3-10. OTHER HEALTH COMPLICATIONS FOR THE PATIENT
Diabetes mellitus is a complex metabolic disorder that can affect many parts of
the body. Disturbances in other body parts may occur even before the usual symptoms
of excessive thirst, too frequent urination, etc., appear.
a. Vascular Disturbances. There may be disturbances in the vessels of any
part of the body. Most likely are problems in the nerves (diabetic neuropathy), the retina
of the eye (diabetic retinopathy), kidneys, and the legs. The diabetic patient has a
decreased blood supply to the tissues of the lower extremities (legs and feet) which
increases the risk of problems in those areas. Any infection in the legs and feet must be
attended to promptly; otherwise, ulcers may form and even gangrene leading to
b. Visual Problems. The retinal capillaries in diabetic patients have a tendency
to develop multiple tiny bulges with small points of hemorrhage and exudates. The
result is that scarring occurs in these capillaries from repeated hemorrhages. Presently
treatment involves controlling the level of sugar in the blood and managing hypertension
associated with the blood sugar level. The effect of laser therapy is being evaluated
and researched also.
c. Neuropathy. Damage to nerve tissue is possible for the diabetic patient.
The patient may experience facial paralysis or loss of muscle tone in the urinary system
may result in diarrhea or constipation. A more common condition is problems in the
legs. The patient may feel itching, numbness, tingling, and/or pain in the legs, a
condition which is worse at night. There may also be a loss of sensation in the legs with
the result that since the patient does not feel intense heat, for example, he can be
burned without realizing it.
d. Infection. Infections heal slowly in diabetic patients. While the infection
persists, diabetes becomes more severe. Skin lesions such as carbuncles and
furuncles occur and are very slow to heal. If a diabetic patient has any skin eruption, he
should contact his physician immediately.
Since the brain is so dependent on sugar, the patient with low blood sugar is in a
life-threatening situation. Look for the signs and symptoms which spell impending doom
and manage the situation early. Making a diagnosis is not critical, but appropriate
interpretations of the patient's signs and symptoms are.