(1) Acute complications
① Diabetic ketoacidosis and hyperosmotic non-ketotic diabetic coma: referred to as hyperosmotic coma, it is an acute complication of diabetes, and some patients can take it as the first symptom.
② Infection: Diabetic patients often have skin purulent infections such as furuncle and carbuncle, which can occur repeatedly and sometimes cause septicemia and sepsis. Fungal infections of the skin, such as tinea pedis, are also common. Fungal vaginitis and Pasteurella are common complications of female diabetes. In addition, tuberculosis and urinary tract infection are also common in diabetic patients.
(2) Chronic complications
① Macroangiopathy: Compared with non-diabetic people, the prevalence of atherosclerosis in diabetic people is higher, the onset age is younger and the disease progresses faster. Atherosclerosis of large and middle arteries mainly invades aorta, coronary artery, cerebral artery, renal artery and peripheral artery of limbs, causing coronary heart disease, ischemic or hemorrhagic cerebrovascular disease, renal arteriosclerosis and arteriosclerosis of limbs. Atherosclerosis of peripheral arteries of limbs is often mainly caused by arterial disease of lower limbs, which is characterized by pain, abnormal sensation and intermittent claudication of lower limbs. Severe blood supply deficiency can lead to gangrene of limbs.
② Microangiopathy: Microvessels refer to capillaries and microvascular networks. Microangiopathy is mainly manifested in retina, kidney, nerve and myocardial tissues, especially diabetic nephropathy and retinopathy.
Diabetic nephropathy is common in patients with a medical history of more than 10 years, and it is the main cause of death in patients with 1 type diabetes. In type 2 diabetes, its severity is second only to coronary artery and cerebrovascular atherosclerosis. Diabetic retinopathy is common in the course of diabetes for more than 10 years, and most patients are complicated with retinopathy of varying degrees, which is an important manifestation of diabetic microangiopathy and one of the main causes of blindness. In addition, cardiac microangiopathy and myocardial metabolic disorder can cause extensive focal necrosis of myocardium, which is called diabetic cardiomyopathy and can induce heart failure, arrhythmia, cardiogenic shock and sudden death.
③ Neuropathy: Clinically, paresthesia at the extremities occurs first, which is like socks or gloves, accompanied by numbness, acupuncture, burning or feeling like stepping on a cotton pad. Sometimes accompanied by hyperalgesia. Then there is limb pain, which is dull, stinging or burning, and it is aggravated at night and in cold season. In the later stage, there may be motor nerve involvement, muscle tone weakening, muscle strength weakening and even muscular atrophy and paralysis. Diabetic autonomic neuropathy is also common, manifested as pupil changes, abnormal perspiration, delayed gastric emptying, diarrhea (after meals or midnight), constipation and other gastrointestinal dysfunction. Postural hypotension, persistent tachycardia, prolonged heart beat interval and other cardiovascular autonomic nervous dysfunction, as well as increased residual urine, urinary incontinence, urinary retention, reverse ejaculation, impotence and so on.
④ Other eye changes: In addition to retinopathy, diabetes can also cause macular disease, cataract, glaucoma, refractive changes, iris and ciliary body diseases, etc.
⑤ Diabetic foot: Diabetic foot is commonly referred to as diabetic foot, which is caused by nerve endings, insufficient arterial blood supply of lower limbs and bacterial infection.