High Blood Sugar: A Threat to the Entire Body

Expert Interviewed: Zou Junjie, Chief Physician, Department of Endocrinology, The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital)

Reporter: Shi Jie

The health threats posed by diabetes extend far beyond high blood sugar itself. Long-term persistent hyperglycemia or the "glucose toxicity" caused by blood sugar fluctuations can slowly damage blood vessels, nerves and various organs throughout the body. Zou Junjie, Chief Physician of the Department of Endocrinology at Shanghai Changzheng Hospital, reminds that such damage is highly insidious. By the time obvious symptoms appear, irreversible harm has often already occurred. Early recognition and regular screening can effectively delay, or even block the progression of complications.

Skin: Itching and Infections

Long-term high blood sugar causes body dehydration, while damaging vascular endothelium and peripheral nerves, triggering a variety of skin problems. Early manifestations include dry skin, itching, pigmentation on the lower extremities, and high susceptibility to fungal infections, recurrent boils, and blisters that are slow to heal. Diabetic autonomic neuropathy can also disrupt sweating patterns, leading to a characteristic pattern of excessive sweating on the upper body and no sweating on the lower body.

Patients can primarily monitor their own skin condition, and ask doctors to check their skin status during follow-up visits. Seek medical attention immediately once any breakage or ulceration appears.

Bones: Pain and Height Loss

High blood sugar accelerates calcium loss and destroys the bone matrix, which may lead to osteoporosis. Typical warning signs include physical fatigue, frequent night leg cramps, pain in the lower back, shoulders, knees and calves, and even reduced height.

It is recommended that people with diabetes regularly undergo bone density tests. Seek medical examination promptly if the above symptoms appear. Take calcium supplements and vitamin D under medical guidance, and use medications that have negative impacts on bones with caution.

Brain: Dizziness and Weakness

Transient ischemic attack, commonly known as "mini-stroke", is a typical early sign of diabetic cerebrovascular disease. It manifests as temporary dizziness, unilateral limb weakness or numbness, sudden facial drooping, and slurred speech. Under the long-term impact of high blood sugar, people with diabetes may also develop diabetic encephalopathy, which presents as impaired learning and memory abilities, dysfunction in language, comprehension, judgment and cognitive functions, and may even progress to dementia in severe cases.

Seek immediate medical attention once any suspected symptoms of mini-stroke appear. For patients with combined hypertension and dyslipidemia, it is recommended to undergo annual carotid ultrasound and intracranial vascular examinations to identify risks in advance.

Eyes: Dryness and Blurred Vision

The incidence of diabetic retinopathy rises significantly with the duration of diabetes. Early symptoms include dry eyes, foreign body sensation, burning sensation, blurred vision, and fluctuating visual acuity.

If persistent dark spots appear in the field of vision or vision declines, seek immediate fundus examination. Patients with type 2 diabetes should complete their first fundus examination at the time of diagnosis, while those with type 1 diabetes should do so 5 years after diagnosis. The review frequency should be adjusted according to the condition: for patients without fundus lesions and with well-controlled blood sugar, re-examination is required every 1 to 2 years; for those with mild lesions, every 6 to 12 months; for those with moderate to severe lesions, every 3 to 6 months, strictly follow the doctor's specific instructions.

Periodontal Tissues: Redness and Atrophy

People with diabetes face a much higher risk of periodontal diseases than the general population. Early symptoms include red and swollen gums, bleeding during brushing, gum recession, and tartar buildup. If left untreated, the condition will progress to loose teeth, and even tooth loss.

It is recommended that people with diabetes undergo a comprehensive oral examination once a year. Seek medical attention as soon as possible if symptoms such as gum bleeding, periodontitis, loose teeth, unhealed oral ulcers, facial swelling or fever appear. Before undergoing procedures such as tooth extraction or dental implant, communicate your blood sugar status clearly with your dentist.

Heart: Chest Tightness and Shortness of Breath

After cardiac autonomic neuropathy occurs, people with diabetes will experience a faster resting heart rate, a heart rate that cannot flexibly adjust with physical activity, and orthostatic hypotension, often accompanied by dizziness, palpitations, and blackouts when standing up. However, most diabetic patients do not experience typical pain during heart disease attacks. Atypical warning signs include chest tightness, shortness of breath, sudden awakening with dyspnea at night, nausea, vomiting, upper abdominal distension and pain, gastric discomfort, sudden cold sweats, unexplained fatigue and dizziness, and even syncope.

It is recommended that people with diabetes complete an electrocardiogram immediately after diagnosis. For those with high-risk factors such as combined hyperlipidemia, hypertension and obesity, regular special coronary artery evaluations are required. Once the above symptoms appear, stay highly alert to myocardial infarction and call 120 immediately.

Kidneys: Foamy Urine

Abnormally increased foam in urine is a typical early sign of diabetic nephropathy. The urine will contain fine, dense foam that is difficult to dissipate even after standing for more than ten minutes. Some patients also experience an increased frequency of urination at night.

Patients with type 2 diabetes should start their first kidney disease screening at the time of diagnosis, while those with type 1 diabetes should do so 5 years after diagnosis. After that, the urine albumin/creatinine ratio should be tested at least once a year. It is important to note that negative urine protein in routine urine tests and normal serum creatinine do not mean there is no kidney damage. The kidneys have strong compensatory capacity, and serum creatinine will not show abnormalities until more than half of the kidney function is lost.

Gastrointestinal Tract: Abdominal Distension and Nausea

Gastrointestinal abnormalities in people with diabetes manifest as feeling full after eating a small amount of food, frequent abdominal distension and nausea, and alternating intractable constipation and unexplained diarrhea without fever or abdominal pain. These problems are mainly caused by autonomic nerve damage, high blood sugar inhibiting gastric contraction, and disrupted gastrointestinal rhythm.

Under medical guidance, prioritize medications that have minimal impact on the gastrointestinal tract. Some hypoglycemic drugs may cause nausea, abdominal distension or diarrhea in the initial stage, and these symptoms usually resolve on their own when taken with meals or after the body adapts. However, if symptoms such as difficulty swallowing, vomiting of undigested food from the previous night, unexplained weight loss, black stools or sudden severe pain appear, seek medical attention as soon as possible. Do not use over-the-counter gastrointestinal medications to mask the condition on your own.

Bladder: Abnormal Urination

Bladder dysfunction caused by diabetic autonomic neuropathy mainly manifests as urinary retention and urinary incontinence. Urinary retention refers to difficulty urinating, thin urine stream, and a persistent feeling of incomplete emptying after urination. Urinary incontinence manifests as frequent urination, urgent urination and urine leakage, which may lead to urinary tract infections in patients.

It is recommended that people with diabetes undergo at least one urinalysis and urinary system ultrasound examination every year. Seek medical attention promptly once abnormal urination symptoms appear.

Lower Limbs: Leg Pain and Intermittent Claudication

Intermittent claudication and resting pain are the core symptoms of lower limb vascular lesions. After walking for a certain distance, patients will experience soreness and stabbing pain in the calves. The pain is relieved after rest, but will recur when they start walking again. As the condition worsens, the legs will continue to hurt even at rest.

Peripheral neuropathy usually occurs symmetrically on both sides, with more severe symptoms in the distal parts of the limbs than the proximal parts. Early manifestations include weakness in the lower limbs, reduced limb tactile sensation, and typical symptoms such as numbness, stabbing pain and burning sensation in the toes. In the advanced stage of the disease, the pain, touch and temperature sensation in the feet will be completely lost. Patients are unable to detect foot injuries, which easily leads to foot infections, ulcers, and eventually diabetic foot. Early warning signs of diabetic foot include thickened calluses, foot deformities, and reduced sensory perception.

People with diabetes may also develop diabetic muscular atrophy, which mostly affects the lumbosacral plexus. It manifests as unexplained pain in one thigh and hip, and difficulty exerting force when walking, which can be easily confused with the symptoms of lumbar disc herniation.

Patients with type 2 diabetes should complete their first nerve screening at the time of diagnosis, while those with type 1 diabetes should do so 5 years after diagnosis. After that, re-examination should be carried out at least once a year. At the same time, it is recommended that people with diabetes aged 40 and above undergo at least one special lower limb vascular assessment every year. In daily life, patients can touch their dorsal foot artery by themselves. If the pulsation is significantly weakened, it most likely indicates that there is stenosis or blockage in the lower limb blood vessels. They can also measure the calf circumference regularly to preliminarily judge the changes in muscle volume.

This article is reprinted with permission from Life Times

[Disclaimer: The information in this article is for popular science reference only and does not constitute medical diagnosis advice.]