Uncontrolled Diabetes: Signs, Complications, Treatment

Diabetes mellitus is a chronic metabolic disorder mainly characterized by high blood glucose, insulin resistance, or deficiency. 

Uncontrolled diabetes can kill you, and it can considerably reduce your lifespan. 

Poorly controlled diabetes causes many chronic complications causing significant morbidity and disability.

There are many sub-types of diabetes mellitus, but the two most common types are type 1 and type 2 diabetes. 

More than 90% of people diagnosed with diabetes are living with type 2 diabetes (1). 

One of the problems with diabetes is that there are not many early symptoms of diabetes. 

This means that about 20% of those living with diabetes remain undiagnosed. 

However, what is even more worrisome is that people are paying insufficient attention to diabetes, and about half of those diagnosed with diabetes have poorly controlled or even untreated diabetes (2).

What is uncontrolled diabetes?

Uncontrolled diabetes means that a person has much higher sugar levels than permissible. As a result, they would often have some symptoms like peeing more often, feeling thirsty most of the time, and fatigue.

Those with uncontrolled diabetes would also report polyphagia. This is a greater urge to eat food, as blood glucose struggles to enter the body cells.

If a person continues to neglect diabetes, diabetes side effects become more apparent. Untreated or poorly managed diabetes may cause worsening of vision, issues with kidney health, tingling sensation in feet and hands, excessive sweating, poorly healing wounds, and many other problems.

How do I know if my diabetes is controlled or uncontrolled?

High blood sugar would produce some signs. However, blood sugar symptoms are unreliable in understanding how well diabetes is controlled. 

Nonetheless, the worsening of pre-existing diabetes symptoms in adults is a clear sign of uncontrolled diabetes.

For example, if you experience worsening eyesight due to diabetic retinopathy or worsening nerve pain, your diabetes is not well controlled. Similarly, living with a poorly healing wound or ulcer is clearly a sign of inadequately controlled blood sugar levels.

Although diabetes symptoms might be suggestive of uncontrolled diabetes, it is not a reliable way to know. 

In many, diabetic side effects may not be very marked, yet poorly controlled diabetes may lead to severe health complications in the long run.

Therefore, the most reliable way to understand if you are controlling diabetes well or not is self-monitoring of blood glucose (SMBG). Everyone with diabetes must monitor sugar levels frequently. 

The best time to test your blood sugar level is in the morning, on an empty stomach, or after at least 8 hours of fasting. 

A person with fasting blood sugar levels above 126 mg/dL (7 mmol/L) indicates diabetes. However, experts say that those living with diabetes must try to keep their fasting blood sugar levels below 131 mg/dL.

However, perhaps the most reliable way of knowing if you have uncontrolled diabetes is by getting tested for glycated hemoglobin (HbA1C). 

This test shows the average blood sugar levels for the last couple of months, not for that particular day. It would show how well you have been controlling diabetes in the previous few months.

Most guidelines say that person with an HbA1C level of 6.5% or higher has diabetes. Doctors suggest that those living with diabetes must try to maintain an HbA1C value below 7%. 

If your level is continually above 7%, then you are most likely living with uncontrolled or poorly controlled diabetes.

Signs and symptoms of uncontrolled diabetes

Although signs and symptoms are not a reliable way to understand your blood sugar level, knowing these symptoms would help you understand how well you control diabetes. 

Moreover, knowing diabetes symptoms is essential if you are not monitoring your blood glucose level regularly.

Some signs of poorly controlled diabetes include polyphagia, increased urge to eat, and increased urge to pee. A person with uncontrolled diabetes feels thirsty most of the time.

If you do not control your diabetes adequately, you have elevated blood sugar, but that glucose cannot enter body cells, thus starving them of energy. 

However, if a person does not pay attention to these early signs, diabetes may keep progressing, causing chronic complications and severely damaging small and large blood vessels and nerves. Severe diabetes can cause life-threatening complications.

What does uncontrolled diabetes feel like?

Poorly uncontrolled type 2 diabetes in adults would have many signs and symptoms. However, quite often, people tend to neglect them. 

If you are not controlling your diabetes, you will constantly feel exhausted and have poor sleep quality.

One would often have many other discomforts, like worsening eyesight due to diabetic retinopathy. In addition, one may also struggle to control blood pressure and even cholesterol levels.

Many people would develop early signs of neuropathy like tingling sensation or pain in the hands and feet. In addition, most would have altered feelings in the hand and foot, also called “socks and glove syndrome.”

Autonomous neuropathy can develop as diabetes, causing dry hands and, simultaneously, a person may experience excessive sweating. In addition, one may also struggle to carry out physical activities due to poor cardiovascular health.

You may notice that even minor scratches may readily get infected and are quite challenging to treat. In addition, even tiny scratches or minor wounds may become poorly healing ulcers. 

So, a diabetic person would experience multiple things and many diabetes problems. First, however, one must learn to identify these signs.

Causes and risk factors

There are many types of diabetes mellitus, but we are primarily interested in type 2 diabetes since it is a lifestyle disorder, unlike other types like type 1 diabetes (auto-immune disorder) or gestational diabetes. 

The primary causes of type 2 diabetes are obesity, excessive calorie intake, low-calorie expenditure, or a sedentary lifestyle. 

If a person consumes too many calories, it elevates blood glucose levels. In response, the body starts producing more insulin to regulate blood glucose levels and enhance glucose intake by body tissues. 

However, body tissues stop responding to insulin’s request to take more glucose over time, and insulin resistance starts. 

Thus, insulin resistance is the primary pathological mechanism in type 2 diabetes, though as diabetes progresses, a person may also develop insulin deficiency.

Other causes and risk factors include a family history of diabetes, specific genetic mutations, and hormonal issues. 

However, type 2 diabetes is predominantly a lifestyle disorder, and thus it is important to manage it through non-pharmacological means.

What happens when diabetes is uncontrolled?

If diabetes is uncontrolled, many problems start. 

First, the body tries its best to adapt to the new conditions, a state of constant high blood sugar levels. Thus, it tries to produce more insulin until beta cells in the pancreas die due to overload or burnout, causing insulin deficiency.

Kidneys try to eliminate as much glucose as possible via urine, which causes high glucose levels in urine and an increased risk of urinary tract infections.

Over the long run, high blood sugar levels damage blood vessels and nerves. This damage to blood vessels/peripheral vascular disease and nerves/neuropathy may cause complications or diabetic issues.

Complications of uncontrolled diabetes

Diabetes may cause acute and chronic complications. However, acute and life-threatening complications are characteristic of uncontrolled type 1 diabetes or end-stage diabetes. 

Severe uncontrolled elevation in blood glucose and insulin deficiency may cause a life-threatening complication called diabetic ketoacidosis (DKA). 

DKA causes excessive thirst, urination, stomach pain, weakness, shortness of breath, and even loss of consciousness, and it needs urgent treatment (3).

However, most people are likely to experience the so-called chronic diabetes complications that occur due to damage to small and large blood vessels and nerves. 

Some of the complications of uncontrolled diabetes are (4):

Complications due to damage to small blood vessels:

• Retinopathy
• Nephropathy
• Diabetic foot or poorly healing ulcers of lower extremities
• Skin disorders

Complications from damage to large blood vessels:

• Heart diseases or even heart attack
• Increased stroke risk
• Peripheral vascular disease

Some complications due to damage to nerves:

• Peripheral neuropathy, mostly causing pain, altered sensation in hands and feet
• Autonomous neuropathy causes altered bladder movement, sweating, poor cardiovascular response to physical exertion, altered gut health, and more.

So, remember that diabetes is not just about high blood glucose levels. Uncontrolled diabetes can even kill. 

It significantly increases the risk of coronary artery disease, cerebrovascular disease, and more. In addition, it is the leading cause of chronic kidney disease (CKD) and even non-traumatic amputation.

Can you reverse uncontrolled diabetes?

For decades, doctors would not accept that type 2 diabetes is reversible. However, much has changed in recent years, and now doctors agree that diabetes is a highly reversible disorder. 

There are many ways in which people can reverse type 2 diabetes, resulting in its long-term remission. 

More than 80% can expect to benefit from lifestyle measures like weight loss and dietary changes, and many people can expect complete diabetes remission and start living without medical drugs.

In highly obese individuals, those with BMI (body mass index) above 40, bariatric surgery could be one of the ways of diabetes reversal. It can help in most of the cases (5). However, bariatric surgery is only for a small number of people living with diabetes and severe obesity.

Perhaps the better way to reverse diabetes could be low-calorie diets. Weight loss and exercise are other highly effective ways to reverse diabetes.

Treatment

A doctor must treat diabetes. Doctors recommend starting with lifestyle interventions like weight loss, regular exercise, and reducing processed carbs intake to manage diabetes. 

However, if lifestyle measures fail, drug therapy or oral hypoglycaemic agents are the primary way to treat diabetes.

There are many kinds of medications that doctors may use alone or in combination to treat diabetes. Some are insulin sensitizers. Others alter glucose metabolism, affect the gut, boost insulin production, and more (7). 

Here it is vital to understand that diabetes treatment is not only aimed at lowering blood sugar levels. It is also aimed at reducing diabetes complications and related mortality. For example, diabetes treatment generally helps with weight loss and reduces the risk of cardiovascular diseases.

Natural remedies and lifestyle changes

In diabetes management, lifestyle changes and natural remedies are not optional – they are a must. Type 2 diabetes is a lifestyle disorder. Hence, its treatment must start with weight loss, increasing physical activity, engaging in training, and dietary changes.

Even a slight weight loss of 5-7% can help improve insulin sensitivity, help control diabetes mellitus risk factors, and reduce diabetes dangers. 

Similarly, 150-300 minutes of aerobic exercise weekly can be life-changing.

When it comes to dietary changes, making small changes can help significantly. Thus, reduce your intake of processed foods, cook more often using fresh products, and increase your intake of fruits and vegetables.

Lifestyle interventions work better, along with natural remedies. First, start by supplementing micronutrients like vitamin C, D, selenium, magnesium, chromium, and omega-3 fatty acids. 

Secondly, start using natural supplements that improve insulin sensitivity, promote weight loss, lower blood sugar levels, and reduce the risk of diabetes-related chronic complications. 

Here, it is vital to understand that natural supplements not only help fight diabetes but also other ailments. They are also an excellent antioxidant source.

Some natural supplements good for lowering blood sugar, improving vascular health, preventing nerve pain, weight loss, increasing insulin secretion, and promoting gut health are cinnamon, bitter melon, fenugreek, berberine, ginseng,  and more.

Conclusion

The majority of people living with diabetes mellitus have uncontrolled diabetes. Remember, poorly controlled diabetes can kill you. 

Fortunately, type 2 diabetes is a highly manageable lifestyle disorder. Therefore, one can not only control diabetes without medications but also prevent diabetes side effects. 

Some excellent ways to control diabetes are weight loss, exercise, dietary changes, and supplementing the diet with micronutrients and natural supplements.

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