This is chapter 9 of my book “DIABETES. A world of possibilities”, which I’m publishing here for free. You can access all the chapters published until now here.
Although I try to keep this book motivating and positive, I think it would be misleading not to warn about the potential consequences of having poorly controlled diabetes. I hope this chapter does not get you down or discourage you. Rather, I hope you take it as the greatest motivation to be as healthy as possible and do everything in your power to control your diabetes and avoid all those health complications that can derive from diabetes.
Because diabetes affects the blood vessels and nerves, it can affect any part of the body. However, certain parts of the body are affected more than others:
Diabetes contributes to high blood pressure and is linked to high cholesterol (the “bad” cholesterol), which is considered to significantly increase the risk of heart attacks, cardiovascular disease, and stroke.
high blood pressure and high blood glucose are contributing factors to the development of diabetic retinopathy, caused by the swelling and bleeding of blood vessels at the back of the eye (retina). This could lead to vision loss or blindness.
poor control of diabetes, high blood pressure, and high cholesterol can cause diabetic nephropathy (kidney disease), which can lead to a need for a kidney transplant or dialysis if left uncontrolled.
The liver plays an important role in the regulation of glucose. Glucose is transported from the intestines to the liver, which stores it as glycogen or uses it as fuel/energy. Insulin receptors of fat, liver, and muscle cells facilitate glucose utilization. Insulin regulates glucose uptake by tissues and promotes the storage of glycogen. Insulin is metabolized in the liver, where it promotes the production of glycogen, proteins, cholesterol, and triglycerides and stimulates the formation of low density lipoprotein, or LDL, to deliver cholesterol to the arteries. In diabetes, the overproduction of glucose by the liver contributes to elevated fasting glucose levels.
The accumulation of fat in the liver may be associated with this glycogen excess.
The liver malfunction can also cause abdominal pain, nausea and vomiting, and rarely, fluid accumulation around the liver.
Liver cells can become inflamed as a result of fat deposition. Untreated, this can lead to scarring of the liver tissue or non-alcoholic cirrhosis. (12)
nerve damage (neuropathy) can be noticed as numbness or tingling in the hands or feet, excessive sweating, or lack of sexual arousal (erectile dysfunction in men).
the nerve damage caused by diabetes can cause nausea, constipation, or diarrhea.
dry skin, slow healing of wounds and burns, fungal and bacterial infections, and diabetic foot (loss of sensation in the foot). In extreme cases, allopathic doctors often recommend amputation of the affected limb.
A condition that is usually considered dangerous is diabetic ketoacidosis (DKA). Unlike other chronic symptoms related to diabetes, ketoacidosis can develop within hours and is considered a medical emergency.
In people with type 1 diabetes who do not produce enough insulin, when glucose is not available to enter the cells and produce energy, the body metabolizes fat instead. As fats break down, they form molecules called ketone bodies or ketones (one of them is acetone) and keto acids, which accumulate in the blood and urine. If high levels are accumulated, these ketones are toxic. The kidneys will attempt to remove these ketone bodies by producing more urine, thus causing further dehydration.
Symptoms of ketoacidosis are the same as uncontrolled diabetes mellitus, i.e. much urine, very hungry and very thirsty, and adding to that, weakness and headache. If dehydration and hydroelectrolyte disorder continue to rise, nausea, vomiting, abdominal pain, and disorientation can appear. (13)
In most cases of ketoacidosis, blood glucose is over 250 mg/dL and may even reach 400 or 800 mg/dL. When it is present, you often have a fruity breath odor. The most severe cases can lead to coma or even death.
Conventional treatment is usually done as an emergency and consists of hydrating with a hypotonic solution and lowering the blood glucose in 6 hours, usually with insulin.
To prevent ketoacidosis, you should maintain controlled glucose levels and drink plenty of fluids.
If you’ve read about diets very low in carbohydrates, such as the paleolithic diet (ancestral or paleo diet), you will know that such diets are usually called ketogenic diets, because the body produces ketone bodies to burn fat for energy instead of glucose.
Many authors and experts recommend a diet low in carbohydrates. How is it possible if we have just seen that ketoacidosis is dangerous? The difference is in the numbers.
What is the difference between ketoacidosis and ketosis?
Both are situations with ketone bodies in the blood, but one is very dangerous and the other one is not.
Ketosis is the body’s normal response to starvation (fasting) or restriction of carbohydrates in the diet. Ketoacidosis, as seen above, is a disproportionate increase in ketone bodies due to lack of insulin, lack of fluid, and elevated levels of blood glucose. (14)
A normal person who decides to follow a low-carb diet or fast for a long enough period of time begins to produce ketone bodies, but at normal levels. Since his body produces insulin, which is an important regulator of the production of ketone bodies, the body maintains its normal activity without ending up with ketoacidosis.
But in a person who does not produce insulin, or with poorly controlled type 1 diabetes, ketosis can turn into ketoacidosis if he continues with such a diet AND does not control blood glucose levels. In order to follow these kinds of diets that are high in protein, it is also important that the kidneys are not damaged.
Ketone bodies are often called “the food of our ancestors,” because they were usual in the past, when it was normal to have nothing to eat for some time.
Therefore, when you read or hear talk about ketosis or ketoacidosis, remember the difference.
Erectile sexual dysfunction
Another important aspect associated with poorly controlled diabetes is the problem of diabetes and sexuality.
The main sexual problem associated with diabetes is erectile sexual dysfunction (ESD), better known as impotence. In fact, one of the leading causes of erectile dysfunction is diabetes mellitus, with a prevalence of between 38 to 59 per cent, depending on age. (15)
Men with diabetes tend to develop impotence ten to fifteen years earlier than men without diabetes. As for women, a third of those who suffer from diabetes experience some form of sexual function decline.
It is considered that the cause of this dysfunction may be due primarily to neuropathy and/or vascular disease that can develop after years with poor sugar control.
There are also some types of drugs and substances associated with the development of erectile dysfunction, such as: abuse of alcohol, tobacco, drug abuse, antihypertensives, antidepressants, H2 antagonists, hormones, non-steroidal anti-inflammatory agents, and tranquilizers.
Proponents of the theory of alkalinity/acidity of the body say that sexual function and desire are products of the autonomic nervous system, which can be paralyzed when blood is too acid.
The official treatment of erectile dysfunction in diabetes mellitus (DMI) is aimed at obtaining an optimized metabolic control (blood glucose well controlled) and the elimination of modifiable risk factors. Up to this point, everything is all right. What I do not think is so right is the amount of drugs used to treat this symptom, ranging from yohimbine with just partial results, to trazadone (tricyclic antidepressant with limited cholinergic effects), or nitroglycerin patches with questionable results. Sildenafil citrate appears to improve erectile function in 57 per cent of diabetic patients with ESD, but with some side effects.
In more severe cases, it can be treated by applying a device that has a cylinder with a manual pump that creates a vacuum to help achieve an erection in men, or with surgical procedures.
At least, I do not think they are appropriate, without having first tried to keep blood glucose levels controlled with diet, exercise, natural hypoglycemics, and, if necessary, insulin (although someone commented to me that he noticed lack of sexual arousal after some time using insulin).
If you want to try more natural means before having to use those more invasive ones, or even to avoid them, I recommend you learn about some of the medicinal plants known to help in cases of impotence—such as ginseng (especially red Korean Ginseng), gingko biloba, resveratrol, maca, Seanol (seaweed extract that has shown to be as effective as Viagra)—a diet low in simple carbohydrates, and exercising regularly.
As I mentioned before, this is my personal way of facing different symptoms (thank God I do not have this problem). First, I try all options that are more natural and less intrusive/invasive with possible side effects and, if nothing works, then I try one of those synthetic methods. That does not mean it’s right, but it’s my way of doing it, and everyone has to decide how to treat his/her own symptoms.
If reading all of these potential symptoms and diseases derived from diabetes does not motivate you to be as healthy as possible, I don’t know what will. Well, surely the love for a child and wanting to be healthy to see her grow up can be even more motivating.
So, cheer up! Do not let diabetes take over your health. Tell your body: I’m in charge here! I’m the boss!
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This post Chapter 9 – Risks and consequences of poorly controlled diabetes was first published at www.healing-diabetes.com