Diabetes is on the rise. The number of people affected in the U.S. has tripled since 1980, with nearly 26 million Americans affected in 2011, according to the Centers for Disease Control and Prevention. Diabetes is a metabolic disease that can be managed with a combination of lifestyle changes, diet and medications. Insulin injections are necessary to treat type 1 diabetes and advanced cases of type 2 diabetes. Untreated diabetes can result in life-threatening metabolic crises. Even if emergency situations are avoided, poorly controlled diabetes damages blood vessels and nerves throughout the body, with devastating consequences over time.
Untreated diabetes can be fatal. One dangerous short-term complication is diabetic ketoacidosis, a rapidly progressing condition. Low insulin levels cause sugar to build up in the blood. The body breaks down fat for fuel, resulting in a buildup of byproducts called ketones and lowering the blood pH. Classic signs and symptoms of DKA are breathing that sounds like sighs, confusion, nausea, vomiting, lightheadedness, dehydration and a fruity smell on the breath. Trauma, stress and infections raise the risk for DKA.
Hyperosmolar hyperglycemic state is another dangerous complication of untreated diabetes. Prominent signs and symptoms include weakness, leg cramps, visual problems, low-grade fever, abdominal bloating and dehydration. HHS is most common in older adults with type 2 diabetes. The condition develops with profoundly high blood sugar levels. Both DKA and HHS are life-threatening medical emergencies.
Untreated or poorly controlled diabetes can damage your eyes. Blood vessel leakage and an overgrowth of new vessels can damage the vision-perceiving portion of the eye. These changes -- known as diabetic retinopathy -- are visible with an ophthalmic exam of the retina. Untreated diabetes also increases your risk for cataracts and glaucoma. Any of these diabetes-related eye diseases can lead to partial or total vision loss.
The nerves, particularly those in the hands and feet, can also be severely damaged by untreated diabetes. Numbness and tingling in the feet and lower legs, along with the hands and forearms, can result, a condition known as "glove and stocking neuropathy." Reduced sensation in the feet means injuries such as blisters and stubbed toes may go unnoticed. Damaged blood vessels delay healing in people with diabetes, and a minor injury may quickly progress to an ulcer. Untreated infection can lead to gangrene, and amputation may be necessary to protect the rest of the body.
Heart and Kidney Damage
Untreated or poorly controlled diabetes increases your risk for serious damage to your heart and kidneys. Blockage of the coronary arteries is more severe and occurs at a younger age in people with diabetes. According to CDC, people with diabetes are more than twice as likely to experience heart attacks and strokes than those who do not have diabetes.
Uncontrolled diabetes also damages the small blood vessels of the kidneys, which may eventually lead to kidney failure. People with end-stage kidney failure require regular dialysis or a kidney transplant to survive.
Is This an Emergency?
- Centers for Disease Control and Prevention: Diabetes Statistics
- Robbins Pathologic Basis of Disease, 6th Edition; Ramzi S. Cotran, M.D., et al.
- Diabetes Care: Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments
- Centers for Disease Control and Prevention: Diabetes Report Card 2012
- Elsevier Clinical Key: Diabetic Ketoacidosis
- American Family Physician: Hyperosmolar Hyperglycemic State
- Centers for Disease Control and Prevention: National Diabetes Fact Sheet 2011
- National Eye Institute: Facts About Diabetic Retinopathy
- American Diabetes Association: Kidney Disease (Nephropathy)