Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Both type 1 and type 2 diabetes ultimately lead to high blood sugar levels, a condition called
hyperglycemia. Over a long period of time, hyperglycemia damages the retina of the eye, the
blood vessels of the kidneys, the nerves, and other blood vessels.
Damage to the retina from diabetes (diabetic
retinopathy) is a leading cause of blindness.
Damage to the kidneys from diabetes (diabetic nephropathy) is a leading cause of
Damage to the nerves from diabetes (diabetic neuropathy)
is a leading cause of foot wounds and ulcers, which frequently lead to
and leg amputations.
Damage to the nerves in the autonomic nervous system can lead to paralysis of the stomach (gastroparesis),
chronic diarrhea, and an
inability to control heart rate and blood pressure during postural changes.
Diabetes accelerates atherosclerosis, (the formation of fatty plaques inside the arteries), which can lead to blockages or a clot (thrombus). Such changes can then lead to heart attack, stroke, and decreased circulation in the arms and legs (peripheral vascular disease).
Diabetes predisposes people to elevated blood pressure, high levels of cholesterol and triglycerides. These conditions
both independently and together with hyperglycemia, increase the risk of heart disease, kidney disease, and other blood vessel complications.
Diabetes can contribute to a number of acute (short-lived) medical problems.
Many infections are associated with diabetes, and
infections are frequently more dangerous in someone with diabetes because the
body's normal ability to fight infections is impaired. To compound the
problem, infections may worsen glucose control, which further delays recovery
Hypoglycemia or low blood sugar occurs
intermittently in most people with diabetes. It can result from taking too much diabetes medication or insulin (sometimes called an insulin reaction), missing a meal, exercising
more than usual, drinking too much alcohol, or taking certain medications for other conditions. It is very important to recognize hypoglycemia and be prepared to treat it at all times.
dizzy, poor concentration, tremor of the hands, and sweating are common symptoms
of hypoglycemia. A person can faint or have a
seizure if blood sugar level
(DKA) is a serious condition in which uncontrolled hyperglycemia (usually due to complete lack of insulin or a relative deficiency of insulin) over time creates a buildup
of ketones (acidic waste products) in the blood. High levels of ketones can be very harmful. This typically happens to people with type 1 diabetes who do not have good blood glucose control. Diabetic ketoacidosis can be precipitated by infection, stress, trauma,
missing medications like insulin, or medical emergencies such as a stroke and heart
Hyperosmolar hyperglycemic nonketotic syndrome is a serious condition in which the blood sugar level gets very high. The body tries to get rid of the excess blood sugar by eliminating it in the urine. This increases the amount of urine significantly, and often leads to dehydration so severe that it can cause seizures, coma, and even death. This syndrome typically occurs in people with type 2 diabetes who are not controlling their blood sugar levels, who have become dehydrated, or who have stress, injury, stroke, or are taking certain medications, like steroids.