Type 2 diabetes is not a sentence, but a condition that can and should be controlled. When this control is effective, a person can live a full life. However, when the disease gets out of control, a state develops that doctors call decompensated diabetes mellitus.
In simple terms, decompensation means a persistent and significant elevation of blood glucose levels due to ineffective treatment or lack of treatment. The body can no longer cope with the effects of high sugar levels, and serious complications begin to develop.
How to Recognize Decompensation? Key Signs and Symptoms
Decompensation does not occur suddenly. It develops gradually, and its symptoms are often ignored. Pay attention to the following warning signs:
Constant thirst and dry mouth: A person drinks a lot but cannot quench their thirst.
Frequent and excessive urination: The body tries to eliminate excess glucose through urine.
Severe weakness and fatigue: Cells do not receive energy because glucose cannot enter them effectively without insulin.
Skin itching, especially in the genital area.
Sudden weight changes: Most often weight loss, as the body begins breaking down fat and muscle to obtain energy.
Slow healing of wounds and cuts.
Worsening vision: “Haze” or blurred vision.
Frequent infections (fungal or bacterial).
An objective indicator of decompensation is consistently high blood glucose readings during self-monitoring and poor laboratory test results.
Diagnostic Criteria: When Is Diabetes Considered Decompensated?
Doctors make this diagnosis based on laboratory data:
Glycated hemoglobin (HbA1c) > 7.0%.
This is the most important marker, reflecting average blood glucose levels over the past 2–3 months.Fasting blood glucose > 7.0 mmol/L.
Blood glucose 2 hours after meals > 10.0 mmol/L.
The higher these values, the more severe the degree of decompensation.
Why Is This Condition Dangerous? Consequences of Decompensated Diabetes
Persistently high blood glucose acts like a toxin, slowly damaging blood vessels and nerves throughout the body. The consequences can be acute or chronic.
Acute Complications (Require Emergency Care)
Hyperglycemic coma – an extremely dangerous condition with loss of consciousness caused by critically high blood glucose levels.
Ketoacidosis – although more typical of type 1 diabetes, it can also occur in type 2 diabetes under conditions of severe stress or infection. The body begins breaking down fats, producing toxic ketone bodies.
Chronic Complications (Develop Over Years, Often Irreversible)
Damage to heart and brain vessels → increased risk of heart attack and stroke.
Diabetic retinopathy → damage to retinal blood vessels, potentially leading to blindness.
Diabetic nephropathy → kidney damage, up to kidney failure.
Diabetic neuropathy → nerve damage causing numbness, pain in the legs, and erectile dysfunction.
Diabetic foot syndrome → ulcers, gangrene, and risk of amputation.
What Leads to Decompensation? Main Causes
Non-adherence to diet (excessive intake of fast carbohydrates, overeating).
Irregular use or self-discontinuation of glucose-lowering medications.
Incorrect medication dosage (too low).
Refusal of insulin therapy when it has been prescribed by a doctor.
Sedentary lifestyle.
Stress and infectious diseases, which raise blood glucose levels.
Lack of self-monitoring (no regular blood glucose measurements).
How to Recover from Decompensation?
Reversing decompensation is a complex task that requires close cooperation with an endocrinologist. The action plan is always individualized, but typically includes:
Therapy adjustment: The doctor will review medication doses and regimens, or prescribe/adjust insulin therapy.
Strict dietary adherence: Returning to the basics—carbohydrate counting, eliminating sugar and refined flour, portion control.
Increased physical activity: Regular, appropriately dosed exercise helps reduce insulin resistance.
Intensified self-monitoring: Blood glucose must be checked more frequently (before and after meals) to understand how food, medications, and activity affect levels.
Treatment of comorbid conditions and control of blood pressure and cholesterol.
Conclusion
Decompensated diabetes is an alarm signal indicating that the current treatment strategy is not working. It is a dangerous but reversible condition. Recognizing the problem, seeking medical help promptly, and being ready to make serious lifestyle changes are the only ways to regain control over the disease and prevent severe complications.