What happens if you leave diabetes untreated?

Blood Sugar Levels

Even though signs of diabetes show up, many people might not realize that there is something wrong with them. However, as symptoms worsen, they do get their diabetes tests and start their diabetes treatment.

It is a fact that many people are living with undiagnosed diabetes. This is due to lack of awareness, lack of availability of basic healthcare, and having preexisting conditions that cloak the signs of diabetes.

Even people who are diagnosed and are taking diabetes treatment may not completely adhere to the treatment. Poorly treated and untreated diabetes can lead to a host of complications which might end up in hospitalization.

Here are a few conditions that can arise with untreated diabetes or poor adherence to diabetes treatment.

  • Increased risk of infections
  • Skin problems
  • Frequent urination
  • Increased thirst
  • Excessive hunger
  • Diabetic retinopathy
  • Diabetic nephropathy
  • Diabetic neuropathy
  • Cardiovascular diseases
  • Stroke

Diabetic retinopathy

Diabetic retinopathy is a disease of the eyes caused due to diabetes. It affects the retina in the eye. Diabetic retinopathy is the leading cause of blindness, but it can be avoided by strictly following diabetes treatment.

Untreated diabetes damages tiny blood vessels and capillaries in the eyes. This leads to leakage of blood from the blood vessels into the eye. Leaking blood vessels cause macular edema (a buildup of fluids in the macula of the eye leading to swelling).

With damage to the blood vessels, there is inadequate supply of oxygen-rich blood to the thin light-sensitive tissues of the retina. This reduces vision of a person with diabetic retinopathy. As the disease progresses, it leads to blindness.

Stages of Diabetic Retinopathy

Mild non-proliferative diabetic retinopathy

In this stage, there is damage to the blood vessels with swelling. This blocks blood supply to all parts of the retina.

Moderate non-proliferative diabetic retinopathy

In this stage, some blood vessels that supply oxygen-rich blood to the retina are totally blocked.

Severe non-proliferative diabetic retinopathy

By the time a patient reaches this stage, most of the blood vessels supplying blood to the retina are blocked.

Proliferative diabetic retinopathy

This is an advanced stage of the disease. New and tiny blood vessels start growing in the retina. These blood vessels are tiny and so they hemorrhage causing fluid buildup and retinal detachment. 

Symptoms of Diabetic Retinopathy

  • Blurred central vision.
  • Double vision and flashing lights in front of the eye.
  • Floating spots or blind spots around the eye.
  • Fluctuating vision with fluctuating sugar levels.
  • Decreased vision and depth perception.

Diabetic Nephropathy

Diabetic nephropathy is a disease of the kidneys caused due to untreated, unmanaged diabetes or poor adherence to diabetes treatment. Diabetic nephropathy is one of the leading causes of end-stage kidney disease; however, diabetic nephropathy can be avoided.

Untreated Diabetes and Kidney Damage

Diabetes is known to affect blood vessels and nerves of the entire body. When blood vessels of the kidneys are affected by diabetes, it leads to diabetic nephropathy. When people with untreated or poorly managed diabetes also have high blood pressure and high cholesterol, there is an increased risk of major vascular complications, and kidney failure.

Kidneys eliminate waste products from the body, regulate blood pressure, regulate the acid levels of the body, and red blood cell regulation.

If there is poor adherence to diabetes treatment, there is damage to blood vessels and nerves. With this, the capacity of kidneys to filter waste products reduces. Nerve damage also leads to difficulty in emptying the bladder.

Diabetic nephropathy takes some time to develop. Initially, it begins with a condition called microalbuminuria and then it progresses to albuminuria.

One of the first signs of diabetes is high blood sugar levels. Chronic high blood sugar levels lead to changes in the structure of proteins. This leads to microalbuminuria. Over a period of time, albumin (a protein made in liver) is excreted via urine as the filtration units of kidney (glomeruli) are damaged. This is called albuminuria.  As the disease progresses, the glomerular filtration process is impaired due to further damage to the glomeruli.

People with untreated or poorly managed diabetes are prone to urinary and kidney infections. This adds up to the kidney damage further. If people with diabetes have hypertension, damage to the glomeruli increases further.

Along with damage to the glomeruli, there is damage to the basement membrane of the kidneys leading to thickening of the tissues. In this stage, most people have macroalbuminuria. Later, there is progressive damage to the kidneys leading to end-stage kidney disease.

Diabetic Nephropathy Symptoms

  • Leg/ankle swelling and cramps
  • Excessive urination during nighttime
  • General weakness
  • Morning sickness, vomiting
  • Anemia
  • Itching
  • Protein in the urine
  • High blood pressure

Diabetic Neuropathy

Diabetic neuropathy is also one of the first signs of diabetes. Like diabetic neuropathy, all complications of diabetes are a result of damage to the blood vessels and nerves. When damage occurs to the nerves, it is called diabetic neuropathy. Diabetic neuropathy leads to numerous complications including diabetic foot disease, a leading cause for foot amputations.

People who have poor control over their diabetes and have persistent high blood sugar levels have damage to their nerve fibers at the cellular level. This leads to diabetic neuropathy. Depending upon the type of nerve fibers that are damaged, there can be different types of diabetic neuropathy.

However, it should be noted that diabetic neuropathy can affect all the organs of the body including the heart, sexual organs, digestive tract and others.

Peripheral Neuropathy

When there is damage to the sensory and motor nerves, it is called peripheral neuropathy. This is a common form of neuropathy and often affects the extremities (arms, legs).

Symptoms of peripheral neuropathy

  • Numbness, tingling sensation in the affected area (feet, legs, toes, fingers, and hands)
  • Wasting of muscles
  • Loss of sensation or extremely sensitive to touch
  • Pain
  • Cramping

Due to diabetes, there is damage to the blood vessels. This damage results in lack of oxygenated blood supply to the nerves leading to damage and neuropathy. Peripheral neuropathy can also result in lack of reflexes, muscle weakness, and foot deformities.

When there is peripheral neuropathy of the foot, there is lack of sensation due to reduced blood supply to the nerves of the feet. This causes reduced immunity and the foot is more prone to injuries and infections.

What starts as a small sore or a canker can result in an ulcer that does not heal. In some cases, it can even lead to amputation of the foot.

Autonomic Neuropathy

When involuntary nerves that control the functions of the heart, digestive tract, blood vessels, sexual organs and others are affected by diabetes, it leads to a condition called autonomic neuropathy.

Symptoms of autonomic neuropathy

  • Excessive sweating
  • Pain in the neck, arm, back, or stomach
  • Nausea, vomiting
  • Lightheadedness
  • Alternating diarrhea and constipation
  • Bladder/fecal incontinence
  • Decreased sexual drive with erectile dysfunction or vaginal infections
  • Fluctuating blood pressure
  • Feeling dizzy or fainting

Proximal Neuropathy

This type of neuropathy is less common. It is also called diabetic amyotrophy. This painful nerve damage occurs mostly in people with type 2 diabetes. It starts with pain in the legs, thighs, buttocks, and hips. It can cause weakness in the affected areas and can even impair movement.

This condition is caused due to changes in the immunity system because of diabetes and can be avoided with tight control over diabetes and lifestyle modifications.

Focal Neuropathy

This kind of diabetic neuropathy comes in suddenly and might subside in a matter of weeks or months. However, this condition is very painful and can cause nerve entrapments.

Symptoms of focal neuropathy

  • Chest pain that can be mistaken as heart attack
  • Abdominal pain and stomachache that can be mistaken as appendicitis
  • Facial paralysis
  • Pain in the pelvis, in the front of the thigh, behind the eye, and carpal-tunnel syndrome

Diabetes and Cardiovascular Diseases

Poorly managed diabetes or poor adherence to diabetes treatment can lead to cardiovascular diseases. Diabetes affects blood vessels and nerves, and so people with diabetes are more prone to cardiovascular diseases.

The presence of cardiovascular diseases like heart attack, stroke, coronary artery disease and others is high in people with type 2 diabetes. India has become a center for diabetes and cardiovascular diseases due to numerous factors including genetic predisposition, diet, and lack of physical activity, stress, hypertension, high cholesterol and obesity.

The combined effect of diabetes and hypertension on blood vessels is adverse and leads to a host of conditions like atherosclerosis and macroangiopathy. In people with diabetes, the lining of the blood vessels are damaged leading to atherosclerosis. High blood sugar levels over a period of time damage major blood vessels and lead to numerous heart diseases and stroke.

Cardiovascular diseases are the major reason for premature deaths and hospitalizations, and coupled with diabetes, it is a major health burden for Indians. Untreated diabetes can have disastrous consequences with life-threatening diseases. That’s why it is important to notice early signs of diabetes and get treatment.