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Understanding Diabetes Beyond Glucose Numbers Complications & Co Morbidities

Nuzhat Chalisa

Diabetes is a growing global health concern that affects all age groups and genders. Analysts predict a worldwide prevalence of 552 million people with diabetes by 2030. Uncontrolled diabetes can lead to acute complications, including but not limited to, hypoglycemia, hyperglycemia, diabetic coma, diabetic ketoacidosis, and diabetic non-ketotic hyperosmolar coma.

Recurrent ongoing hyperglycemia can lead to chronic complications. These complications occur due to a mix of microangiopathy, macrovascular disease, and immune dysfunction. Microangiopathy can affect all vital organs, including they kidneys, heart, and brain, as well as eyes, nerves, lungs, and local gums and feet. Macrovascular problems can lead to cardiovascular disease, stroke, and peripheral vascular disease leading to gangrene and amputation. The damaging effects of hyperglycemia on the vasculature significantly contribute to diabetes complications and comorbidities.

Additionally, there are many other complications of diabetes which are not recognized and often remain unaddressed, such as diabetic dermopathy, osteoporosis, sleep apnea, musculoskeletal impairments, gastroparesis and dental problems, mental health issues, and vitamin deficiencies.

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Type 2 diabetes has been disproportionately increasing in minority populations. Non-Caucasian populations such as Hispanics, African Americans, and Asians are much more likely to develop type 2 diabetes and less likely to have effective control. Certain ethnic populations have a higher risk of complications from diabetes than others.

In addition to the societal and humanistic effects, the management of diabetes and its’ complications has substantial economic impact. If diabetes is undetected or its complications are poorly managed, patients can experience a poor health-related quality of life with significant morbidity and mortality, so optimal prevention and treatment strategies are necessary.

Adequate and sustained control of blood sugar levels can prevent or delay the onset of diabetes-related complications. However, effective interventions, at both the individual and population levels, are desperately needed to slow the diabetes epidemic and reduce the burden of diabetes-related complications.