Advances in the diagnostics and therapy of acute and chronic complications of diabetes mellitus

Acute as well as chronic complications of diabetes mellitus are caused by inadequate metabolic therapy. The main acute complications, always aetiologically connected with absolute or relative insulin deficit, are diabetic ketoacidosis, lactic acidosis and the non-ketotic hyperosmolar syndrome. The suspicion or diagnosis of these acute, metabolic disturbances always requires hospitalization and emergency intensive therapy.
The long-term “toxic” action of chronic hyperglycaemia on all types of vessels is the cause of several microangiopathic syndromes (retinopathy, nephropathy) as well as of macroangiopathic complications such as ischaemic disease of the heart, brain or lower extremities. Corresponding mechanisms are involved in the appearance of nervous system degeneration – diabetic neuropathy. Early intensive “near-normalization” of glycaemia exerts a preventive influence. In any efficient plan of diabetes mellitus therapy it is therefore mandatory to diagnose sufficiently early all risk factors and early symptoms of diabetic complications. It creates the chance to apply specific methods for delaying their progress and decreasing the danger of the involved organs’ insufficiency.