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Acute complications are complications that develop rapidly and can be exemplified as diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), lactic acidosis (LA), and hypoglycemia. [1] Chronic complications develop over time and are generally classified in two categories: microvascular and macrovascular.
Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to type 1 diabetes and gestational diabetes. [1] In type 1 diabetes, there is a lower total level of insulin to control blood glucose, due to an autoimmune-induced loss of insulin-producing beta cells in the pancreas.
Type 1 presents abruptly following a pre-clinical phase, while type 2 has a more insidious onset; patients may remain asymptomatic for many years. [24] Diabetic ketoacidosis is a medical emergency that occurs most commonly in type 1, but may also occur in type 2 if it has been longstanding or if the individual has significant β-cell ...
Among these complications, sensorineural hearing loss is significant, with its severity correlating with T2DM progression. Hearing loss impacts quality of life, causing economic and emotional strain. It is an independent risk factor for dementia , cognitive decline , social withdrawal , anxiety , depression , and physical decline, especially in ...
DKA often has serum glucose level greater than 300 mg/dL (HHS is >600 mg/dL). [6] DKA usually occurs in type 1 diabetics whereas HHS is more common in type 2 diabetics. [6] DKA is characterized by a rapid onset, and HHS occurs gradually over a few days. [6] DKA also is characterized by ketosis due to the breakdown of fat for energy. [6]
People with type 1 diabetes mellitus who must take insulin in full replacement doses are most vulnerable to episodes of hypoglycemia (low blood glucose levels). This can occur if a person takes too much insulin or diabetic medication, does strenuous exercise without eating additional food, misses meals, consumes too much alcohol, or consumes alcohol without food. [5]
Dosage changes can help address that, at the risk of side effects and complications. [108] Women with type 1 diabetes show a higher than normal rate of polycystic ovarian syndrome (PCOS). [110] The reason may be that the ovaries are exposed to high insulin concentrations since women with type 1 diabetes can have frequent hyperglycemia. [111]
During this asymptomatic period, an abnormality in carbohydrate metabolism can occur, which can be tested by measuring plasma glucose. [16] Chronic hyperglycemia at above normal levels can produce a very wide variety of serious complications over a period of years, including kidney damage, neurological damage, cardiovascular damage, damage to ...