b'Chapter hapterComplications of DiabetesDiabetes is associated with complications that can occur after diabetes develops. These complications develop as a result of prolonged high blood glucose levels and changes to the small blood vessels in the body.The complications of diabetes are:Damage to the eyes (retinopathy), nerves (neuropathy)and kidneys (nephropathy).Heart attack and stroke (cardiovascular disease).Impotence (sexual difficulties)Foot ulcers or amputations (circulation and nerve damage).Studies have shown that if blood glucose and cholesterol levels and blood pressure are kept within normal limits, the risk of damage to the body is reduced.There are two types of Diabetic EmergencyIf a diabetic does not control these factors, either of two problems can occur:Hypoglycaemia (hypo) : too little sugar in the blood. Hyperglycaemia (hyper): too much sugar in the blood.This imbalance leads to illness.HypoglycaemiaWhen the insulin level in the body is too high, the sugar level in the blood is low. The sugar level can become too low if the diabetic injects too much insulin, doesnt eat properly, excessive alcohol intake, over exercises and burns off sugar faster than normal or becomes ill, particularly with diarrhoea or vomiting. In this situation the small amount of sugar is quickly used up and within minutes, the brain will not function properly. This condition will rapidly lead to unconsciousness.The patient requires treatment with an intake of sugar.HyperglycaemiaWhen the insulin level in the body is too low, the sugar level in the blood is high. Sugar is present in the blood but cannot transfer into the body cells because there is little or no insulin. Cells become starved of sugar and the body breaks down other stored food and energy sources such as fats. Common causes include, incorrect doses of medication, excess carbohydrate intake or stressful situations. If this continues, the hyperglycaemic condition will gradually deteriorate and may lead to unconsciousness(diabetic coma).The patient requires treatment with an intake of insulin.Medical Emergencies 199'