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What's the worst case scenario?

N

ne0h

Well-Known Member
So suppose someone who has type 2 does not control their diet or take their medication and blood sugar continues to be high, what is the worst that can happen? And does it take years and years before complications can develop or can serious complications come about quickly like in a few months?
 
The worst case is death Im afraid . It can happen quite quickly depending on the level.
 
This is not going to be an easy read, but I will list some of the complications that arise from poor diabetes management (for both type 1 and type 2s). These are often from years of neglect, but there is no 'set' time for these to kick in. This is by no means an exhaustive list, but these are what keeps me on the straight and narrow.

Neuropathy. This usually affects the legs and most notably the feet, but it can affect other areas too (e.g. The arms). Nerves in the feet and legs are damaged by high blood sugars. This can cause anything from tingling, right up to severe pain and amputation. Some people have referred to their neuropathy as the salami effect, as over time they have to have more and more of their legs amputated.

Retinopathy. High blood sugars cause damage to the small blood vessels in the area of the eyes known as the retinas. Over time they burst and leak. The body tries to heal, making new blood vessels. However, it makes them in areas of the eye where they should not be. This will eventually lead to blindness. However, large numbers of diabetics can have their vision saved with laser eye surgery, especially if it is caught early.

Erectile dysfunction. Obviously not a problem for women, but I believe poor blood sugar control can cause loss of libido in women.

Kidney damage. The kidneys can be damaged by high blood sugars, which in severe cases causes kidney failure.

Gastroparesis. This is also known as delayed stomach emptying. The nerves in the stomach are damaged, so the body cannot properly control digestion. This can create problems with digestion. Symptoms can vary widely, but it can make it much more difficult to control blood sugars, as it's unclear when food will be processed by the stomach.

Ketoacidosis. This can be an immediately life threatening condition. High levels of ketones build up in the body, which become toxic. This is temporary so long as blood sugars are lowered to safe levels, but requires urgent medical attention.
 
Thank you for taking the time to reply Charles. You know since I have been diagnosed I have not taken it seriously enough. I'm constantly on and off my medication and I don't control my diet. Obviously, I'm worried that these complications might set in on me at any minute.
 
Another thing to consider, is how long were you diabetic before they diagnosed you? That would certainly add to the time. The best thing you can do is to take it seriously.

I work on the National Diabetes Audit, where we produce a report on mortality amongst diabetics. it's very uncomfortable reading, but the "highlights" (well, more like "lowlights") are:
  • 1 in 10 diabetics have had a cardio vascular adverse event (e.g heart attack) within the past 2 years. This is the highest risk factor.
  • The next highest risk factors are kidney disease and limb amputation
  • The risk of mortality (i.e. the risk of death of a diabetic compared to a non-diabetic in a given year) is 35%.

The good news is that you can avoid this if you take it seriously. It's very easy to lose control, we've all had times when we've let our control slip. If you don't control it, unfortunately, you will, in all likeliness, experience complications.
 
Diabetes can be terrifying when you focus on the worst case scenario. The problem is that food has become such a big part of coping with reality. You feel down, you grab a slice of cake to ease the pain. This compounds the problem in the case of diabetes.
So, we have gone over the negatives. Now, let's start breaking the cycle by looking at the positives. It is never too late to start making changes. Complications do usually take a long time to really take hold. In the majority of cases good control can stop them in their tracks. Managing diabetes takes effort and willpower to begin with, but it gets easier and easier the longer you travel on the success path.
The obvious question is 'How do I change my ways, especially when I am feeling so down?' The first thing to do is to educate yourself. The more you know about something, the better able you will be to deal with it. There are some amazing books out there which can set you on the right track. A lot of people here swear by the book 'Think like a pancreas.' My own personal saviour was Dr Richard Bernstein's 'Complete Diabetes Solution.' Dr Bernstein has been diabetic since childhood, and is now a healthy man in his 80s, so he knows his stuff, and practices what he preaches. It is by no means an easy read, but in my opinion it is so worth it. The book advocates cutting out almost all carbohydrates, focusing instead on a diet based on protein. This means eating eggs, cheese, meat, and nuts in reasonable quantities. I decided to try it, firmly believing I was saying goodbye to any enjoyment of food. I was wrong. I enjoy food so much more now, because I don't constantly crave it. My meals satisfy me, and I just don't need to snack any more in between meals which are always at least 4 hours apart, often more like 5 or 6.
Whatever way of eating you decide to follow, the best thing you can do is get yourself a blood testing meter if you haven't already. I know this can be difficult for type 2s, and your healthcare team may even tell you it's unnecessary. They are wrong. Plain and simple. How can you be expected to stick to a healthy regime if you can't see evidence it is working? I would advise you become the squeaky wheel for as long as it takes to get a meter and regular prescriptions of test strips. If they won't budge, it is well worth financing a meter yourself if you can afford to.
It's also best to make lots of notes to monitor your progress. Look at food labels and note down carb and protein amounts, what your blood sugars are when you eat, and a couple of hours afterwards. As you start to see success, you can get a real snowball effect with the benefits. After a couple of months, it can seem like second nature.

Best of luck, and keep posting.
 

Well, I obviously don't like it, but............... you know.

That 1:10 is quite a shocker. Are there any age related stats for that? Or indeed, assuming those numbers are lifted from an audit report, is it on public record anywhere I could read?

Many thanks.
 
I think the best advice is to invest in a good book. I have added Dr Bernstein's book to my wish list and will get it asap.
 
Peripheral neuropathy is bad enough, but don't forget autonomic neuropathy too. You may be less aware of it. Some of those 1 in 10 having cardio-vascular events may not even have felt the warning signs. The really dangerous thing about diabetes is that it does some of the worst work silently, and you may not know how badly your health has been compromised already, even if hands and feet feel fine. The only safe thing to do is to tightly control BG numbers -- it's the only rational response.
 
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