Problems Associated with Diabetes
   
There are many problems associated with diabetes, some more serious than others. Learning what these problems are and how to deal with them as early as possible in your diagnosis will be very helpful to you. The following are some of the problems associated with diabetes:

Hypoglycemia

Hypoglycemia is when your blood sugar is too low. Hypoglycemia cannot really be prevented. The best you can do is keep your diabetes as well controlled as possible and learn how to treat hypoglycemia, if it happens, to prevent it from getting worse. The trick is to learn to recognize the symptoms of hypoglycemia. This way, you can treat it before it gets worse. All diabetics experience hypoglycemia at some point, no matter how well they control their sugar so get to know the symptoms and learn how to treat it.

Your doctor will have told you how often to test your sugar levels and what your target range is however, if at anytime you feel unwell, do not hesitate to test more often. Checking your sugar will tell you if it is low. If you feel any of the symptoms listed below do not hesitate to treat for hypoglycemia. Even if you are not able to test at the time, if you suspect hypoglycemia, treat for it immediately.

Below are some of the main signs and symptoms:

      ● Feeling shaky
      ● Feeling hungry
      ● Feeling dizzy
      ● Breaking into a sweat
      ● Turning pale
      ● Being clumsy and uncoordinated.
      ● Sudden changes in behaviour eg: bursting into tears or becoming angry for no reason.
      ● Headaches
      ● Confusion
      ● And in some cases, even seizures.

Make sure your friends, family and work colleagues know the signs and symptoms of hypoglycemia and what to do if you are suffering from it.

Treating hypoglycemia

Taking in some form of sugar is the quickest way to bring your blood sugar back up. You can take this in the form of fruit juice (try about half a glass to start with - you can always have more if your sugar stays a little low), 2 or 3 glucose sweets which you should be able to get from a pharmacy or 5 or 6 boiled sweets.

Check your blood sugar again about 15 to 30 minutes after your treatment. If your sugar is still low, or if you are still feeling hypo, take some more of your chosen sugar. Once you are over your hypoglycemia make sure you follow your regular meal and snack regime to keep your blood sugar up.

If in doubt, ask your doctor or dietician to advise you on the best foods to treat your hypoglycemia and always make sure you carry some form of sugar with you wherever you go.

It is important to always carry some form of sugar with your because if you do not treat hypoglycemia immediately it can get worse and result in you passing out. If this happens you will be unable to eat or drink and you will need urgent treatment. This treatment could be in the form of a glucagon injection or even hospital treatment.

Glucagon is injected in the same way as insulin and will raise your blood sugar. Your doctor will prescribe glucagon for you. It is important to ensure that your family, friends and work colleagues understand your condition and are aware of what to do in an emergency. Ask your health care worker to teach you family how and when to administer glucagon.

If there is no glucagon available you will need urgent medical treatment. Make sure the people you live and work with know to get you to the nearest emergency department or to call for an ambulance should you ever pass out from suspected hypoglycemia.

It is a good idea to carry a card with you stating that you are a diabetic and giving the emergency number to call should you pass out. That way, if you pass out in a public place people will know how to help you. You should also keep all of your emergency numbers by the phone at home in case you ever need urgent help.

Sometimes diabetics pass out without ever knowing that their blood sugar was dropping. This is known as hypoglycemia unawareness.

Hypoglycemia unawareness tends to occur more often in people who have had diabetes for a long time. I does not happen to all diabetics and it may never happen to you so don't worry about it but do be aware that it can happen. It is most likely to happen in people who have suffered nerve damage due to long term diabetes (diabetic neuropathy) or to people on medication for other conditions such as hypertension (high blood pressure) and heart disease. If you have any concerns about hypoglycemia unawareness please discuss it with your doctor.

Hyperglycemia

Hyperglycemia is another condition associated with diabetes. Hyperglycemia means blood sugar levels that are too high. No matter how well you control your diabetes you will probably experience hyperglycemia at some time.
While it is not as serious as hypoglycemia in the short term, it can become a serious problem if it is not controlled over a period of time. Hyperglycemia is one of the major causes of the complications found in diabetics. For this reason it is important that you know how to recognise and treat hyperglycemia.

Hyperglycemia occurs either due to lack of insulin or the inability to use the insulin that is present. In type two diabetes, although the body may have enough insulin, it is not as effective as it should be. If you have type two diabetes you may need to inject insulin or you may be able to control you blood sugar with tablets or diet or a combination of two or more of these methods. In type one diabetes the body does not manufacture insulin and you will need to inject it.

Hyperglycemia can also come about as a result of eating more that your diet plan allows or from getting too little exercise. Illness and stress can also lead to hyperglycemia

The problem could be that you ate more than planned or exercised less than planned. The stress of an illness, such as a cold or flu, could also be the cause. Other stresses, such as family conflicts or school or dating problems, could also cause hyperglycemia.

Signs and symptoms of hyperglycemia include:

      ● Feeling very thirsty
      ● Increased urination
      ● High blood sugar levels
      ● Sugar in your urine.

Part of managing your diabetes is checking your blood glucose often. Ask your doctor how often you should check and what your blood glucose levels should be. Checking your blood and then treating high blood glucose early will help you avoid the other symptoms of hyperglycemia.

Treating Hyperglycemia

The best thing you can do regarding hyperglycemia is exercise good control over your diabetes. Get to know your individual symptoms of hyperglycemia so you can treat it early and prevent it from getting worse.

Once you have identified hyperglycemia as your problem you need to bring your glucose levels down. You will need to talk your doctor or health care professional about the safest way to reduce your blood sugar levels.

Drinking plenty of water can help as can exercise. However if your blood sugar is above 13.5 mmol/l (approx 240mg/dl) you should test your urine for ketones before exercising. Never exercise if you have ketones in your urine as you may increase your glucose level rather than decrease it.
If you regularly suffer from hyperglycemia you may need to adjust the amount of food you are eating. Gradually make changes in your meal plan and see if you can find a balance that suits you. You may want to consult with your dietician regarding these changes.

If you begin an exercise regime and make adjustments to your meal plan but still have problems with hyperglycemia discuss the situation with your doctor. He/she may try you on a different type of insulin or medication or adjust your dosage or the times you administer it.

Ketoacidosis

Ketoacidosis occurs when there is a dangerously high level of ketones in the body. It occurs mainly in type 1 diabetics but is seen rarely in type 2 diabetics. Ketoacidosis is a serious and potentially life-threatening condition which may result in a diabetic coma

Ketones are acids and they can build up in the blood and be passed in the urine. Ketones are a sign that you do not have enough insulin. They can indicate that your diabetes in not well controlled or that you are becoming ill.  

Treating Ketoacidosis

Treating ketoacidosis is a job for your health care team and is mainly carried out in hospital. You can do much to avoid the problem by knowing how to prevent it from arising.

Preventing ketoacidosis begins with regular monitoring of your blood and urine and knowing the signs and symptoms of a build up of ketones.

      ● Excessive thirst or dryness in the mouth
      ● High levels of ketones in the urine
      ● Excessive urination
      ● High blood sugar

Later signs of Ketoacidosis include vomiting, feeling tired, confusion, shortness of breath a sweetish smell on the breath and dry or flushed skin.

Ketoacidosis can be a life threatening condition. If you have any of the signs and symptoms of Ketoacidosis contact you health care professional at once or go to the nearest emergency hospital.

Test your urine for ketones regularly if your blood sugar goes above 13.5mmol/l (approx. 240mg/dl). Also check for ketones often if you are ill or if you have any of the signs and symptoms of Ketoacidosis.

Call your health care professional if you are at all concerned.