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Uncontrolled Diabetes Causes

Hyperglycemia In Diabetes

Hyperglycemia In Diabetes

Print Overview High blood sugar (hyperglycemia) affects people who have diabetes. Several factors can contribute to hyperglycemia in people with diabetes, including food and physical activity choices, illness, nondiabetes medications, or skipping or not taking enough glucose-lowering medication. It's important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications requiring emergency care, such as a diabetic coma. In the long term, persistent hyperglycemia, even if not severe, can lead to complications affecting your eyes, kidneys, nerves and heart. Symptoms Hyperglycemia doesn't cause symptoms until glucose values are significantly elevated — above 200 milligrams per deciliter (mg/dL), or 11 millimoles per liter (mmol/L). Symptoms of hyperglycemia develop slowly over several days or weeks. The longer blood sugar levels stay high, the more serious the symptoms become. However, some people who've had type 2 diabetes for a long time may not show any symptoms despite elevated blood sugars. Early signs and symptoms Recognizing early symptoms of hyperglycemia can help you treat the condition promptly. Watch for: Frequent urination Increased thirst Blurred vision Fatigue Headache Later signs and symptoms If hyperglycemia goes untreated, it can cause toxic acids (ketones) to build up in your blood and urine (ketoacidosis). Signs and symptoms include: Fruity-smelling breath Nausea and vomiting Shortness of breath Dry mouth Weakness Confusion Coma Abdominal pain When to see a doctor Call 911 or emergency medical assistance if: You're sick and can't keep any food or fluids down, and Your blood glucose levels are persistently above 240 mg/dL (13 mmol/L) and you have ketones in your urine Make an appointment with your Continue reading >>

Diabetes - A Major Risk Factor For Kidney Disease

Diabetes - A Major Risk Factor For Kidney Disease

Diabetes mellitus, usually called diabetes, is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. Insulin is a hormone that regulates the amount of sugar in your blood. A high blood sugar level can cause problems in many parts of your body. The most common ones are Type 1 and Type 2. Type 1 diabetes usually occurs in children. It is also called juvenile onset diabetes mellitus or insulin-dependent diabetes mellitus. In this type, your pancreas does not make enough insulin and you have to take insulin injections for the rest of your life. Type 2 diabetes, which is more common, usually occurs in people over 40 and is called adult onset diabetes mellitus. It is also called non insulin-dependent diabetes mellitus. In Type 2, your pancreas makes insulin, but your body does not use it properly. The high blood sugar level often can be controlled by following a diet and/or taking medication, although some patients must take insulin. Type 2 diabetes is particularly prevalent among African Americans, American Indians, Latin Americans and Asian Americans. With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood. Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that h Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

On this page: Diabetes and diabetic retinopathy • DR symptoms • Types of diabetic eye disease • Who gets diabetic retinopathy? • Minorities and diabetic eye disease • When is DR a disability? • Eye exam assistance program • Prevention • Diabetic retinopathy videos Diabetic retinopathy — vision-threatening damage to the retina of the eye caused by diabetes — is the leading cause of blindness among working-age Americans. The good news: Diabetic retinopathy often can be prevented with early detection, proper management of your diabetes and routine eye exams performed by your optometrist or ophthalmologist. According to the International Diabetes Federation (IDF), the United States has the highest rate of diabetes among 38 developed nations, with approximately 30 million Americans — roughly 11 percent of the U.S. population between the ages of 20 and 79 — having the disease. About 90 percent of Americans with diabetes have type 2 diabetes, which develops when the the body fails to produce enough insulin — a hormone secreted by the pancreas that enables dietary sugar to enter the cells of the body — or the body becomes resistant to insulin. This causes glucose (sugar) levels in the bloodstream to rise and can eventually damage the eyes, kidneys, nerves or heart, according to the American Diabetes Association (ADA). Risk factors for type 2 diabetes include obesity, an unhealthful diet and physical inactivity. Unfortunately, the prevalence of obesity and type 2 diabetes has increased significantly in the United States over the past 30 years. According to data released by the U.S. Centers for Disease Control and Prevention (CDC) in December 2015, there were 1.4 million new cases of diabetes reported in the U.S. in 2014. Though this annual number is d Continue reading >>

Management Of Persistent Hyperglycemia In Type 2 Diabetes Mellitus

Management Of Persistent Hyperglycemia In Type 2 Diabetes Mellitus

The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc. All topics are updated as new evidence becomes available and our peer review process is complete. INTRODUCTION — Initial treatment of patients with type 2 diabetes mellitus includes education, with emphasis on lifestyle changes including diet, exercise, and weight reduction when appropriate. Monotherapy with metformin is indicated for most patients, and insulin may be indicated for initial treatment for some [1]. Although several studies have noted remissions of type 2 diabetes mellitus that may last several years, most patients require continuous treatment in order to maintain normal or near-normal glycemia. Bariatric surgical procedures in obese patients that result in major weight loss have been shown to lead to remission in a substantial fraction of patients. Regardless of the initial response to therapy, the natural history of most patients with type 2 diabetes is for blood glucose concentrations to rise gradually with time. Treatment for hyperglycemia that fails to respond to initial monotherapy and long-term pharmacologic therapy in type 2 diabetes is reviewed here. Options for initial therapy and other therapeutic issues in diabetes management, such as the frequency of monitoring and evaluation for microvascular and macrovascular complications, are discussed separately. (See "Initial management of blood glucose in adults with type 2 diabetes mellitus" and "Overview of medical care in adults with diabetes mellitus". Continue reading >>

How Diabetes Affects Wound Healing

How Diabetes Affects Wound Healing

Diabetes is a condition in which the body does not effectively use sugar. It is estimated that there are nearly 18 million Americans with diabetes, and approximately 15 percent of diabetics will develop a foot ulcer at some point. Foot ulcers are the most common wounds for this patient population. Wound healing can be slowed when the patient is diabetic. An important point to remember about a diabetic patient wound is that it heals slowly and can worsen rapidly, so requires close monitoring. There are several factors that influence wound healing in a diabetic patient, and may include: Blood Glucose Levels It all starts here. An elevated blood sugar level stiffens the arteries and causes narrowing of the blood vessels. The effects of this are far-reaching and include the origin of wounds as well as risk factors to proper wound healing. Poor Circulation Narrowed blood vessels lead to decreased blood flow and oxygen to a wound. An elevated blood sugar level decreases the function of red blood cells that carry nutrients to the tissue. This lowers the efficiency of the white blood cells that fight infection. Without sufficient nutrients and oxygen, a wound heals slowly. Diabetic Neuropathy When blood glucose levels are uncontrolled, nerves in the body are affected and patients can develop a loss of sensation. This is called diabetic neuropathy. When there is a loss of sensation, patients cannot feel a developing blister, infection or surgical wound problem. Because a diabetic patient may not be able to feel a change in the status of a wound or the actual wound, the severity can progress and there may be complications with healing. Immune System Deficiency Diabetes lowers the efficiency of the immune system, the body's defense system against infection. A high glucose level ca Continue reading >>

Oral Health Problems And Diabetes

Oral Health Problems And Diabetes

Diabetes is a disease that can affect the whole body — your eyes, nerves, kidneys, heart, and other important systems in the body. It can also affect your mouth. People with diabetes face a higher than normal risk of oral health problems. Why are people with diabetes more likely to develop oral health problems? The link between diabetes and oral health problems is high blood sugar. If blood sugar is poorly controlled, oral health problems are more likely to develop. This is because uncontrolled diabetes weakens white blood cells, which are the body’s main defense against bacterial infections that can occur in the mouth. Just as studies have shown that controlling blood sugar levels lowers the risk of major organ complications of diabetes — such as eye, heart, and nerve damage — so to can diabetes control protect against the development of oral health problems. Specifically, what are some of these oral health problems? Dry mouth: Uncontrolled diabetes can decrease saliva flow, resulting in dry mouth. Dry mouth can further lead to soreness, ulcers, infections, and tooth decay. Gum inflammation (gingivitis) and periodontitis: Besides weakening white blood cells, another complication of diabetes is that it causes blood vessels to thicken. This slows the flow of nutrients to and waste products from body tissues, including the mouth. When this combination of events, the body loses its ability to fight infections. Since periodontal disease is a bacterial infection, people with uncontrolled diabetes might experience more frequent and more severe gum disease. Poor healing of oral tissues: People with uncontrolled diabetes do not heal quickly after oral surgery or other dental procedures because blood flow to the treatment site can be damaged. Thrush: People with diabetes Continue reading >>

Diabetes Causes Thrush

Diabetes Causes Thrush

Diabetes, especially uncontrolled diabetes, increases the risk of multiple complications, including infections of oral thrush. Although oral thrush is a relatively common and mostly harmless yeast infection, the combination of thrush and diabetes can cause serious complications. An Overview of Diabetes Diabetes mellitus, or diabetes, impairs the body’s ability to control levels of glucose, the sugar converted by body cells into energy. Consequently, blood sugar levels can rise to dangerously high levels. There are two varieties of diabetes, both of which increase the risk of oral yeast infections. Type 1 diabetes occurs when the pancreas loses the ability to manufacture insulin, the hormone that controls blood levels of glucose. Type 1 diabetes onset usually occurs in childhood or adolescence. Type 2 diabetes is the most common variety of diabetes. The pancreas produces insulin in cases of type 2 diabetes, but one of two complications occurs: the body loses the ability to use insulin properly the pancreas produces insufficient insulin. Type 2 diabetes is also called adult onset diabetes, as the condition usually develops in adults. Changes in dietary habits and an increase in obesity have seen a rise of type 2 diabetes in children and adolescents, however. Thrush and Yeast Infections Thrush is the common name for yeast infections caused by the microorganism Candida albicans. Candida albicans is a common microorganism that is found on the mouth, digestive tract and skin of most people. Under normal circumstances, the body’s immune system keeps Candida albicans growth under control. Under certain circumstances, Candida growth can outpace the body’s ability to control the organism and yeast infections occur. Oral thrush and vaginal yeast infections are common yeast i Continue reading >>

Diabetes

Diabetes

Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. There are two main types of diabetes: type 1 diabetes – where the body's immune system attacks and destroys the cells that produce insulin type 2 diabetes – where the body doesn't produce enough insulin, or the body's cells don't react to insulin Type 2 diabetes is far more common than type 1. In the UK, around 90% of all adults with diabetes have type 2. During pregnancy, some women have such high levels of blood glucose that their body is unable to produce enough insulin to absorb it all. This is known as gestational diabetes. Pre-diabetes Many more people have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes. This is sometimes known as pre-diabetes. If your blood sugar level is above the normal range, your risk of developing full-blown diabetes is increased. It's very important for diabetes to be diagnosed as early as possible because it will get progressively worse if left untreated. When to see a doctor Visit your GP as soon as possible if you experience the main symptoms of diabetes, which include: urinating more frequently than usual, particularly at night feeling very tired weight loss and loss of muscle bulk cuts or wounds that heal slowly blurred vision Type 1 diabetes can develop quickly over weeks or even days. Many people have type 2 diabetes for years without realising because the early symptoms tend to be general. Causes of diabetes The amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach). When food is digested and enters your bloodstream, insulin moves glucose out of the blood and into cells, where it's broken down to produce ene Continue reading >>

Avoiding Complications Of Diabetes

Avoiding Complications Of Diabetes

It can take work to get your diabetes under control, but the results are worth it. If you don't make the effort to get a handle on it, you could set yourself up for a host of complications. Diabetes can take a toll on nearly every organ in your body, including the: Heart and blood vessels Eyes Kidneys Nerves Gastrointestinal tract Gums and teeth Heart and Blood Vessels Heart disease and blood vessel disease are common problems for many people who don’t have their diabetes under control. You're at least twice as likely to have heart problems and strokes as people who don’t have the condition. Blood vessel damage or nerve damage may also cause foot problems that, in rare cases, can lead to amputations. People with diabetes are ten times likelier to have their toes and feet removed than those without the disease. Symptoms: You might not notice warning signs until you have a heart attack or stroke. Problems with large blood vessels in your legs can cause leg cramps, changes in skin color, and less sensation. The good news: Many studies show that controlling your diabetes can help you avoid these problems, or stop them from getting worse if you have them. Diabetes is the leading cause of new vision loss among adults ages 20 to 74 in the U.S. It can lead to eye problems, some of which can cause blindness if not treated: Glaucoma Cataracts Diabetic retinopathy, which involves the small blood vessels in your eyes Symptoms: Vision problems or sudden vision loss. The good news: Studies show that regular eye exams and timely treatment of these kinds of problems could prevent up to 90% of diabetes-related blindness. *CGM-based treatment requires fingersticks for calibration, if patient is taking acetaminophen, or if symptoms/expectations do not match CGM readings, and if not pe Continue reading >>

12 Signs Of Uncontrolled Diabetes

12 Signs Of Uncontrolled Diabetes

12 Signs of Uncontrolled Diabetes Blood tests tell you and your doctor when your glucose levels are too high. But signs of uncontrolled diabetes can appear all over your body. High blood glucose can damage nerves, blood vessels, and organs, resulting in a wide array of symptoms. Talk with your doctor if you spot any of them, so you can stay in control of your diabetes and improve your quality of life. © 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement. You Might Also Like Continue reading >>

Diabetes During Pregnancy

Diabetes During Pregnancy

What is diabetes? Diabetes is a condition in which the body can't make enough insulin, or can't use insulin normally. Insulin is a hormone. It helps sugar (glucose) in the blood get into cells of the body to be used as fuel. When glucose can’t enter the cells, it builds up in the blood. This is called high blood sugar (hyperglycemia). High blood sugar can cause problems all over the body. It can damage blood vessels and nerves. It can harm the eyes, kidneys, and heart. In early pregnancy, high blood sugar can lead to birth defects in a growing baby. There are 3 types of diabetes: Type 1 diabetes. Type 1 diabetes is an autoimmune disorder. The body's immune system damages the cells in the pancreas that make insulin. Type 2 diabetes. This is when the body can’t make enough insulin or use it normally. It’s not an autoimmune disease. Gestational diabetes. This is a condition in which the blood glucose level goes up and other diabetic symptoms appear during pregnancy in a woman who has not been diagnosed with diabetes before. It happens in about 3 in 100 to 9 in 100 pregnant women. What causes diabetes during pregnancy? Some women have diabetes before they get pregnant. This is called pregestational diabetes. Other women may get a type of diabetes that only happens in pregnancy. This is called gestational diabetes. Pregnancy can change how a woman's body uses glucose. This can make diabetes worse, or lead to gestational diabetes. During pregnancy, an organ called the placenta gives a growing baby nutrients and oxygen. The placenta also makes hormones. In late pregnancy, the hormones estrogen, cortisol, and human placental lactogen can block insulin. When insulin is blocked, it’s called insulin resistance. Glucose can't go into the body’s cells. The glucose stays in Continue reading >>

Hospital Admission Guidelines For Diabetes*

Hospital Admission Guidelines For Diabetes*

These guidelines are to be used for determining when a patient requires hospitalization for reasons related to diabetes. Inpatient care may be appropriate in the following situations: Life-threatening acute metabolic complications of diabetes. Newly diagnosed diabetes in children and adolescents. Substantial and chronic poor metabolic control that necessitates close monitoring of the patient to determine the etiology of the control problem, with subsequent modification of therapy. Severe chronic complications of diabetes that require intensive treatment or other severe conditions unrelated to diabetes that significantly affect its control or are complicated by diabetes. Uncontrolled or newly discovered insulin-requiring diabetes during pregnancy. Institution of insulin-pump therapy or other intensive insulin regimens. Modification of fixed insulin-treatment regimens or sulfonylurea treatment is not, by itself, an indication for hospital admission. Guidelines for hospital admission are given below. Guidelines are never a substitute for medical judgment, and each patient’s total clinical and psychosocial circumstances must be considered in their application. Therefore, there may be situations in which admission is appropriate, although the patient’s clinical profile does not comply with these guidelines. For example, inadequate family resources may dictate admission of newly diagnosed type 1 diabetic patients who otherwise do not meet the admission guidelines. ACUTE METABOLIC COMPLICATIONS OF DIABETES Admission is appropriate for the following: Diabetic ketoacidosis Plasma glucose >250 mg/dl (>13.9 mmol/l) with 1) arterial pH <7.30 and serum bicarbonate level <15 mEq/l and 2) moderate ketonuria and/or ketonemia. Hyperglycemic hyperosmolar state Impaired mental status Continue reading >>

Diabetes And Fatigue: Everything You Need To Know

Diabetes And Fatigue: Everything You Need To Know

What exactly is fatigue? Is it just being tired after working a long week or not getting enough sleep? The answer is no. Fatigue is excessive tiredness that makes carrying out simple tasks difficult and interferes with one or more life functions. Sounds terrible, doesn’t it? Well imagine having a chronic illness along with the fatigue. Diabetes and fatigue have a strong relationship, and it can make a person’s life very difficult. The following article will discuss the relationship, along with ways to beat and reduce the risk of living with diabetes and fatigue. What is diabetes fatigue? As it was mentioned above, diabetes fatigue is an extreme tiredness that individuals with diabetes can experience. It is a tiredness that disrupts a person’s life and makes it difficult to function. It is very common, and studies have shown that 85% of those with diabetes experience fatigue. Some signs of fatigue include: Dizziness Irritability Headache Inability to concentrate Problems remembering things Blurry vision Slowed reflexes and muscle weakness Is feeling fatigue a sign/symptom of diabetes? Feeling fatigued is definitely a symptom of diabetes. However, fatigue can also be a sign or symptom of many other diseases, so it is important that you talk to your doctor about any problems that you are having. I advise reading the following: Reactive hypoglycemia, a term used to define the crash that a person gets after eating a lot of sugar and carbs, can be an early sign of diabetes. In order for the body to use the sugars and carbs that are consumed for fuel, each molecule must be paired with insulin to get into the cell. If there isn’t enough insulin available, then the sugar molecules stay in the bloodstream and cause high blood sugar. What happens is that over time, eating Continue reading >>

Diabetes: Foot & Skin Related Complications

Diabetes: Foot & Skin Related Complications

How can diabetes affect feet and skin? For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause some serious complications, including foot and skin problems, as well as heart disease, stroke, kidney disease, eye damage, and other problems. How can diabetes affect my feet? Diabetes can cause two problems that can affect your feet: Diabetic neuropathy — Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold or pain. This lack of feeling is called diabetic neuropathy. If you do not feel a cut or sore on your foot because of neuropathy, the cut could get worse and become infected. Peripheral vascular disease — Diabetes also affects the flow of blood. Without good blood flow, it takes longer for a sore or cut to heal. Poor blood flow in the arms and legs is called peripheral vascular disease. (The word "peripheral" means "located away from a central point," and the word "vascular" refers to the blood vessels. Peripheral vascular disease is a circulation disorder that affects blood vessels away from the heart.) If you have an infection that will not heal because of poor blood flow, you are at risk for developing gangrene, which is the death of tissue due to a lack of blood. To keep gangrene from spreading, the doctor may have to remove a toe, foot, or part of a leg. This procedure is called amputation. Diabetes is the most common, non-traumatic cause of leg amputations. Each year, more than 56,000 people with diabetes have amputations. However, research suggests that more than half of these amputations can be prevented through proper foot care. What are some common foot problems of people with diabetes? Anyone can get the foot problems listed below. For people Continue reading >>

The Treatment Of Severely Uncontrolled Diabetes Mellitus.

The Treatment Of Severely Uncontrolled Diabetes Mellitus.

Abstract Patients with severely uncontrolled diabetes mellitus must be cared for by physicians and nurses who understand the pathophysiology of ketoacidosis and nonketotic hyperglycemia, who carefully seek and treat precipitating or underlying illnesses, and who can provide the patients with continuous clinical attention and laboratory monitoring. Most patients with diabetic ketoacidosis survive the acute metabolic disorder; the infrequent deaths are usually due to serious underlying illnesses. The latter are more common in patients with nonketotic hyperglycemia, who are usually older than those with ketoacidosis and who usually also have serious underlying chronic diseases. The essential features of treatment for either of the foregoing acute metabolic disorders are administration of insulin (especially gingerly in the older patients with nonketotic hyperglycemia, despite their commonly remarkable hyperglycemia); rehydration with NaCl solutions; and IV administration of K+, usually not until after a few hours of treatment with insulin and NaCl solutions. Administration of NaHCO3 is usually not necessary except in patients with a blood pH less than 7.1. Administration of phosphate has been recommended as part of the treatment for ketoacidosis, but its need is uncertain. Although patients with nonketotic hyperglycemia are often more severely dehydrated and hyperglycemic than those with ketoacidosis, they usually should be given smaller amounts of insulin, NaCl solutions, and K+, and less rapidly. Continue reading >>

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