5 Deaths of Diabetes

 

There are many ways to die from diabetes, and as I have stated elsewhere diabetes will KILL you.  I wanted to delve a little deeper into how, exactly.  Below are my 5 deaths of diabetes: this is not an exhaustive list, diabetes refuses to be pigeonholed.  

 

1 Sepsis

Sepsis occurs when bacteria has begun to grow in and destroy tissues.  As the bacteria grows it gives off toxins (poisons) that pollute the bloodstream.  Unfortunately sepsis can begin very simply, as a cut or ingrown toenail, which is not improving.  This would usually be noticed immediately, and the wound would be very painful, but due to multiple factors the patient may not feel any pain.  As the infection increases in the patient, the body increases the blood glucose, which jams the immune system.  So the infection gets worse.  At it’s worst, sepsis will cause multiple organ failure, and will be fatal.  If you have diabetes, especially if it is poorly controlled, you may have little warning in this situation.  Checking your sugars regularly is crucial.  If you are not feeling well, let someone know, get help.

2 Myocardial Infarction (MI)

A myocardial infarction or heart attack.  In diabetes there are multiple forms of neuropathy, cardiac autonomic neuropathy affects the heart.  Neuropathy is loss of sensation, or more specifically pathology of the neural system.  Autonomic neuropathy is common, and being unfelt it will never be complained of by the patient.  The result of this is that in diabetes you are more likely to have a silent heart attack, no shoulder pain, no back pain, no crushing chest pain, just death.  If you, or your family members, have a history of heart disease then ask your doctor for more information.

3 End Stage Renal Disease (ESRD)

ESRD is the result of damage to your kidneys.  The kidneys function to filter the blood.  When glucose levels are too high, the glucose will be filtered by the kidney, and the kidney will be damaged.  This is one reason that labs are taken, one of the markers of kidney damage is blood or glucose in the urine.  This kidney damage is called diabetic nephropathy (dysfunction of the nephrons), and will lead to worsening kidney failure.  Once the kidneys have failed, you will require dialysis.  Dialysis is where you get to spend inordinate amounts of time with a large machine that will filter your blood for you.  As we have dialysis machines, this does not lead directly to death, but it’s not a sign of particularly good health either.  More info on how dialysis machines work here.  A Guide to Dialysis and Kidney Disease is also available from the National Council for Aging Care.

4 Amputation

It is a strange yet simple road that leads to amputation.  Amputation is most likely to occur in the legs or feet, which are also known as the lower extremities (in the literature it will often be noted as a lower extremity amputation).  Something as simple as ill-fitting shoes may cause a callus.  A callus if left untreated will cause an ulceration, an ulcer is a sore that does not heal. An ulcer if it progresses will become infected, this infection may reach the bloodstream (causing bacteremia and sepsis) or the bone (causing osteomyelitis – bone infection).  Once the infection reaches the bone it is very difficult to treat.  As the bacteria grows it eats through the bone, and walls itself off as it goes.  This makes it difficult for antibiotics to reach the bacteria.  Amputation is often required due to bone infection which has failed to respond to antibiotics.   

5 Depression

This last item is not a physical death, but more of a spiritual death.  Depression is noted to be vastly increased in both elderly patients and diabetics.  For those patients to whom both apply, they receive a double dose.  My other deaths of diabetes attach what you are, your physical structure.  Depression attacks who you are, and I feel that it is worse to lose who you are than what you are.  As a surgeon, I have seen patients recover from deaths one through four above.  We as a society have found replacements and amazing treatments for loss of many of the organs or systems above, but we cannot replace the soul.  

And there you have it, my 5 deaths of diabetes.  There are many other hazards here, and I’m sure that different physicians might choose different lists, but this one is mine.  Stay tuned for more great information, and make sure to sign up for our newsletter.  What is your number 1 death, or what complications are you most afraid of?  Feel free to share in the comments below.