Get to know the different complications when diabetes is untreated.
According to the International Diabetes Federation in 2021, there is a 7.5% prevalence of diabetes in adults in the Philippines. Ibig sabihin madami ito at tinatayang umabot sa 4.3 million na tao ang na-diagnose na may diabetes sa populasyon na may higit kumulang 100 million.
It is alarming as the organization expects there will be a steady growth of these cases over the succeeding years. Based on the 10th Edition of the Diabetes Atlas, it projected that in 2030, cases of people with diabetes will grow to 5.46 million. And by 2045, it is estimated to be around 7.50 million.
Ayon naman sa Diabetes Philippines, Inc., Board of Trustee member, Dra. Cynthia Sanchez sa isang forum noong nakaraang taon, 2023, naibahagi niya na diabetes ang ika-apat na leading cause of death dito sa Pilipinas. It is a grim picture to see. The fatality stems from the complications due to untreated or uncontrolled diabetes.
To understand why this is the case, we must get familiar with the different complications of diabetes. Kapag naunawaan na natin ang mga komplikasyon na ito, we can help ourselves and our loved ones avoid these to ensure better health and quality of life. Ika nga sa isang kasabihan, prevention is better than cure.
Diabetes has several complications which can be classified accordingly:
- It may depend on which organ(s)/part(s) of the body has complications due to diabetes; or,
- it can also depend on the manner and timing the complication is diagnosed
Based on the area affected, it can be classified into two:
Macrovascular Complications Due to Diabetes
Ang mga komplikasyon na ito ay may kinalaman sa pagkakaroon ng bara sa kahit anong malaking daluyan ng dugo sa katawan. These are often found in the heart such as the coronary arteries and aorta, or other large blood vessels found in the limbs or even the brain.
Coronary Heart Disease (CHD)
This is the gradual build up of plaque within the walls of the heart and its coronary arteries. This build up is usually gradual, narrowing the passages where blood flows into the heart. Over time, it prevents the patient’s heart muscles from receiving enough oxygen and worse, this causes rupture or formation of blood clots that eventually leads to heart failure. Do note that although diabetes is a risk factor for CHD, there are other risk factors such as family history, high blood pressure, smoking and obesity.
Cardiomyopathy
As defined by the Harvard Medical School, this covers a broad condition where the heart muscle called myocardium is weakened as a result of any heart disease. It can either mean that the heart muscle abnormally thinned or abnormally thickened. This impacts the rhythm of how the heart pumps blood that may cause blood to be stagnant and form clots. When this clot breaks free, it may block an artery that may lead to brain or lung damage, and heart failure.
Arrhythmia
An arrhythmia is a term that describes the abnormal pattern or timing of heartbeats. When your heart skips a beat, it is not always a cause of great concern but experiencing minor symptoms of palpitations, chest pain, shortness of breath, and others should prompt the patient to consult a doctor for proper diagnosis. At the very least it may cause fainting but it can get serious where it may lead to heart failure or even sudden death.
Cerebrovascular Disease
This is related to the brain and the arteries and veins. From these two we can infer that the term cerebrovascular is about the blood flow in the arteries and veins of the brain. And the diseases related to this can mean having a build up in the blood vessels that may lead to blood clot or blockage, and worse, rupture. This can affect a part of the brain temporarily or permanently. These conditions can result to stroke, Transient Ischemic Attack (TIA), Carotid Stenosis, and Cerebral Aneurysms.
Peripheral Artery Disease (PAD)
This is caused by the reduced blood flow in arteries located in the arms, legs and abdomen. It may cause skin discoloration, sores, weakness, or feeling of coldness. This may also cause pain or discomfort while walking. The damage in the skin, tissues and muscles may worsen if the arteries are completely blocked that leads to limb loss.
Microvascular Complications Due to Diabetes
Salungat naman sa nauna, ito ay may kinalaman sa mga sakit na nagsisimula sa maliliit na daluyan ng dugo. These are problems due to stress or damage in the tiny passages of heart, brain or other parts of the body. As such, these can be difficult to diagnose and are often long-term complications.
Diabetic Retinopathy
This condition is related to the loss of vision or blindness due to diabetes. In particular, it occurs due to the impact of diabetes in the blood vessels in the retina. The damage to the retina can be in the form of scarring, fluids leaking causing blurry vision. And when fluids do not drain as it should and cause blockage, it may even lead to glaucoma.
Diabetic Nephropathy
This is when the complication due to diabetes is already affecting the kidneys. As it impairs the kidneys, the overall health of the patient is compromised. This condition results in high blood pressure and progression of kidney failure eventually requiring dialysis or even kidney transplant.
Diabetic Neuropathy
Finally, this occurs in patients with consistent high blood sugar. Over time, it slowly damages the patient’s nerves causing pain and affecting other organs or parts of the body. Depending on which nerves are affected, there are different types of diabetic neuropathy.
| Type of Nerve Damage | Affected Areas |
| Peripheral Nerve Damage | hands (mga kamay), feet (mga paa), legs (mga binti), and arms (mga braso) |
| Autonomic Nerve Damage | heart (puso), bladder (pantog), stomach (tiyan), intestines (bituka), sex organs (ari o mga pribadong parte ng katawan), or eyes (mga mata) |
| Proximal Nerve Damage | thighs (hita) , hips (bewag), buttocks (puwit), or legs (binti) |
| Focal Nerve Damage | hand (kamay), head (ulo), torso (katawan), or leg (binti) |
Based on the manner/timing it affects a patient, it can be classified into two:
Chronic Complications
The symptoms may start unnoticed at first but gradually, over time, the complications may worsen. Maaaring hindi ito namamalayan sa simula at natutukoy na lamang pag malala na. These may result in chronic complications like, but not limited to, kidney disease, heart disease, eye damage, and nerve damage. These conditions only stress how regular checkups and immediate treatment are important. At their early stage, such complications are still treatable.
Acute Complications
These are conditions that may happen anytime. Ibig sabihin kahit anong oras, basta may diabetes, ang mga kondisyong ito ay pwedeng maranasan ng pasyente. Moreover, it can be the reason for the development of other chronic complications mentioned above. Examples of these are hypoglycemia (low blood sugar), and hyperglycemia (high blood sugar).
Conclusion
Diabetes can decrease the quality of a patient’s life significantly when symptoms are ignored and complications are left unmonitored and untreated. In the same manner, it is something that can be managed. These complications resulting from diabetes can be cured when diagnosed early. What is more important is the attention and care for diabetic patients.
There are several medications currently available at MedChoice to treat type 2 Diabetes Mellitus, such as ZELTINE-MR®, GLIPDIN®, SOLADIN®, GLUDIN®, but do consult your doctor first to learn about the right treatment and proper medication.
Tandaan, dito sa MedChoice, kami ay Todo Aruga sa Thyroid at Diabetes.
References:
10th Edition International Diabetes Federation Atlas (2021), Philippines Diabetes Report 2000 – 2045, https://diabetesatlas.org/data/en/country/157/ph.html
Philippine News Agency (July 26, 2023), 1 in 14 adult Filipinos have diabetes , https://www.pna.gov.ph/articles/1206492
American Physical Therapy Association (2008), Diabetes-Related Microvascular and Macrovascular Diseases in the Physical Therapy Setting https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579903/
American Heart Association (January 10, 2024), Coronary Artery Disease – Coronary Heart Disease, https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/coronary-artery-disease
Harvard Health Publishing (Dec 19, 2014), Cardiomyopathy: Symptoms, diagnosis and treatment, https://www.health.harvard.edu/cardiomyopathy-symptoms-diagnosis-and-treatment
John Hopkins Medicine (2024), Arrhythmias, https://www.hopkinsmedicine.org/health/conditions-and-diseases/arrhythmias
American Association of Neurological Surgeons (2024), Cerebrovascular Disease, https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Cerebrovascular-Disease
Penn Medicine (2024), Peripheral Artery Disease (PAD) https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/peripheral-artery-disease-pad
National Eye Institute (February 22, 2024), Diabetic Retinopathy, https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy
John Hopkins Medicine (2024), Diabetic Nephropathy (Kidney Disease), https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/diabetic-nephropathy-kidney-disease
The British Diabetic Association (2024), Complications of Diabetes, https://www.diabetes.org.uk/guide-to-diabetes/complications#acute