Diabetes mellitus is the scientific name for diabetes. It is a chronic, or long-lasting, disease in which blood glucose (BG), or blood sugar, levels are elevated in a person’s blood. This happens because BG is unable to enter the cells that make up the muscles, nerves, heart, lungs, kidneys, and other organs in our body. When our cells can’t get glucose, they don’t function well, and this can lead to cell and tissue damage, or even, eventually, death.
[note for media] It would be helpful to our audience to have a simple illustration here in the visual language that Paige has developed that depicts the difference between a healthy muscle or organ cell into which BG can easily gain entry, and an UNhealthy muscle or organ cell into which BG CANNOT easily gain entry. (I can’t remember whether Paige had begun work on an illustration like this or not…)
People living with type 2 diabetes may develop the same acute or chronic complications that may occur in those who have type 1 diabetes. However, the risk of acute complications, such as hypoglycemia or having a low BG level is lower in patients with type 2 diabetes, except in:
- Elderly or frail individuals
- People with chronic kidney disease
- People with severe liver disease
- People who drink excessive amount of alcohol
- People who are taking drugs to treat type 2 diabetes, such as sulfonylureas (e.g. glyburide or glimepiride), or who are taking insulin
- People who skip meals or eat at unusual times (people who have diabetes usually need to eat meals at regular times, such as “breakfast, lunch, and dinner”)
- People who are very physically active
In general, the chronic (or long-term) complications of diabetes occur because of the damaging effects that high BG has on the blood vessels that supply nourishment to various organs in our body. This damage reduces blood flow to these organs and may reduce their functions. These complications can be divided into two groups:
- Microvascular complications occur when the damaged blood vessels are relatively small, such as those that nourish eyes (retinopathy), nerves (neuropathy) and kidneys (nephropathy). Unlike people living with type 1 diabetes, many more people living with type 2 diabetes are unaware that they have it, and often live for many years before they are diagnosed. As a result, many of them have already developed some of the complications described in the table below by the time they find out they have diabetes.
The table that appears below—and ALL of the tables that will be used in ALL of the articles across EndoD—will need to be embedded/incorporated into the body copy of each article so that the typographic style of the table itself looks as if it “belongs” to the typographic style of the articles. This means that the typeface family of each table needs to be Fira, and the type size of all of the type that constitutes each table needs to be large enough to ensure readability on both the web version/laptop version of this AND on the smartphone version of this. We also need to design a color scheme for these tables that visually unifies their look-and-feel across the entire system of articles. These should also NOT be treated as images, but rather as part of the content of each article into which they are embedded.
TABLE 1: A description of common microvascular complications of diabetes mellitus
| Complications | Symptoms (If and when they occur) | How to Prevent… | How to Treat… |
| Retinopathy (Damage to the retina) | · Blurred vision · Eye floaters · Black spots in vision · Loss of central vision · Blindness | · Control BG & BP (blood pressure) · Annual detailed eye exam · Report any new change in vision to your MD · Avoid smoking. | · Control BP & BG · Laser treatment · Vitrectomy |
| Nephropathy (Damage to the kidneys) | · Worsening BP control · Protein in urine · Swelling · Frequent urination · Shortness of breath · Mental fog or confusion | · Control BG and BP · Get urine microalbumin at least annually · Monitor blood creatinine · Avoid a high protein diet · Treat w. ACEI or ARB | · Control BG and BP · Treat w. ACEI or ARB · Low salt diet · Avoid medicines that can damage your kidneys (e.g., NSAIDs.) |
| Neuronopathy (Damage to the nerves) | · Numbness of the feet · Tingling · Foot pain · Foot ulcers | · Control BG and BP · Annual foot exam · Avoid walking barefoot. · Inspect feet daily. · Avoid tight shoes. | · Control BG and BP · Treat calluses · Treat any foot ulcer (by HCP) · Diabetic shoes. · Gabapentin/Pregabalin for pain |
2. Macrovascular complications occur when the damage from having diabetes affects larger blood vessels, such as the coronary arteries (heart), cerebral arteries (brain) and the arteries that supply blood to the limbs. This damage can lead to angina, heart attack, strokes, foot ulcers and gangrene. People with type 2 diabetes tend to have several other risk factors that could directly or indirectly cause these complications. Unfortunately, they are at a much higher risk of being negatively affected by these complications.
The table that appears below—and ALL of the tables that will be used in ALL of the articles across EndoD—will need to be embedded/incorporated into the body copy of each article so that the typographic style of the table itself looks as if it “belongs” to the typographic style of the articles. This means that the typeface family of each table needs to be Fira, and the type size of all of the type that constitutes each table needs to be large enough to ensure readability on both the web version/laptop version of this AND on the smartphone version of this. We also need to design a color scheme for these tables that visually unifies their look-and-feel across the entire system of articles. These should also NOT be treated as images, but rather as part of the content of each article into which they are embedded.
TABLE 2: A description of common macrovascular complications of diabetes mellitus
| Complications | Symptoms (If and when they occur) | How to Prevent… | How to Treat… |
| Heart (cardiac) | · Chest pain · Shortness of breath · Silent heart attack (MI) | · Control BG, BP, and lipids · Take statins as prescribed by your doctor · Receive SGLT-2 & GLP-1 treatment · Quit smoking. · Take a stress test and alter lifestyle decisions and/or medications based on the results | Medications to treat cardiac symptoms Angioplasty/Stent placement Heart bypass surgery Controlling BP & lipids Receive SGLT-2 & GLP-1 treatment |
Brain (cerebral) | · Dizziness · Slurred speech · Paralysis · Sudden vision loss | · Control BG, BP, and lipids · Take statins as prescribed by your doctor · Quit smoking | Aspirin Plavix (Clopidogrel) Carotid endarterectomy (surgery) Controlling BP & lipids |
| Limbs (Peripheral Arteries) | · Leg pain when walking · Foot pain · Foot & leg ulcers that won’t heal | · Control BG, BP, and lipids. · Take statins as prescribed by your doctor · Quit smoking | Aspirin Angioplasty Surgery Controlling lipids and BP. |
Controlling BG, BP, and cholesterol can prevent these complications. For these high-risk patients, the target BP should be less than 130/85, and the target LDL-Cholesterol level should be less than 70 mg/dL. Some of the diabetic medications available to people in Texas provide additional protection to the cardiovascular system, and they could also provide benefits to people who do not have diabetes but who are at increased cardiovascular risk. Two classes of such medications include:
- SGLT-2 inhibitors (such as Jardiance®, Farxiga® etc.)
- GLP-1 agonists (such as Ozempic®, Trulicity® etc.)
- GLP-1/GIP agonists (such as Mounjero®)
To learn more about these medications, please read the articles we’ve written about them that you’ll find here.
Some Important Things to Remember about Type 2 Diabetes Complications
Poorly controlled type 2 diabetes may cause damage to various blood vessels, which can affect different parts of the body in different, undesirable ways, and may lead to severe symptoms, disability, and an increased risk of dying. The good news is that these complications can be prevented if they are diagnosed early, and if diabetes and related conditions are treated aggressively.
We’ve just provided you with an overview of how living with type 2 diabetes can potentially cause various physical complications. To learn more about these, please refer to other articles you’ll find across this website that describe individual complications, such as neuropathy, nephropathy, retinopathy, and cardiovascular disease. Poorly controlled type 2 diabetes may increase your risk of damage to various parts of the body which can lead to severe symptoms, serious disabilities, and which can increase the risk of death.
This information has been created to help our readers construct general knowledge about diabetes. Reading the contents of this article is not a substitute for the kind of medical advice you can get from your doctor or other healthcare providers that are licensed to practice by the State of Texas.
- Hypoglycemia (low BG, or low blood sugar) means that a person’s blood sugar level is less than 70 mg/dL. Your BG may drop if you:
· Have not eaten enough carbs in the past four to eight hours.
· Have skipped or delayed meals
· Have increased your activity
· Have recently consumed alcohol
· Have recently taken too much diabetes medication or insulin.- When your BG (blood sugar) is low, you may feel anxious, or become sweaty and shaky, or feel hungry, or feel weak, confused, or drowsy. Untreated hypoglycemia can be fatal.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that can relieve pain, reduce inflammation, and treat fever.
- Lipids are fatty compounds that perform a variety of functions in your body. They’re part of your cell membranes, and they help control what goes in and out of your cells. They help with moving and storing energy, absorbing vitamins, and making hormones. Having too much of some lipids is harmful.
