In diabetes, elevated blood sugar levels and the loss of sensitivity to insulin make it difficult or nearly impossible for cells to maintain homeostasis. The complications of diabetes are divided into two major categories; acute and chronic. Acute complications consist of:
- Diabetic Ketoacidosis
- Nonketotic hyperosmolar hyperglycemia
Hypoglycemia, usually seen in type 1 diabetes, results from taking too much insulin, missing a meal, or over-exercising. Diabetic ketoacidosis is also more likely to occur in poorly controlled or untreated type 1 diabetes. Nonketotic hyperosmolar hyperglycemia is a very serious condition that occurs when blood sugar rises to extreme levels, usually in type 2 diabetics with some insulin production or type 1 diabetics who are receiving inadequate levels of insulin for their acute situation.
Glycosylation refers to the binding of glucose to proteins. The poorer the glucose control, the greater the binding, which leads to changes in the structure and function of the protein.
Sorbitol is a sugar molecule that is formed from the glucose within cells. Increased sorbitol levels within cells create an osmotic effect. Osmosis refers to the movement of water molecules from an area of high concentration to an area of low concentration. Increased oxidative stress is a major factor in the risk of the chronic complications of diabetes.
One of the critical goals in diabetes prevention and treatment is to flood the body with high level of antioxidant compounds to counteract the negative effects of free radicals and pro-oxidants.
Homocysteine is a potentially harmful compound formed in the conversion of the amino acid methionine to cysteine. Homocysteine is thought to promote atherosclerosis by directly damaging the artery and by reducing the integrity of the vessel wall, as well as by interfering with the formation of collagen.
Blood pressure control is essential in preventing the complications of diabetes, especially kidney disease, retinopathy, and stroke. The health of the artery is critical to maintaining normal blood pressure. Endothelial cell dysfunction can lead to stiffening of arteries because normally endothelial cells produce nitric oxide, which relaxes the blood vessel wall. Some important lifestyle factors that may cause high blood pressure include:
- Lack of exercise
The dietary factors include:
- High sodium-to-potassium ratio
- Low fiber
- High sugar diet
- High saturated fat and low omega-3 fatty acid intake
- Diet low in calcium, magnesium, and vitamin C
Special foods for those with high blood pressure may consist of the following:
- Celery is a particularly interesting recommendation for high blood pressure because of the noted compound 3-n-butylphthalide (3nB).
- Garlic and onions are also important foods for lowering blood pressure.
Some of the long-term (chronic) complications consists of:
- Atherosclerosis and other vascular lesions are the underlying factors in the development of many of the chronic complications of diabetes.
- Retinopathy and cataracts of diabetes is a serious eye disease involving the retina.
- Neuropathy usually refers to the loss of peripheral nerve function and is characterized by tingling sensations, numbness, loss of function, and a characteristic burning pain known as neuropathic pain.
- Poor wound healing is common in diabetes such as microvascular changes leading to poor circulation and functional deficiency of vitamin C.
- Foot ulcers are common in individuals with diabetes due to the microvascular changes leading to a lack of blood supply, peripheral neuropathy, poor wound healing, and immune system dysfunction leading to chronic infections in the feet.
- Immune system dysfunction often begins to occur long before a diagnosis of diabetes is made. A recurrent vaginal or skin yeast infection is the clue that leads to the detection of diabetes in many cases.
- Depression and cognitive difficulties are very common in diabetics. Depression may begin to occur decades before the onset of type 2 diabetes when the individual first develops insulin resistance.
Part 12: Recommendations for Specific Chronic Complications
Recommended reading: How to Prevent and Treat Diabetes with Natural Medicine (Michael Murray, N.D., Michael Lyon, M.D.)