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| Complications of diabetes: what are the risks? |
Currently,
in Belarus, more than 300,000 people are suffering from diabetes. Metabolic
disorders lead to a constant increase in blood glucose. Diabetes usually
develops slowly, which is why in many cases it is diagnosed too late. Early
control of blood glucose levels threatens the development of complications,
sometimes more serious than diabetes itself.
The reason for the development of many concomitant
diseases in diabetes mellitus is hyperglycemia - a continuous increase in blood
glucose. Cells have to break down excess glucose, which in turn leads to the
formation of reactive oxygen species - free radicals, which create additional
problems. First, they cause damage to the blood vessels, leading to damage to the
nervous system, visual impairment, and, in time, the development of kidney
failure. Significantly increases the risk of myocardial infarction or stroke
due to the possible development of thrombosis and atherosclerosis.
Diabetes problems occur in many patients - it is
very important to identify the risk early.
Diabetic neuropathy - damage to the nervous system
in sugar
Due to damage to the blood vessels due to high
glucose levels in the blood, nerve fibers do not receive enough oxygen and
nutrients. Along with other metabolic processes caused by hyperglycemia, for
example, an increase in the production of so-called "end glycation
products" (AGE products), i.e., modified proteins or lipids, this leads to
gradual destruction of nerve fibers. On the other hand, AGE products increase
the production of active oxygen species and disrupt the function of antioxidant
systems; on the other hand, under oxidation conditions, production of AGE
products is enhanced, thus leading to the formation of a vicious cycle and leading
to the development of diabetic neuropathy - one of the most common diseases
associated with diabetes mellitus. This violation is seen in almost all three
diabetic patients and places significant limits on daily life. First, the
delicate nerve endings are damaged, which are responsible for the transmission
of pain and heat sensors. Neuropathy can affect the body's autonomic nervous
system. It provides independent control of the functions of the organs and the
whole body and cannot be controlled by humans consciously.
Symptoms of Diabetic Neuropathy
Diabetic neuropathy can thus manifest itself in
very different ways, depending on which nerves are affected by the wound.
Diabetic neuropathy can lead to loss of touch, pain, or fever. Leg numbness is
often seen as emotions no longer transmit emotions. The result of nerve
dysfunction can be the development of chronic pain syndrome, as well as
paresthesia. Paresthesia and pain can be manifested by shaking, crawling, and
fever. With the defeat of the autonomic (autonomic) nervous system, arrhythmia,
suspension problems, and lack of consensus of the other. Sometimes, due to
nerve damage, patients lose their ability to detect hypoglycemia, which puts
them at greater risk for diabetes. Like any disease,
Key features of the treatment of diabetic
neuropathy
When deciding on the treatment of diabetic
neuropathy, three important factors should always be considered:
• A key factor in gaining your blood sugar. This
can be achieved by changing lifestyle and, if necessary, adjusting drug
treatment.
• Generally, symptomatic treatment with
appropriate medication is used to improve the patient's condition.
• A third important factor is the inhibition of
pathological metabolic processes, for example, the production of the above-mentioned
AGE products, by benfotiamine. In addition, thioctic (alpha-lipoic) acid can be
used to facilitate oxidative reactions. These important biological factors can
be used to reduce symptoms, reduce disease progression, and prevent long-term
effects.
Diabetes Foot Syndrome - a common problem for diabetes
neuropathy
Disorders
of the nervous system due to diabetesic neuropathy and ulcers of the lateral
arteries can lead to amputation of the foot. As the nerves die in the leg, the
patient ceases to feel the damage and pressure points. The fact that a person
stops feeling the harmful effects (brushing, callus, sharp objects) leads to
the formation of wounds. Wounds are quickly infected, and the healing process
is slow. Abscesses may damage soft tissues and bones, which may eventually lead
to amputation of the foot or part of the foot. To prevent these processes,
prophylactic treatment should be mandatory and the feet should be checked
regularly.
Risk of thrombosis and occlusive lesion of the
peripheral artery as diabetic
Damage to the walls of blood vessels over time
leads to the formation of atherosclerosis. This leads to a decrease in blood
flow to the affected areas. As a result, the tissues that need the most oxygen
do not get enough oxygen. In addition, thrombi are easily formed in
atherosclerotic plaque. As a result of thrombosis, the risk of developing
myocardial infarction and stroke is greatly increased. In particular, patients
with type 2 diabetes are more likely to have a stroke, as they are more likely
to have lipid metabolism disorders and high blood pressure. But it should be
noted that patients with type 1 diabetes are also more likely to have a stroke,
compared with healthy people.
Intermittent claudicating disease
is associated with diabetes
The narrowing of the lower extremity arteries is
called chronic occlusion of the lower extremity arteries (HOZANK). Initially,
the disease manifests itself as weakness and muscle spasms due to poor blood
flow, later pain in the legs, especially while walking. Because of the pain,
the patient has to stop while walking to rest. In the later stages, the disease
can lead to necrosis and, as a result, amputation of the affected organ. Since
the first symptoms appear only with 90% artery stenosis, it is important to
take steps to prevent this problem even when there are no symptoms.
Kidney damage to sugar - diabetes as a
co-occurring disease
Constant increase in blood glucose damages the
small capillaries of the kidneys. Due to the gradual decrease in renal glomeruli
activity, detoxification mechanisms are gradually deteriorating, which plays an
important role in ensuring kidney function. Damage caused by diabetes is seen
in about 1 in 10 patients with diabetes. This damage may already have occurred
at the onset of diabetes mellitus, and over time, its course may improve
without any obvious manifestations. Symptoms of the disease and symptoms of
intoxication develop in most patients only at the end of the disease. If the
result is negative, the kidneys may stop working. In this case, the only way to
improve the patient's condition is dialysis or kidney transplantation. Kidney
disease can be diagnosed in the early stages according to the results of a
blood test, so such tests should be performed regularly.
Retinal injury as a concomitant disease in
diabetes mellitus - diabetesic retinopathy
The effects of high blood sugar also affect the
retina capillaries. Diabetes retinopathy is a common cause of blindness. As a
result of cell death of small retinal vessels, vascular aneurysms and
occlusions are formed, which can lead to bleeding due to rupture of small
arteries.
To compensate for the loss of arteries, new ones
are formed, but they also break down easily, which can lead to retina
formation. Along with other preventive measures, laser treatment can help stop
the spread of symptoms. To diagnose during diabetes retinopathy, regular visits
by an ophthalmologist are required.
Recognition and prevention of early stages of
diabetes-related illnesses
After the diagnosis of diabetes, the patient
should be tested for compatible diseases. As diabetes progresses, patients need
to monitor the state of the nervous system and to detect problems in the early
stages of treatment. In this case, it is important to monitor the patient's
complaints, measure blood pressure, and assess leg sensitivity. Sensitivity is
often tested with a tuning fork because for the first time with diabetes, the
nerve fibers that sense sensitivity suffer.
A healthy lifestyle as a factor in preventing
diabetes-related illnesses
There are a number of steps that diabetic patients
can take to prevent the development or progression of complications. First, you
must stop smoking and cut down on alcohol. Smoking adversely affects the
condition of blood vessels, putting additional blood vessels at risk. Because
of their neurotoxic effect, alcohol is banned mainly in patients with diabetic
neuropathy. The liver is unable to effectively control blood sugar at the same
time as the decline in alcohol consumption. This can lead to the development of
hypoglycemia.
A healthy diet, combined with adequate exercise
and weight control - these are the steps you can be thankful for that can
reduce the growth of symptoms, despite the presence of diabetes mellitus. In
addition to controlling blood sugar levels, effective control of blood pressure
and blood lipids should be provided to improve the protection of blood vessels.
