.

“Heart disease and diabetes are often discussed hand in hand.  That’s because 85% of people diagnosed with diabetes will die from cardiovascular disease.”

– Judy Carter

Complications with Feet

When you have diabetes, even a ‘simple’ callous can lead to a major foot complication. This is because diabetics often have nerve damage (or neuropathy) in their feet. Nerve damage causes poor blood flow as well as loss of feeling. While non-diabetics are able to feel they have a small cut on their foot, a diabetic may not. This loss of sensation combined with poor circulation can lead to a bad infection, which can then lead to amputation.

This nerve damage can also cause changes to the actual shape of your feet and toes. If this happens, it’s important to speak to your doctor about getting special therapeutic shoes instead of forcing your feet and toes into shoes that no longer fit and may cause further damage.

Gastroparesis

Gastroparesis is a condition in which the stomach takes too long to empty its contents. In diabetics, the vagus nerve, which controls the movement of food through the digestive tract, becomes damaged because of regularly-high glucose levels. When this happens the muscles of the stomach and intestines no longer function normally and the movement of food slows or stops completely. This condition can happen with Type 1 or Type 2 diabetes.

Signs and symptoms of gastroparesis can vary but usually include nausea, heartburn, weight loss, vomiting, abdominal bloating, feeling full suddenly when you’ve just started eating, lack of appetite, erratic glucose levels, and spasms of the stomach lining.  These symptoms can be mild or severe, depending on the individual.

The real problem with gastroparesis is that it can make managing blood glucose even harder. Because food essentially becomes stuck in the stomach for hours, when it does eventually make its way to the small intestine, blood glucose levels can suddenly spike.

Another complication is that when food that stays in the stomach too long it can cause a bacterial overgrowth because of fermentation. Beyond this, the food can also harden into solid masses called ‘bezoars’ that cause nausea and vomiting, and potentially may even cause a very dangerous blockage.

While some medications can help with this condition, a better treatment is to change your eating habits. For instance, it is recommended for people with diabetes and gastroparesis, to eat less food at each sitting, consuming smaller meals throughout the day instead of three large ones.  Walking after each meal is also recommended.

Your health practitioner may also recommend limiting high-fat and high-fiber foods, which can slow digestion.  If the condition becomes very severe, individuals may need to go on an all-liquid diet.

Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)

Hyperosmolar Hyperglycemic Nonketotic Syndrome, or HHNS, is a serious condition that is normally seen in older diabetics with either type 1 or type 2 diabetes, but more often in type 2.  What is significant to note, though, is that hospitalizations for HHS in children and adolescents have increased by 52.4% between the years of 1997 and 2009. [5]

HHNS occurs when blood sugar levels rise and, in an effort to rid the body of this excess quickly, the sugar is passed into the urine. At first, a lot of urine is made and the individual has to go to the bathroom often. Eventually, the person may not go to the bathroom as often and the urine may become very dark.

It is critical to drink water with this condition, even if you are not thirsty, as dehydration can set in quickly.  If left unchecked, the dehydration can become more severe and may lead to seizures, coma, and eventually death.

Type 2 diabetes does not need to be a death sentence, or even cause the complications and problems that I outlined today.  In fact, the condition can be well managed and even reversed with the right diet and lifestyle medication program.  If you have diabetes or have a loved one dealing with it, be smart.  Get proactive and take action now to stop the progression of the condition and prevent complications.

“The sooner people find out they have pre diabetes and take action, the better their chances of preventing type 2 diabetes.”

– Ann Albright, PhD, RD

Resources

[1] Data from the National Diabetes Statistics Report, 2014 (released June 10, 2014) – American Diabetes Association

[2] Association between Adherence to Basal Insulin and Hypoglycemia, First Report Managed Care

[3] Number (in Thousands) of Hospital Discharges with Diabetic Ketoacidosis (DKA) as First-Listed Diagnosis, United States, 1988–2009, Centers for Disease Control and Prevention

[4] Number of People Initiating Treatment for End-Stage Renal Disease Related to Diabetes Mellitus (ESRD-DM), United States, 1980–2008, Centers for Disease Control and Prevention

[5] Hyperosmolar Hyperglycemic State: A Historic Review of the Clinical Presentation, Diagnosis, and Treatment, Diabetes Care