Impairment of growth and susceptibility to certain infections can occur as a result of chronic hyperglycemia.Acute hyperglycemia involving glucose levels that are extremely high is a medical emergency and can rapidly produce serious complications (such as fluid loss through osmotic diuresis). It is most often seen in persons who have uncontrolled insulin-dependent diabetes.The following symptoms may be associated with acute or chronic hyperglycemia, with the first three composing the classic hyperglycemic triad:
Polyphagia – frequent hunger, especially pronounced hunger
Polydipsia – frequent thirst, especially excessive thirst
Polyuria – increased volume of urination (not an increased frequency, although it is a common consequence)
Blurred vision
Fatigue
Restlessness
Weight loss or weight gain
Poor wound healing (cuts, scrapes, etc.) Dry mouth
Dry or itchy skin
Tingling in feet or heels
Erectile dysfunction
Recurrent infections, external ear infections (swimmers ear)
Delayed gastric emptying
Cardiac arrhythmia
Stupor
Coma
Seizures
Abnormal movements: chorea, choreoathetosis, ballism, dystonia, opsoclonus-myoclonus, parkinsonism, hemifacial spasm, and Holmes tremorFrequent hunger without other symptoms can also indicate that blood sugar levels are too low. This may occur when people who have diabetes take too much oral hypoglycemic medication or insulin for the amount of food they eat. The resulting drop in blood sugar level to below the normal range prompts a hunger response.Polydipsia and polyuria occur when blood glucose levels rise high enough to result in excretion of excess glucose via the kidneys, which leads to the presence of glucose in the urine.
Other immunosuppressive agents used to treat the inflammation associated with dermatomyositis include cyclosporine A, cyclophosphamide, and tacrolimus.Physical therapy is usually recommended to prevent muscle atrophy and to regain muscle strength and range of motion. Many individuals with dermatomyositis may need a topical ointment, such as topical corticosteroids, for their skin disorder. They should wear high-protection sunscreen and protective clothing. Surgery may be required to remove calcium deposits that cause nerve pain and recurrent infections.Antimalarial medications, especially hydroxychloroquine and chloroquine, are used to treat the rashes, as is done for similar conditions.Rituximab is used when people do not respond to other treatments.As of 2016, treatments for amyopathic dermatomyositis in adults did not have a strong evidence base; published treatments included antimalarial medications, steroids, taken or orally or applied to the skin, calcineurin inhibitors applied to the skin, dapsone, intravenous immunoglobulin, methotrexate, azathioprine, and mycophenolate mofetil. None appears to be very effective; among them, intravenous immunoglobulin has had the best outcomes. Prognosis
Before the advent of modern treatments such as prednisone, intravenous immunoglobulin, plasmapheresis, chemotherapies, and other drugs, the prognosis was poor.The cutaneous manifestations of dermatomyositis may or may not improve with therapy in parallel with the improvement of the myositis. In some people, the weakness and rash resolve together. In others, the two are not linked, with one or the other being more challenging to control. Often, cutaneous disease persists after adequate control of the muscle disease.The risk of death from the condition is much higher if the heart or lungs are affected.