Failure to Diagnose Diabetes

Diabetes is a dangerous, and sometimes fatal disease, especially if left untreated. Diabetes can be caused either by genetic susceptibility and environmental factors, or come on later in life as a result of other health conditions. Even so, it can be difficult to get a proper and timely diagnosis

Delayed or misdiagnosis is actually astonishing when it comes to diabetes, considering nearly 1 in 10 people in the United States suffers from the disease, making the proper diagnosis and treatment essential to the health of the American population. When diabetes is left unchecked due to misdiagnosis, bodies quickly become irreparably damaged. 

What causes diabetes, what treatments are available and what are some of their risks, and what happens if diabetes is left untreated or diagnosed? 

What Causes Diabetes?

If the system in the body that is meant to regulate blood sugar ceases to function correctly, excess sugar is left in the bloodstream. This inability within the body to regulate blood sugar is called diabetes. Both insulin and glucagon are part of this regulatory process. Insulin is a hormone that comes from a gland found near the stomach called the pancreas. The pancreas is responsible for secreting the right amount of insulin into the bloodstream. 

Insulin then circulates, enabling glucose to enter the cells of the body, which in turn lowers the overall amount of glucose in the bloodstream. As blood sugar drops, so does the secretion of insulin from the pancreas, and the cycle is complete.

Conversely, glucose, which is a form of sugar, is a source of energy for the cells that make up muscles and other tissues within the body. Glucose originates from two major sources: food and the liver. Sugar is then absorbed into the bloodstream, where it enters cells. The liver then stores the sugar and makes glucose. When glucose levels in the body are low, the liver will secrete glucagon which releases the stored glucose and keeps the body within a normal blood sugar range. 

What are the Three Types of Diabetes and Their Causes?

Each type of diabetes has a distinctly different cause, yet has surprisingly similar symptoms. 

Type 1 Diabetes: an autoimmune disease wherein the pancreas stops producing insulin—a hormone that allows the body to get energy from food. It is a chronic condition in which the pancreas produces little or no insulin. Different factors, including genetics and some viruses, may contribute to type 1 diabetes. Although type 1 diabetes usually appears during childhood or adolescence, it can develop in adults, and for the most part, the exact cause is unknown.

Type 2 Diabetes: insulin resistance caused by the body’s inability to use glucose properly. As a result, the pancreas makes extra insulin to compensate, however, over time it is unable to continue to produce enough insulin to maintain balance. In this case, it is an impairment in the way the body regulates and uses glucose as a fuel that creates the issues. This chronic condition results in too much sugar circulating in the bloodstream. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous, and immune systems.

Gestational Diabetes: a type of diabetes diagnosed for the first time during pregnancy. Like other types of diabetes, gestational diabetes affects how cells use glucose. This type of diabetes occurs when the various hormones working to keep blood sugar levels in check, ceases to function effectively. The exact reason is not known why some women get gestational diabetes and others don’t, but when hormone levels change because of pregnancy, this may also interfere with blood sugar-regulating hormones, as well.

What are the Signs and Symptoms of Diabetes?

The signs and symptoms of all types of diabetes do not vary widely. The severity of the symptoms of each individual patient experiences can, however, vary, depending on how much the patient’s blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms at all. 

Some of the major signs and symptoms of type 1 and type 2 diabetes are increased thirst, frequent urination, extreme hunger, unexplained weight loss, presence of ketones in the liver, fatigue, irritability, blurred vision, and slow healing sores and infections. 

What are the Treatment Options Available for Diabetes?

Each type of diabetes requires a specific type of treatment, ranging from medications to lifestyle changes. Insulin and other oral medications, in combination with blood sugar monitoring, may be necessary. Others may be able to manage their blood sugar by eating a healthy diet and engaging in regular, moderate to strenuous physical activity. 

The overall treatment for patients suffering any type of diabetes is caring for the general health of a patient, starting with maintaining a healthy weight through a good diet and exercise plan.  

Type 1 and Type 2 Diabetes: Specific Treatments

Treatment for type 1 diabetes requires insulin injections or the use of an insulin pump. This goes in tandem with frequent blood sugar checks. Type 2 diabetes treatments involve primarily lifestyle changes on top of blood sugar monitoring medications, insulin, or both. 

Blood Sugar Monitoring

Depending on the individual treatment plan, it may be necessary for a patient to check their blood sugar levels up to four times a day, and even more often if the patient is also taking insulin. 

Those receiving insulin therapy have the option to monitor their blood sugar levels with a continuous glucose monitor. A continuous monitor can not completely replace a glucose meter, but it can drastically reduce the number of fingersticks necessary to check blood sugar levels, and at the rate necessary for proper monitoring and provide information about trends in blood sugar levels.

A1C Testing

An A1C test can be used to measure average blood sugar levels for the past two or three months. A1C testing along with daily blood sugar level monitoring is usually recommended for diabetes patients.

Though repeated daily blood sugar tests are likely part of a daily treatment plan, A1C testing is a better overall indicator of how well blood sugar is being regulated by the patient’s treatment plan over time. An elevated A1C level may signal the need for a change in either oral medication, insulin regime, or meal plan.


People with type 1 diabetes require insulin therapy to survive. People with type 2 and gestational diabetes may require insulin therapy, but not in every case. 

There are various types of insulin that may be used at different times of the day. Insulin can be short-acting, rapid-acting, and long-acting, with myriad intermediate options. Because stomach enzymes interact with insulin, it can not be taken orally. It must be injected using a fine needle and syringe or an insulin pen

An insulin pump is another type of insulin delivery system. A tube carries the insulin from the reservoir inside of the device through a catheter that is inserted under the skin. There is also a tubeless pump option available. The insulin pump can be adjusted to deliver more or less insulin depending on meals, activity, and blood sugar levels.

Oral and Other Medications

There are medications available that can be taken orally to treat diabetes. Some of these medications are able to stimulate the pancreas into producing and releasing more insulin. Another oral medication inhibits the production and release of glucose from the liver creating less of a need for insulin. 

Yet another type of medication works within the stomach before the body even breaks it down into sugar by blocking the action of stomach enzymes that break down the carbohydrates or make tissues more sensitive to insulin. Lastly, there is also a medication on the market that inhibits the kidneys from reabsorbing sugar back into the body and it is excreted as waste in the urine. 


People who suffer from type 1 diabetes may benefit from a pancreas transplant. A successful pancreas transplant patient would no longer need insulin therapy.

Unfortunately, transplants are not always successful. These types of procedures can pose serious risks. Once the transplant is complete, the patient will need a lifetime of immunosuppressant drugs to prevent organ rejection. 

Because these medications can have serious side effects, transplants are usually reserved for patients who can not control their diabetes at all or those who also need a kidney transplant.

What Happens if Diabetes is Left Untreated?

There are serious long-term effects on the body if blood sugar levels are left unchecked for long periods of time. High levels of sugar in the blood can quickly damage the vessels that supply oxygen to organs.

Kidney Damage

One of the organs most commonly damaged by high blood sugar are the kidneys. The kidneys are responsible for filtering out waste products from the body, and a damaged kidney is unable to effectively filter waste from the bloodstream. One of the tell-tale signs of poor kidney function is microalbuminuria, or elevated levels of protein in the urine. 

Kidney disease, when related to diabetes, is called diabetic nephropathy. Diabetic nephropathy is a progressive disease and is not apparent initially and requires a test to evaluate whether or not the patient is at risk.

Circulatory System

Because diabetes raises the risk of developing high blood pressure, it can put strain on the heart. This is due to high glucose levels, which can contribute to the formation of fatty deposits in the blood vessel walls. Over time, blood restriction within the vessels can increase the risk of atherosclerosis which is the hardening of blood vessels.

The effects of diabetes can cast a wide net as it can double both the risk of heart disease and stroke. This makes it even more important for patients who suffer from diabetes to engage in regular exercise and commit to a healthy diet.

The lack of blood flow caused by vessel hardening and fatty deposits can eventually begin to affect the hands and feet and cause pain. For example, a patient’s feet may feel cold, or conversely, they may be unable to feel heat due to lack of sensation. This condition is known as peripheral neuropathy, which is a type of diabetic neuropathy that causes decreased sensation in the extremities. It’s particularly dangerous because it may prevent someone from noticing an injury or infection.

Diabetes also increases the risk of developing infections or ulcers of the foot. Poor blood flow and nerve damage increase the likelihood of having a foot or leg amputated.

Central Nervous System

Diabetes causes diabetic neuropathy or damage to the nerves. This can affect perceptions of heat, cold, and pain. It can also make someone more susceptible to injury. 

Diabetes can also lead to swollen, leaky blood vessels in the eye, called diabetic retinopathy. This can damage vision and  even lead to blindness. 

Reproductive System

The changing hormones during pregnancy can cause gestational diabetes and, in turn, increases the risk of high blood pressure. There are two types of high blood pressure conditions for pregnant women to be aware of, preeclampsia and eclampsia.

In most cases, gestational diabetes is easily controlled, and glucose levels return to normal after delivery. Symptoms are similar to other types of diabetes, but may also include repeated infections affecting the vagina and bladder. 

The risks associated with gestational diabetes affect both the mother and infant. It can make delivery more complicated, an infant may have a higher birth weight, and has a greater risk of developing type 2 diabetes.

Delayed or Missed Diagnosis

Diabetes is an all-encompassing disease that requires constant care and can cause damage to all body systems if not treated properly. A delay in diagnosis can lead to multisystem organ failure and damaged blood vessels causing constant pain. 

It is exceedingly important that a physician treating a patient suffering from diabetes, in any form, get proper and timely treatment to stave the oncoming tide of injuries that are caused by long-term high blood sugar in the bloodstream. 

If you or a loved one was injured or killed by a negligent physician to a misdiagnosis or treatment of diabetes, there is possible recourse. 

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