Understanding the risks of uncontrolled diabetes is a step in the right direction of your health, while taking control of this disease and the health battle it brings is even more important. In this blog post, we will explore what is uncontrolled diabetes, its symptoms, its risks, and some best practices to manage it effectively.
Diabetes is a chronic condition that affects millions of people worldwide. According to Diabetes Statistics, 37.3 million people (11.3%) of the U.S. population have diabetes and is the eighth leading cause of death in the US from 2021 statistics, per the CDC. When diabetes is uncontrolled, it can lead to various complications and serious health risks, but there is hope as there are ways to combat diabetes.
From a Dietitian who loves to provide diabetic education, I hope you enjoy this post. The knowledge of another Dietitian and Certified Diabetes Care and Education Specialist (CDCES), Amy Beney,MS, RD, CDCES and Owner of Nutrition Insights PLLC, is throughout this post, too.
Uncontrolled Diabetes Defined
A very simple definition of uncontrolled diabetes from My Choice Wisconsin is having a hemoglobin A1c (HbA1c) equal to or greater than 9. This site also has a clinical guideline handout summarizing uncontrolled diabetes here that is very beneficial and is easy to read and understand. Clearly, one’s blood glucose levels are consistently elevated and, thus, the HbA1c, which measures the average blood sugar levels in the past 3 months, is outside the target range of 7% or less for those with diabetes.
Uncontrolled Diabetes Symptoms
Diabetes that is not managed causes a myriad of symptoms, such as increased thirst, low blood glucose levels (hypoglycemia), high blood glucose levels (hyperglycemia), frequent urination, and others. Excessive thirst, also known as polydipsia, is a common symptom of uncontrolled diabetes. High blood sugar levels can cause dehydration, leading to increased thirst and dry mouth. Uncontrolled diabetes can result in both low and high blood sugar episodes. Hypoglycemia may cause shakiness, dizziness, confusion, and sweating, while hyperglycemia can lead to fatigue, frequent urination, blurred vision, and slow wound healing. Unmanaged diabetes often leads to increased urination or polyuria as the kidneys try to remove excess glucose from the bloodstream. This can result in frequent trips to the bathroom, especially during the night.
A few other symptoms to be aware of are fatigue, unexplainable or unintended weight loss, and increased hunger. High blood sugar levels can interfere with the body’s ability to convert glucose into usable energy, resulting in feelings of tiredness and exhaustion, fatigue and a lack of energy. If diabetes is uncontrolled, the body may not be able to utilize glucose properly, causing it to turn to alternative energy sources like muscle and fat. This can result in unintentional weight loss, despite normal or increased food intake. Some individuals with uncontrolled diabetes may experience excessive hunger, known as polyphagia. This occurs because the body’s cells are not receiving enough glucose, leading to increased appetite or the feeling of constantly craving food.
Uncontrolled Diabetes Risks
The risks or complications that come with poorly managed diabetes are vast, yet most can be prevented with proper glucose control, a healthy diet, and exercise. Risks and complications include diabetic wounds, loss of sight, nerve damage, and diabetic ketoacidosis (DKA). Persistent high blood sugar levels can impair the body’s ability to heal wounds. Even minor cuts or sores can develop into serious infections, leading to diabetic foot ulcers or other complications to include the need for amputation. Uncontrolled diabetes increases the risk of developing diabetic retinopathy, a condition that affects the blood vessels in the retina. If left untreated, it can lead to vision loss and even blindness. Prolonged uncontrolled diabetes can cause damage to the nerves, a condition known as diabetic neuropathy. This can result in numbness, tingling, and pain, usually in the hands and feet. Lastly, uncontrolled diabetes can lead to a life-threatening condition called diabetic ketoacidosis. DKA occurs when the body doesn’t have enough insulin to break down glucose for energy, causing the body to break down fat instead. This process produces toxic ketones, leading to a buildup of acid in the blood.
Amy mentioned that other long-term side effects of high blood sugar include
- Cardiovascular disease
- Kidney damage (diabetic nephropathy)
- Kidney failure
- Damage to small vessels-eyes, feet,
- Bone and joint problems
- Memory issues
- Teeth and gum infections
- Blood vessel damage
Special Note: For women with uncontrolled diabetes who become pregnant, there is an increased risk of complications for both the mother and the baby. Poorly controlled blood sugar levels can lead to complications such as preeclampsia, gestational diabetes, birth defects, premature birth, and macrosomia (large birth weight). Uncontrolled diabetes can also have an impact on mental health, considering the stress and challenges of managing a chronic condition, coupled with the physiological effects of high blood sugar levels.
Uncontrolled Diabetes Best Practices
- See Your Doctor: Regular visits to your healthcare provider are crucial for managing uncontrolled diabetes, specifically an Endocrinologist. They can help assess your condition, adjust medication dosages if necessary, and monitor your overall health.
- See a Registered Dietitian and/or CDCES: A registered dietitian or a certified diabetes care and education specialist (CDCES) – these can be one in the same – can provide personalized guidance on nutrition and meal planning. They can help create a balanced diet that suits your individual needs, taking into account your blood sugar levels, weight goals, and overall health.
- Purchase and Use a Glucometer: Invest in a reliable and accurate glucometer to monitor your blood sugar levels regularly or see if your insurance will cover the cost of one. Consult your healthcare provider to determine the best glucometer for your needs and learn how to use it correctly. If you qualify, Amy and I both recommend continuous glucose monitoring (CGM), which is a “system to track glucose levels every few minutes, 24/7, through a tiny sensor inserted under your skin.” It can replace finger sticks in people with diabetes and can identify patterns that help blood sugar management.
- Check Blood Sugar Levels After Meals: Monitoring your blood sugar levels after meals is vital for understanding how different foods affect your glucose levels, in real time. Your healthcare provider and/or dietitian can advise you on target ranges and help you interpret the results.
Other best practices to do would be to take medications as prescribed, know what to do if having a hypo- or hyperglycemic episode, obtain a HbA1c test every 3 months with a target result, and conduct stress management since chronic stress can contribute to elevated blood sugar levels.
Uncontrolled diabetes poses significant risks to a person’s health and well-being. This post is meant to shed light on uncontrolled diabetes symptoms, risks, and best practices for management. It should not take the place of medical advice from your doctor. Take proactive steps to gain control over this condition by visiting with an Endocrinologist and Registered Dietitian and/or certified diabetic educator.
Uncontrolled Diabetes Resources
- American Diabetes Association
- NIH on CGM
- Recipe Book — snacks with 15-30 grams of carbs and meals with 30-75 grams of carbs