Short-term Diabetes Complications
Infections
People with diabetes have a harder time fighting infections because of impaired immune
functions. This impaired ability can further affect glucose control.
Hypoglycemia
A blood glucose level of less than 70 milligrams (mg)/deciliter (dL) (3.5 millimoles
[mmol]/L) is called hypoglycemia. This condition occurs when you have too much
insulin and not enough glucose in the blood.
The usual causes of hypoglycemia include:
 Taking too much diabetic medication
 Missing meals
 Sudden increase in amount of exercise
 Alcohol abuse
 Neuropathy
 Malabsorption
Common symptoms include:
 Headache
 Nausea
 Sweating
 Trembling
 Hunger
 Anxiety
 Confusion
 Drowsiness
 Lack of coordination
 Heart palpitations
Complications of hypoglycemia include:
 Coma
 Death
Diabetic ketoacidosis (DKA)
DKA is a major medical emergency. It typically occurs in people with type 1 diabetes,
but can occur in any individual with diabetes. The lack of insulin and an increase in
glucagon lead to the production of glucose and ketone bodies (acidic waste by-products)
by the liver. Infections, stress, and trauma often precipitate DKA.
DKA is characterized by:
 Elevated blood glucose levels
 Ketones in the blood and urine
Common symptoms include:
 Intense thirst
 Polyuria (frequent urination)
 Constipation, cramps, and blurred vision, with or without abdominal pain, as well as
possible vomiting
Complications of DKA include:
 Cerebral edema
 Circulatory failure
 Acute respiratory distress syndrome
 Disseminated intravascular coagulation
Hyperosmolar hyperglycemic nonketotic syndrome (HHNS)
This condition typically occurs in individuals with type 2 diabetes. It occurs when blood
sugars are alarmingly high, which leads to a loss of sugar in the urine. In turn, individuals
become dehydrated because they are unable to drink enough fluid to compensate for the
urinary losses. The typical feature of acetone-smelling breath often is missing.
Common symptoms include:
 Intense thirst
 Polyuria (frequent urination)
 Constipation, cramps, blurred vision, with or without abdominal pain, as well as
possible vomiting
 Weakness
 Drowsiness
Key features include:
 Hyperglycemia
 Hyperketonemia
 Metabolic acidosis
Hyperglycemia leads to osmotic diuresis, resulting in:
 Dehydration
 Loss of key electrolytes:
– Sodium
– Chloride
– Potassium
Lactic acidosis
Lactic acidosis sometimes is caused by intense exercise, certain diseases, and in rare
cases metformin overdose.
References and recommended readings
American Diabetes Association®. Living with diabetes: complications. Available at:
http://www.diabetes.org/living-with-diabetes/complications/. Accessed June 20, 2012.
Mahan LK, Escott-Stump S, Raymond JL. Krauses’s Food and the Nutrition Care
Process. 13th ed. St Louis, MO: Elsevier Saunders; 2012.
MedlinePlus. Lactic acidosis. Available at:
http://www.nlm.nih.gov/medlineplus/ency/article/000391.htm. Accessed June 20, 2012.
Review Date 6/12
D-0581