患糖尿病後會有甚麼併發症？
What are the complications of Diabetes Mellitus?
(一) 急性併發症 Acute complications
- 急性血糖過低 Acute Hypoglycemia (abnormally low level of blood sugar)
患者可能出現會出心跳加速、嚴重饑餓、頭暈、眼花、震顫、發抖、冒冷汗、嘴唇、舌頭或手指有麻痺感覺，昏昏欲睡、甚至昏迷不醒。若患者清醒，可服用10-15克醣類，如方糖/果汁糖3粒，3茶匙砂糖，或普通汽水/果汁1/2杯，徵狀改善後加麵包1小片或餅乾3-4塊。Patients may have cold sweat, shakiness, pallor, racing heartbeat, drowsiness or even unconsciousness. If the patient is conscious, 10-15g of carbohydrate can be applied, e.g. 3 lumps of cube sugar/ fruit candies, or 1/2 glass of normal soft drinks/fruit juice, and take 3-4 biscuits after the symptoms are improved. - 急性血糖過高 Acute Hyperglycemia (abnormally high level of blood sugar)
患者可能會呼吸快而深、有噁心、嘔吐、劇渴現象、並引致神智不清或昏迷情況。此時患者應盡快送院醫治。Patients may have deep, rapid breathing, nausea, vomiting and excessive thirst leading to unconsciousness or coma (a state of prolonged unconsciousness). Patients in this stage should be admitted to hospital as soon as possible.
(二) 慢性併發症 Chronic complications
若糖尿病控制不當，血糖長期偏高，血管和神經系統容易受到損壞，令身體器官長期受損，甚至喪失功能。If diabetes mellitus is not adequately controlled and glucose level remains high over prolonged period, blood vessels and nervous system are easily impaired and result in long-term damage of organs or even failure.
| 器官 Organ | 併發症 Complications |
| 腦 Brain | 腦血管病如中風等 Cerebrovascular disease, e.g. stroke |
| 眼睛 Eyes | 視網膜病變、白內障、青光眼 Retinopathy, cataract, glaucoma |
| 心臟及血管 Heart and blood vessels | 冠心病、心臟衰竭、高血壓 Coronary artery disease, heart failure, high blood pressure |
| 腎臟 Kidneys | 蛋白尿、感染、腎功能衰竭 Proteinuria, infection, kidney failure |
| 足部 Foot | 神經病變、血管病變、潰瘍、感染(下肢潰瘍感染長期不癒者，可能需要截除下肢) Neuropathy, vasculopathy, ulcer, infection (Those who suffer from long-term ulcer of lower limbs may need amputation) |
理想的血糖控制可減低併發症，透過以下方法可得知血糖控制情況：
Ideal glucose control can reduce complications. The conditions of glucose control could be known by the following methods:
(1) 糖化血紅蛋白 (HbA1C)
血紅素是紅血球中的一種蛋白質，它會將氧氣帶到身體組織並將二氧化碳帶離組織。血液中的葡萄糖可以附在血紅素上。由於紅血球的平均壽命約3個月，透過量度HbA1C，便可反映病友過去2-3個月的平均血糖水平。Haemoglobin is a kind of protein in red blood cell which carries oxygen to body tissue and carbon dioxide away from body tissue. Glucose in blood can attach to haemoglobin. Since red blood cell has an average life of about 3 months, the average glucose level in the last 2-3 months of patients can be shown by measuring of HbA1c.
理想的HbA1C水平應保持在<6.5%。研究發現，HbA1C每下降1%，可以降低因糖尿病而死亡的風險21%，微血管病(如視網膜病變、腎功能衰竭等)之風險37%。The ideal HbA1c level should be kept at <6.5%. Studies show that 1% decrease in HbA1c could reduce the risk of death of diabetes mellitus by 21% and diseases of capillary (e.g. retinopathy, kidney failure, etc.) by 37%.
(2) 空腹及餐後血糖值 Blood glucose value of fasting and after meal
| 血糖值 Blood glucose value (mmol/L) | 理想 Ideal | 普通 Normal | 欠佳 Poor |
| 空腹 Fasting | 4.0-6.0 | <8.0 | >10.0 |
| 餐後2小時 2 hours after meal | <8.0 | <10.0 | >12.0 |
研究發現，病友如可以定期自我監察血糖，能有助血糖控制，從而減低出現併發症。Researches show that if patients could monitor glucose regularly by themselves, blood glucose could be better controlled and reduce the risk of complications.
(3) 尿糖 Urine sugar
我們可以利用尿糖試紙測試尿糖。當血糖值高於10mmol/L時，腎臟吸收能力下降，因此便會在尿液中驗出糖份。由此可見，尿糖測試不能準確反映真正的血糖值，亦無法顯示血糖過低的情況，並非病友用以監察血糖控制及減少併發症機會的最佳方法。此外，年紀和藥物都能影響尿糖測試的準確性。We can use Clinistix paper to test urine sugar. When blood glucose value is higher than 10mmol/L, the absorption capability of kidney decreases and therefore sugar could be found in urine. Hence, urince test for sugar cannot accurately reflect the true blood glucose value and fail to show hypoglycemic condition and it is not the best method to monitor glucose control by patients and reduce complications. In addition, age and drugs could also affect the accuracy of urine test of sugar.
