In general the complications of diabetes can be divided into emergency conditions and long-term disorders. The patient with severe diabetes who is taking insulin is particularly susceptible to serious emergency situations of diabetic coma and insulin shock. With the diabetic coma, the onset is gradual, although it may be more rapid in children. The skin is hot and dry, the face flushed, and breathing is deep and laboured. Nausea, high blood sugar, excess sugar in the urine, drowsiness, lethargy and loss of consciousness -- these are signs of a diabetic coma. After the first signs of insulin shock or reaction, (a very low blood sugar), the onset is sudden. Some signs are perspiration, pale, clammy and cold skin, shallow breathing, hunger, mental confusion and double vision. There may be sugar in the urine, low blood sugar and loss of consciousness. These conditions require prompt medical attention.

The individual should be taken to the hospital for emergency treatment. With the diabetic coma, there is a very high level of glucose or sugar in the blood. The individual will require insulin injections to stabilise his condition. When the insulin shock occurs, the individual should consume some form of simple sugar, such as sweetened orange juice or some candy, while seeking medical intervention. The diabetic should be instructed in the nature of his disorders, the complications to be avoided, and the role he must play in the control of his condition. A strict diet is very important. Modern, easy-to-manage machines are available for diabetics to monitor their blood sugar. Other complications which develop over a period of time include the increase of fatty acids in the blood. This predisposes diabetics to a condition which may lead to heart disorder and may damage small and large blood vessels. Diabetics often have blurred vision and generally the longer the diabetic condition exists, the more prone the individual is to further complications such as kidney disease and hypertension. Because of poor circulation, a relatively high blood sugar level and decreased ability to repair damaged tissue, the diabetic may suffer serious complications from minor infections. Ulceration and gangrene, particularly of the lower extremities, are among these complications. The basic principles of good personal hygiene, cleanliness and prompt (medical) treatment of minor injuries or irritations of the skin, must be stressed as important in the prevention of complications. Give special attention to the care of the feet -- visit the chiropodist regularly. Finally, there is risk in pregnancy for diabetic women.

Blindness or kidney failure may occur and they risk giving birth to deformed babies so there is a definite need for special care during pregnancy, childbirth and after. HEALTH HTH