Complications of Diabetes and How to Control Them

Complications of Diabetes and How to Control Them

Your Complete Guide for Pakistan | PharmaServePK

Diabetes is no longer just a “sugar problem” – it is the fastest-growing chronic disease in Pakistan. According to the International Diabetes Federation (IDF) 2024 report, more than 33 million Pakistanis are living with diabetes, and almost 50% don’t even know they have it. Uncontrolled diabetes silently damages almost every organ in the body.

Complications of Diabetes and How to Control Them

1. How Diabetes Damages the Body (The Silent Mechanism)

High blood glucose acts like sandpaper inside your blood vessels and poisons the small nerves over time. Two main processes are responsible:

Macro-vascular complications → Big blood vessels (heart attacks, strokes, leg amputations)

Micro-vascular complications → Small blood vessels (eyes, kidneys, nerves)

The good news? 80–90% of these complications can be prevented or delayed with proper control.

2. Cardiovascular Complications (No.1 Killer in Diabetic Patients)

Heart attack risk: 2–4 times higher

Stroke risk: 2–4 times higher

70% of people with diabetes die because of heart disease in Pakistan

Early signs Pakistani patients usually ignore:

Chest tightness after walking to the bazaar

Sudden breathlessness while climbing stairs

Pain in calves while walking (claudication)

How to protect your heart

Target HbA1c: <7% (or <6.5% if you are young and newly diagnosed)

Blood Pressure: <130/80 mmHg

LDL Cholesterol: <70 mg/dL (use Atorvastatin 20–40 mg daily if prescribed)

Quit smoking/beedi immediately

Daily 30–40 minute brisk walk (even inside your courtyard if outside is polluted)

3. Diabetic Nephropathy (Kidney Failure)

Pakistan has one of the highest rates of diabetic kidney disease in the world. Almost 1 in 3 patients on dialysis in Pakistan reached there because of uncontrolled diabetes.

Warning signs most people miss:

Foamy urine (protein leak)

Swelling on feet/ankles in the morning

Needing to wake up at night to urinate (nocturia)

Control strategy

Annual kidney function test (Serum Creatinine + eGFR + Urine ACR)

Keep BP <130/80 – ACE inhibitors (Enalapril, Lisinopril) or ARBs (Losartan, Telmisartan) are the best medicines for kidneys

SGLT2 inhibitors (Dapagliflozin, Empagliflozin) reduce kidney failure risk by 40% – now available in Pakistan as low-cost generics

Reduce salt to <5 g/day (one teaspoon)

4. Diabetic Retinopathy & Eye Damage

Every year, thousands of Pakistanis lose vision because of diabetes. Retinopathy is the leading cause of blindness in working-age adults.

Symptoms appear very late:

Blurring that comes and goes

Dark spots or flashes

Difficulty reading Quran or phone

Prevention is simple

Annual eye check-up with pupil dilation (fundus examination) – many eye clinics in Pakistan do it free on World Diabetes Day

Control sugar + BP + cholesterol

Laser treatment or Anti-VEGF injections (Lucentis/Accentrix) can save vision if done on time

5. Diabetic Neuropathy (Nerve Damage)

More than 50% of diabetic patients in Pakistan suffer from nerve pain or numbness.

Types you should know:

Burning feet syndrome (common in summer)

Numbness starting from toes → “walking on cotton” feeling

Severe stomach pain, loose motions alternating with constipation (gastroparesis)

Home remedies that actually work in Pakistan:

Capsaicin (mirchi) cream – apply on burning feet

Alpha-lipoic acid 600 mg daily (imported but effective)

Vitamin B-12 (Mecobalamin) injections if deficient

Pregabalin or Duloxetine (prescribed by neurologist)

6. Diabetic Foot & Amputation Risk

Pakistan has one of the highest lower-limb amputation rates in the world – most are preventable!

Daily foot care routine (takes only 2 minutes):

Wash feet with lukewarm water (not hot)

Dry properly, especially between toes

Apply moisturizer (avoid between toes)

Check for cuts, blisters, red spots

Never walk barefoot – even inside home

Choose footwear wisely: Bata’s “Power” or local “Servis Cheetah” diabetic shoes are good and affordable.

7. Infections – The Hidden Danger

Diabetics have weaker immunity. Common infections in Pakistan:

Urinary tract infections (especially women)

Skin infections/boils (balgam)

Tuberculosis (TB rates 5–10 times higher)

Fungal infections (daad, kharish)

Tips:

Keep sugar <180 mg/dL after meals

Get annual flu vaccine + Pneumococcal vaccine (Prevenar-13)

One-time Hepatitis B vaccination series

8. Sexual & Reproductive Complications

Erectile dysfunction → affects 60–70% men after 10 years of diabetes

PCOS & infertility in women

Higher risk of miscarriage

Solutions available in Pakistan:

Sildenafil (Vigore, Rigix) works well if sugar is controlled

Metformin + lifestyle helps PCOS

Pre-pregnancy sugar control (HbA1c <6.5%) drastically reduces complications

9. Your 7-Point Daily Control Checklist (Pakistan-Friendly)

Morning FBS (80–130 mg/dL)

2-hour post-meal <180 mg/dL

Take medicines on time (Metformin, Gliclazide, Empagliflozin, Insulin)

30–45 min walk or household work

Eat roti with high-fiber sabzi (avoid white rice/potato at night)

Drink 2–3 litres water

Sleep 7 hours – poor sleep raises sugar next day

10. Latest Medicines Available in Pakistan (2025)

Ozempic/Rybelsus (Semaglutide) → weekly injection or daily tablet

Mounjaro (Tirzepatide) → dual GLP-1/GIP – strongest sugar & weight reducer

Jardiance, Forxiga → protect heart + kidney + weight loss

Complications of Diabetes and How to Control Them

Final Word

Diabetes is a serious disease, but it is NOT a death sentence. Thousands of Pakistanis are living healthy, active lives even after 20–30 years of diabetes because they follow simple rules.

Start today. Check your sugar. See your doctor. Take your medicines. Walk daily.

Your eyes, kidneys, heart, and feet will thank you 10 years from now.

PharmaServePK – Serving Health, Saving Lives

Naeem Mustafa