June 10, 2008

ambulance-emergencyRapid treatment is crucial if you're experiencing stroke symptoms.(ISTOCK)Type 2 diabetes can damage blood vessels and nerves, so just about every part of your body can be affected by the disease.

Diabetes care generally focuses on day-to-day living to prevent complications, such as eating right and exercising, but it's also important for you to know how to get help if you have one of these medical emergencies. Controlling your blood sugar can lower the chances of all of the following emergencies (with the exception of hypoglycemia). You should also keep an eye on your cholesterol and blood pressure to reduce the risk of heart attack and stroke.

Tell your doctor right away if you notice any foot injuries, no matter how small, because they can rapidly lead to amputation. You may be referred to a hospital if your condition is serious. Some hospitals and centers now have "limb salvage" programs to help you keep your feet, such as New York University Medical Center; the Wisconsin Heart Hospital outside of Milwaukee; Riverside Methodist Hospital in Columbus, Ohio; and University Foot & Ankle Institute at various locations in California. Ask your doctor where you can find the best foot-saving expertise in your area.

Heart attack
The death rate from heart disease is two to four times higher in adults who have diabetes than those without it. You should be aware of heart attack symptoms, such as chest pain, shortness of breath, and nausea; call 911 immediately if you experience them.

Next Page: Hyperglycemia [ pagebreak ]Diabetes ComaDiabetes Coma Doctor-Patient VideoIgnoring diabetes symptoms is risky  Watch videoMore about diabetes complications

High blood sugar can result from not taking enough insulin, eating too much, or being sick or stressed. Symptoms include excessive thirst, excessive urination, and blurry vision. Hyperglycemia can lead to an emergency condition called diabetic ketoacidosis, usually in people with type 1 diabetes. It can also cause a condition called nonketotic hyperosmolar syndrome in people with type 2 diabetes.

You can often treat hyperglycemia by exercising, according to the American Diabetes Association. If your blood sugar is over 240 mg/dL, you should check your urine for ketones, a potentially harmful substance created when the body burns stored fat for energy. If your blood sugar is above 240 mg/dL and you test positive for ketones, exercise can make your blood sugar go even higher. Speak with your doctor to create a plan to lower your blood glucose level.

This problem develops when your blood sugar drops below 70. It can be due to taking too much insulin, taking certain oral medications (such as sulfonylureas or meglitinides), not eating enough food to match medication, exercising vigorously, or drinking alcohol excessively. Symptoms may include hunger, shakiness, dizziness, confusion, and sweating. The most common treatment is to check your blood sugar (just to make sure it's too low, not too high—it can be hard to tell), then consume something sugary. The American Diabetes Association recommends consuming three glucose tablets, five or six pieces of hard candy, or a half cup of juice. Wait 15 to 20 minutes and then check your blood sugar again. If your blood sugar is still low and you are still experiencing symptoms, then repeat the treatment. It's important to keep one of these items available at all times.

If untreated, hypoglycemia can cause you to lose consciousness. If you pass out from hypoglycemia, you will need immediate attention with an injection of glucagon or—if glucagon is not available—emergency hospital treatment.

Next Page: Kidney failure [ pagebreak ]Kidney failure
Diabetes is the top cause of kidney failure in the United States, accounting for 44% of new cases in 2002, according to the National Institutes of Health. About 10% to 40% of people with type 2 diabetes develop kidney failure. To prevent kidney problems, you should have routine tests for protein in the urine, which is one of the first signs of kidney failure. More advanced kidney failure causes other symptoms, including swelling of the ankles or legs, increased blood pressure, nighttime urination, and a reduced need for insulin or other medications.

Blood-pressure-lowering drugs and other interventions can slow down kidney failure. The only treatment for end-stage renal disease, the most advanced stage of kidney failure, is dialysis or kidney transplant.

About two-thirds of people with diabetes die of heart disease or stroke.Rapid treatment is crucial if you're experiencing stroke symptoms (there's a three-hour window after a stroke starts in which doctors can use a clot-dissolving drug). If you think someone is having a stroke, ask them to do three things: try to smile (one side may droop); raise their hands over their head (difficulty on one side); and say a sentence (speech may be slurred). Call 911 if they have any of these symptoms, according to the National Stroke Association.

Vision loss
Diabetes is the leading cause of new cases of blindness in adults ages 20 to 74. You should be checked by an eye doctor regularly, as retinopathy can often be asymptomatic. You should also call your eye doctor if you have any sudden changes in your vision, such as blurriness or spots in your field of vision where you cannot see. Depending on how far your retinopathy has advanced, there are different forms of laser surgery available as treatment.

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