|6 Major Complications of Diabetes Mellitus [message #531]
||Thu, 30 April 2020 19:08
Registered: January 2020
Diabetes is a condition that is characterized by the body’s inability to control glucose levels. The complications of diabetes are sequel to glycogen coating the major and minor vessels, through a process known as Glycation.|
How Diabetes causes Hypertension
Glucose is converted to glycogen for storage by the liver, when in excess. When needed, it is then broken back to glucose through a process known as glycogenolysis. Excessive sugars lead to excess glucose in the bloodstream, which leads to the glycation of proteins. The end result is the formation of advanced glycation end products (AGEs).
AGEs lead to collagen deposition on the vessels, making them stiff.
Fibrin and albumin are also deposited leading to alteration of the vessel components. Antibodies then form against these end products of glycation, which eventually leads to Inflammation of the vessels. In the end, inflammation and healing leads to atherosclerosis which is the mother of all problems.
Atherosclerosis narrows down vessels, which leads to increased pressure at which blood passes. The elevated blood pressure affects the heart, kidney, vessels, nerves, brain and the eyes.
Cardiovascular Diseases- Diabetes predisposes one to blood pressure, which can leads to hypertensive heart disease, angina, coronary heart disease, acute myocardial infarctions and strokes. The fragility of vessels, as a result of fibrin and collagen deposition, increases the chances of vessel collapse.
Stroke- Stroke is characterized by one sided paralysis. It occurs on the opposite side to where the vessel ruptured in the brain. It occurs sequel; to hypertension.
Neuropathy- Neuropathy is abnormal nerve conduction. It presents as a feeling of pins and needles and pain that is pierces your extremities. Nerves are supplied by micro-vessels called vasa vasora that keep them alive. When gylcation of vessels occurs, these vessel narrow and blood supply to these nerves is affected. The symptomatology results in inability to feel pain, and abnormal sensations felt.
Examples of neuropathies are:
Erectile dysfunction in men
Diarrhea and constipation/
Chronic Kidney Disease (CKD)- The kidney’s functioning unit is called a nephron. These nephrons are supplied by micro vessels. When one has uncontrolled diabetes, these vessels no longer carry transport efficiently. The nephron’s activity fails due to decreased blood levels, and hence the kidney fails to function. Chronic kidney disease is the most common cause of death in diabetic patients, according to the W.H.O. Patients with acute illnesses such as the recent Corona virus are likely to succumb, when compared to their peers without CKD. The kidney’s role is to prevent glucose and proteins from being excreted in urine. When this function fails, these products cause even further damage to the kidney as they are being excreted.
Retinopathy/ Blindness- Diabetes affects eyesight through action on the micro vessels that affect supply the retina. The retina is a light sensitive area, which converts the signals received to nerve conductance to the brain.
There are two stages in retina involvement
Non-proliferative stage-no symptoms occur, other than the constriction of the vessels due to build up glycogen.
Proliferative stage-Vessels start to clog. In response, the body generates new vessels. At the proliferative stage is where symptoms such as blood vision, color blindness, poor night vision and total blindness.
Other complications involving the retina are:
Diabetic ketoacidosis-Insulin drives into cells, from the blood stream. This provides energy for muscle cells and brain cells. Lack on insulin makes sugar to remain in the bloodstream. As a result of lack of glucose for energy, cells result to using fat for energy (KETONES). As a result, acid builds up in the body leading to acidotic state that causes a coma. Treatment is insulin and hydration.
Hyperglycemic hyperosmolar state- Occurs when glucose concentration in the bloodstream, overshadows the normal concentration. This leads to an osmotic reaction where water is drawn from cells, leaving the patient in a dehydrated state. This induces a coma.
Drug’s side effects
Other complications that affect diabetic patients occur as side effects of the drugs consumed. An example is Furosemide a drug used in chronic kidney disease causes reversible deafness.