Risk factors
There are several risk factors that can favor the development of diabetes, especially type 2 diabetes, which include the following:
- Overweight and lack of physical exercise
- Smoking
- Low-fiber, high-fat, and sugary diet
- Medications that can affect the body’s metabolism of carbohydrates
- Genetic factors that may cause some families to be more likely to develop diabetes
Complications and manifestations of diabetes
Individuals with diabetes are also at greater risk of developing cardiovascular diseases such as heart attack, stroke, or circulatory problems in the legs and feet (peripheral artery disease). These complications of diabetes are typically called "macrovascular" complications, which means that these complications affect the larger blood vessels. The risk of macrovascular complications is especially high in people who also have high blood pressure. In addition, if hyperglycemia persists over the years, the smaller blood vessels in the eyes, nerves, and kidneys can become damaged. These complications are called "microvascular" complications of diabetes.
Ketoacidosis is always a serious complication for type 1 diabetics. This condition results in the production of excess acetyl CoA which is converted to ketone bodies. Acidosis results and, if untreated or not resolved by the body, coma and death can occur. In type 2 diabetic patients, most often the acetyl CoA is converted to cholesterol resulting in hyperlipidemia and heart disease in these patients.
The elderly type 2 diabetic is at risk for a hyperosmolar nonketotic coma. The patient becomes dehydrated due to increased urine excretion to help lower blood glucose. If reduced renal or cardiac function is also present, glucose excretion is impaired and blood glucose concentrations can become extremely high. Ketones are not produced in excess; thus, the patient remains nonketotic. Insufficient hydration, elevated blood glucose, and decreased renal excretion of waste products result in an increased osmolality and total concentration of all plasma components.
