Common Questions about Diabetes Mellitus

1. Can diabetes cause sudden death?

Diabetes mellitus, not to be confused with Diabetes insipidus, is more of an insidious disease affecting multiple body systems. If DM is not well controlled and the patient is not getting the routine screening with their physicians, the health conditions that will develop in the future can end up becoming fatal. There are though two acute conditions that can be serious if not intervened on and they are called Diabetic ketoacidosis and hyperosmolar hyperglycemic state.

2. How does diabetes kill someone (what is the actual cause of

death)?

As mentioned about, most deaths from DM are from secondary complications of poorly controlled DM. If you’re referring to DKA or HHS, the condition usually causes severe dehydration, metabolic acidosis, electrolyte abnormalities, etc and if left untreated will result in hemodynamic instability and in the most extreme and severe case can lead to death. Though most of the patients treated in the hospital recover with proper treatment.

3. What are the important warning signs that diabetes is causing

serious health problems?

As above, DM is a very insidious disease and can sneak up on you. If an individual has DM, then he or she needs to follow with the doctor closely to monitor for any signs of organ dysfunction from their DM. For example, a routine exam for patient with diabetes would require urine check for protein to make sure their kidneys are not being affected.

4. What parts of the body are most affected by diabetes?

Generally, all parts of the body are affected. If it had to be in the order of the importance of the organ in question, it may be the cardiovascular system.

5. What is ketoacidosis, and how can it be harmful?

The pathophysiology is complicated but, in a nutshell, it is an acute condition seen in people with DKA where the absence or resistance of a hormone called insulin results in limited uptake of sugar from the blood. The sugar builds up in the blood however due to the body not being able to utilize the sugar, it turns to another source of energy that starts burning fat. This source of energy is less efficient and produces a byproduct, ketones. The buildup of ketones causes the blood to become acidic, leading to multiple metabolic abnormalities affecting multiple organ systems.

6. How and why does blood vessel damage occur in people with

diabetes?

Pathophysiology is complicated. But generally due to increased rate of nonenzymatic glycosylation, increased diacylglycerol and beta 2 protein kinase activity, and increased aldose reductase activity. This may lead to permeability issues, occlusions that lead to ischemia, and neovascularizations.

7. What are the consequences of low blood sugar?

If you are talking about low blood sugar (hypoglycemia) in strictly diabetics, then the consequences depend on the age range.

In older adults there are some associations with increased dementia. From an acute standpoint, it puts them at risk for episodes of weakness and dizziness which causes them to fall and sustain fractures. For younger adults there is some association with cardiovascular disease. Can also lead to difficulty in controlling sugars due to being afraid of getting hypoglycemic again.

8. What happens if diabetes goes untreated, and how long can

someone live with untreated diabetes?

It depends on how severe their diabetes is and also what type of diabetes they have, type 1 or type 2. For example a person with type 2 DM with A1c of 7 can live a normal life without treatment as long as they can keep that level of control with diet and exercise. On the other hand a type 1 DM person who has very severe DM, is at risk of getting into DKA state and severe illness if not treated.