Consequences of Untreated Type 1 Diabetes Mellitus

In order to help regulate blood sugar levels, diabetes is a chronic illness that needs continuing care. Consequences of untreated type 1 diabetes include blindness, renal failure, nerve damage, and other long-term problems.

Untreated diabetes frequently results from a person being unaware that they have the condition. 7.2 million Americans are believed to have diabetes without a diagnosis, as reported by the Centers for Disease Control and Prevention (CDC). [Ref]

People with diabetes may neglect to seek treatment for it. High blood sugar symptoms are frequently unnoticeable and simple to ignore.

Your blood sugar may be high and you won’t even be aware of it if you don’t test it frequently. Diabetes testing equipment, however, may be pricey, and insurance may not always cover it.

Untreated Type 1 Diabetes could lead to DKA which is a fatal complication. People may die within days.

What happens if you leave Type 1 Diabetes Untreated?

Leaving Type 1 Diabetes untreated is a very serious mistake and can result in death within days. People with Type 1 Diabetes are insulin deficient and can develop DKA within 12 to 24 hours.

When insulin doses are missed, and often after missing even one single dose, the body starts utilizing fats instead of sugar.

Fat metabolism leads to the formation of ketone bodies. Ketones are acidic in nature and they turn the blood more acidic.

The normal blood PH is 7.40 (7.35 to 7.45). When ketones start to accumulate because of the deficiency of insulin, the blood PH starts to drop.

Blood PH <7.35:

With a PH of <7.35, the patient may develop nausea, vomiting, and abdominal pain.

Blood PH <7.32:

With further acidemia or acidity added to blood (because of more ketones), the person may start to notice difficulty in breathing. The person may be taking deep rapid breaths to remove ketones (acetone) via the respiratory tract.

Blood PH <7.0:

When the PH drops to <7.0, the person may become confused and drowsy. Simultaneously body fluid and electrolytes become abnormal. The patient may develop hyperkalemia and severe dehydration.

Blood PH <6.8:

Any PH below 6.8 is considered incompatible with life.

How rapidly a person goes into DKA depends on how deficient he/she is in insulin. However, it may take as little as 12 to 24 hours for a person to develop DKA if insulin deficiency is 100% (meaning the person is not producing any insulin.

For a partially deficient Type 1 Diabetic individual, it may take as long as one week.

Take home message:

Untreated Type 1 diabetes can result in death within a few days. It is important not to miss your insulin dose, even a single dose!

In times of acute stress, one should check ketones in urine via a dipstick or Ketometer. If urinary or blood ketones are positive after stopping insulin, don’t wait! Get one dose of your rapid and long-acting insulin and go straight to the emergency.

Your doctor will be giving you intravenous fluids, checking and correcting abnormal electrolytes, correcting acidosis by giving alkali (sodium bicarbonate) if acidosis is severe, and may give you antibiotics if an infection is an exacerbating factor.

Late complications of Untreated Type 1 Diabetes:

Untreated type 1 diabetes is rapidly fatal. However, uncontrolled Type 1 Diabetes can slowly damage your organs.

The target blood glucose for a diabetic should be:

• Fasting blood glucose of 70 to 115 (can be more relaxed in older type 1 diabetic patient)
• Random blood glucose of 100 to 150 (can be more relaxed in older type 1 diabetic patients)
• HbA1C of less than 6.5% (can be up to 7 – 7.5 in older diabetic patients with comorbid conditions like renal, liver, or heart diseases)

When the insulin dose is insufficient to achieve these targets, the person will develop complications. Long-term complications may take five to ten years for a Type 1 diabetic to develop.

However, in patients with very high blood sugar and A1C crossing 11%, complications may develop in a few years.

Here are a few long-term complications of patients with poorly controlled Type 1 Diabetes:

Skin Complications:

In fact, a person’s skin issues may be the first indication that they have diabetes. These indications may progress significantly if diabetes is left untreated.

Some of these are alarming, while others can just be superficial problems (harmless). In any case, you should be careful of any abnormalities in your skin and discuss any worries you have with your doctor; it’s always better to be safe than sorry.

Fortunately, most skin disorders may be avoided or are simple to cure if discovered early. Commonly patients develop ulcers, blisters, and infections. These skin infections are more likely to affect your feet.

Other diabetes-related skin diseases may include acanthosis nigricans in which tan or brown elevated spots develop on the sides of the neck, under the arms, and in the groin.

They can occasionally develop on the hands, elbows, and knees as well. People who are extremely overweight are more likely to develop acanthosis nigricans. The best course of action is weight loss. Some creams might enhance the appearance of the spots.

Other skin conditions include:

• Digital sclerosis causes the development of thick, waxy, and tight skins on the posterior sides of the hands.
• Eruptive xanthomatosis is another manifestation of untreated diabetes. It comprises skin growths that are hard, yellow, and resemble peas.

Cognitive problems:

Diabetes that is not under control increases the chance of developing memory loss and other cognitive issues.

Blood arteries, glial cells, and nerve cells in the brain and peripheral nerves of the body can all suffer harm from blood glucose levels that are above normal.

Another way that diabetes could impair memory is by silently harming the capillaries (which are the small blood vessels that form the network for the exchange of oxygen and glucose between blood vessels and tissue cells).

There is also evidence that any type of diabetes can increase the chances of cognitive impairment in individuals. [Ref]

This is why treating type 1 diabetes is essential as prolonged uncontrolled diabetes will leave you with cognitive abnormalities.

Foot Complications:

Diabetes-related neuropathy is a kind of long-term nerve injury that can be brought on by high blood sugar levels that are left untreated.

Neuropathy brought on by diabetes can affect any part of the body, although it most frequently affects the legs and feet.

You could get foot numbness as a result of the disease. A blister, cut, or pain may go unnoticed if your feet are numb.

A rock in your sock that is slicing your foot, for instance, could not even be felt by you. Unnoticed and untreated wounds might grow infectious.

Diabetes that is not managed can also impact the blood flow to your feet and legs. Such mismanagement increases a person’s risk of peripheral artery disease (PAD).

Arteries narrow or obstruct as a result of this disorder. Poor circulation (reduced blood flow) might make it challenging for an infection or foot ulcer brought on by diabetes to heal.

Infections of Untreated Diabetes:

High blood sugar levels may reduce a person’s immune system’s ability to defend itself. Long-term diabetics have a higher risk of infection, reduced blood flow to the limbs, and peripheral nerve damage.

Sugar levels in your blood and tissues are too high, which encourages bacterial development and hastens the spread of diseases.

People who do not tend to their diabetes can be seen with fungal infections of the nose and throat.

On another note, one of the main reasons people get UTIs is untreated diabetes. Germs like Escherichia coli are frequently to blame for these UTIs. Infections of the kidneys and bladder inflammation are both frequent as well.

Loss of Vision:

This widespread eye ailment is the leading cause of blindness in individuals who are employed. Diabetic retinopathy is caused by the blood vessels in the retina being destroyed by high blood sugar.

Swollen, leaky, or ruptured blood vessels can cause eyesight to blur or stop blood flow. Although occasionally new blood vessels can grow, they aren’t always healthy and may exacerbate pre-existing vision problems. Diabetes-related retinopathy frequently affects both eyes.

Kidney Failure:

A kidney’s blood vessel clusters, called glomeruli, that filter waste from the blood might get damaged over time if diabetes is not properly managed. It may also result in excessive blood pressure and renal damage.

Increased pressure in the kidneys’ sensitive filtration mechanism from high blood pressure might result in further renal damage.

Untreated diabetes can lead to renal failure, which can result in fluid retention, swollen arms, and legs, increased blood pressure, or lungs packed with fluid (pulmonary edema).

It can also induce hyperkalemia, which can have dangerous effects on both the mother and the fetus during pregnancy.

Cardiac Complications:

Heart disease is both extremely prevalent and dangerous. In the US, it is the top cause of mortality for both men and women.

Diabetes doubles your risk of developing heart disease or a stroke, and it also puts you at a younger age than someone without diabetes. Your risk of developing heart disease increases the longer you have diabetes. [Ref]

Over time, excessive blood sugar might harm your heart’s nerves and blood vessels. Additionally, diabetic patients are more likely to have other heart disease risk factors:

When you leave your blood sugar untreated, it gets out of control and results in conditions that include high blood pressure where the arteries can be damaged.

Diabetes and Autoimmune diseases

several autoimmune diseases are co-related with diabetes type 1. It is because the defense system of the body gets weaker and weaker with time and the body becomes unable to deal with these situations. some of the autoimmune diseases related to diabetes are listed below:

• Anemia.
• Vitiligo.
• Rheumatoid arthritis.
• Crohn’s disease.
• Gastritis.
• Neurodermatitis.
• Psoriasis.
• Alopecia.

Apart from the above-mentioned diseases, different other autoimmune diseases, as well as endocrine defects, can be the consequences of untreated type 1 or type 2 disease.

General Symptoms of Untreated Type 1 Diabetes:

Uncontrolled or Untreated type 1 or type 2 diabetes patients may complain of severe weakness and lethargy. They may lose significant weight despite eating properly and healthily.

Because insulin is required for the cellular uptake of glucose, insufficient insulin can result in starvation at the cellular level.

This results in muscle wasting and weight loss. In addition, people may develop autonomic diabetic gastroparesis. This complication of diabetes affects the stomach and bowels.

People may develop bloating, gases, diarrhea, constipation, or diarrhea alternating with constipation, and abdominal pain.

Because GI symptoms are very disturbing, people with uncontrolled diabetes may lose interest in foods and avoid meals. This could exacerbate the muscle wasting, cachexia, and weight loss associated with uncontrolled diabetes.

What can you do?

The greatest approach to stop diabetes-related issues from becoming life-threatening is to get tested and treated for it as soon as possible.

In many of your body’s vital organs and systems, untreated diabetes type 1 or 2 has the potential to cause devastation, which might result in several consequences.

Understand the symptoms of untreated diabetes, particularly if you have a family history of diabetes and other health conditions that may increase your chance of either type 1 or type 2 diabetes.

Diabetes might possibly cause harm that can be slowed down or even reversed by careful management, even if it wasn’t detected early.