How Can Complications In Diabetes Affect The Blood Vessels
It is a well-known fact that various diabetic complications can lead to damage caused in various blood vessels of the body. When blood vessels of a particular organ are damaged effectively, the particular organ ceases to function in a normal healthy manner. The organs which are at a higher risk owing to diabetes and its related complications include the heart, the eyes, the human brain, as well as those of the kidneys.
How The Kidneys Work Or Dont
The kidneys main job is to filter accumulated waste products from normal cell function throughout the body and the food you eat and excess fluids from the blood and excrete them in your urine. Heres how it works.
Blood enters your kidneys through an artery, and urine exits your kidneys through tubes called ureters that lead to your bladder.
Your kidneys, which are each about the size of a fist and located below your rib cage on either side of your spine, each contain about 1 million nephrons, or filtering units. Each nephron contains a network of tiny blood vessels that acts as a filter, called a glomerulus.
Waste products as well as salt and minerals your body needs sodium, calcium, potassium, phosphorus are filtered into tiny tubules, where they are either reabsorbed into the blood or passed into urine.
When a nephron can no longer filter effectively because the glomerulus is damaged, the remaining working nephrons take on the extra work. At first, even if a large number of nephrons stop working, you wont experience a buildup of waste products or fluid.
But as more and more nephrons stop functioning, the remaining nephrons can no longer keep up, and waste products and fluid begin to accumulate in your body.
When your kidneys are not able to filter waste products from the blood as well as they should, you can develop CKD. This can lead to a gradual loss of kidney function, which can worsen over time and eventually lead to kidney failure if left untreated.
Diabetes And Cardiovascular Disease
Cardiovascular disease includes blood vessel disease, heart attack and stroke. It’s the leading cause of death in Australia.
The risk of cardiovascular disease is greater for people with diabetes, who often have increased cholesterol and blood pressure levels. Smoking, having a family history of cardiovascular disease and being inactive also increase your risk.To reduce your risk and pick up any problems early:
- Have your blood pressure checked at least every six months, or more often if you have high blood pressure or are taking medication to lower your blood pressure.
- Have your HbA1c checked at least every year, or three- to six-monthly if recommended.
- Have your cholesterol checked at least every year. Further pathology tests such as an electrocardiogram or exercise stress test may also be recommended by your doctor.
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Regular Eye Exams Are Important
All people with diabetes are at risk for diabetic retinopathy. Diabetic retinopathy develops over time and often goes unnoticed until vision loss occurs.
Following your diabetes ABCDEs and getting your eyes checked regularly by an ophthalmologist or optometrist are crucial to prevent vision loss or keep it from getting worse.
If you have diabetic retinopathy, very effective treatments are available. Your eye-care specialist will explain these to you.
Diabetes And Nerve Damage
Nerve damage can affect your hands, feet, legs, and arms.
High blood sugar can lead to nerve damage called diabetic neuropathy. You can prevent it or slow its progress by keeping your blood sugar as close to your target range as possible and maintaining a healthy lifestyle.
Managing your blood sugar is an essential part of your diabetes care plan. Not only does it help you with day-to-day wellness, it can help prevent serious health problems down the road.
Nerve damage is one possible complication from having high blood sugar levels for a long time. High blood sugar damages your nerves, and these nerves may stop sending messages to different parts of your body. Nerve damage can cause health problems ranging from mild numbness to pain that makes it hard to do normal activities.
Half of all people with diabetes have nerve damage. The good news is that you can help prevent or delay it by keeping your blood sugar as close to your target levels as possible. When you do this, youll also have more energy, and youll feel better!
Symptoms of nerve damage usually develop slowly, so its important to notice your symptoms early so you can take action to prevent it from getting more serious.
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Diabetes And Healthy Weight
If you are overweight, even losing a small amount of weight, especially around the abdomen, helps to lower your blood pressure, blood glucose and cholesterol levels.
It can be difficult trying to lose weight, so to get started set yourself a short-term, achievable goal. Try thinking about the food you are eating, whether you really need it, if it’s a healthy choice, and consider the portion size. An accredited practicing dietitian can help you set a realistic meal plan and answer any food related questions you may have.
How Does Diabetes Attack In Kidney Patients
If diabetes is not kept in control, the blood sugar level increases. This is called “hyperglycemia” . And, this high blood sugar can damage tiny blood vessels in your body. Imagine what happens to sugar cubes when it is left overnight unwrapped. It get all sticky and gluey. Now visualise how sugar “sticks” on your small blood vessels and makes it difficult for blood to flow to your organs. Damage to blood vessels happens most frequently in the eyes, feet, nerves, heart and kidneys. Think of your kidneys as a coffee filter. Your kidneys keep filter out the waste and excess fluid, and keeps things that you need within your body. The kidneys are full of small blood vessels. Over time, high blood sugar can cause these blood vessels to become all narrow and clogged. As the kidneys receives less blood, less waste and fluid is filtered out of your body. Kidney disease that is caused by diabetes is called “diabetic kidney disease.Continue reading > >
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How Does Diabetes Affect Our Kidneys
The kidneys filter nearly 200 quarts of our blood every day. Diabetes is a disease of excess sugar in our blood. To remove this excess glucose from the body, the kidneys are under extreme stress and this can easily result in a kidney disorder, called diabetic nephropathy. In 2011, diabetes caused nearly 44% of kidney failure cases. This makes diabetic kidney disease the Number One complication of diabetes one that is likely to affect almost every diabetic to some extent. In nearly half the cases of kidney disease, it could lead to kidney failure as well. Diabetes damages the kidneys and the urinary system in three main ways: Damage to blood vessels in the kidneys: Too much sugar damages the filters in the kidneys Damage to nerves: Fine nerves in the hands, feet, etc. are corroded by the extra sugar in the blood Damage to the urinary tract: Nerves run from our bladder to our brain and let us know when the bladder is full and we need to go. Damage to these nerves could mean we dont react when our bladder is full. Result: extra pressure on the kidneys. Retained urine can also allow urinary tract infections to grow and migrate back to the kidneys. Read this excellent article for more info on how diabetes affects kidneys and how to reduce the risks of diabetic nephropathy.Continue reading > >
Minimally Invasive Procedures And Surgery For Diabetic Arterial Disease
When diabetic arterial disease causes severe foot or calf pain, or when wounds develop on feet, your UPMC vascular surgeon may recommend minimally invasive interventions or surgery to restore circulation to your legs.
Minimally invasive treatments
In minimally invasive treatments, your vascular surgeon inserts a long flexible tube called a catheter into a blood vessel in your leg through a tiny incision. The surgeon guides the catheter to the site of the blockage.
The catheter can carry different devices, such as angioplasty balloons and stents. These devices help open blocked arteries and keep them open.
Leg bypass surgery
If your vascular surgeon cannot perform a minimally invasive procedure, he or she may recommend leg bypass surgery.
Your vascular surgeon makes an incision in your leg near the blocked artery. Using a part of one of your own veins or a synthetic blood vessel, the surgeon attaches one end to the artery above the blockage and the other end below the blockage.
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Why Choose Upmc For Diabetic Arterial Disease Care
- Vascular surgeons at the UPMC Heart and Vascular Institute treat more than 1,000 people with diabetic arterial disease each year.
- We pioneered wound care in western Pennsylvania, starting the first wound clinic in the area and providing expertise in evaluating and treating diabetic foot wounds.
- Our comprehensive, team-based approach includes vascular, orthopaedic, plastic, and general surgeons as well as podiatry and internal medicine professionals all working together to provide an effective treatment plan that is right for you.
For an appointment with a vascular specialist at the UPMC Heart and Vascular Institute, complete an appointment request form or call 1-855-876-2484 .
How Diabetes Can Affect The Eyes
Most people know that diabetes is about insulin abnormalities, whether its not producing enough insulin or bodys inability to recognize insulin and use it properly or resistance to insulin . Quite a few know that the pancreas is involved in this, and are at least vaguely aware that diabetes can result in a host of complications. The connection between the diabetes and those problems, however, is less clear. How can insulin affect the eyes or the kidneys or the limbs? Its not an unreasonable thing to wonder, but in fact the abnormal blood sugar due to diabetes can cause a variety of problems.
When sugar stays in the blood, it will weaken and damage blood vessels
By the time there are symptoms of diabetic retinopathy, the damage from it is already done
Moral of the lesson? Diabetes can do a lot of silent damage. Dont wait for that to become visible detect and prevent what you can.
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When To Get An Eye Exam
You should get an eye exam once a year, unless your ophthalmologist or optometrist has suggested something different. The risk of vision loss can be greatly reduced with regular checks. Remember, you may not be aware of changes to your vision and many problems can be treated when caught early.
If you notice any of the following changes to your vision, go see an eye doctor immediately:
- blurred vision
- flashes of light in the field of vision
- sudden loss of vision
- blotches or spots in vision
Diabetic retinopathy can worsen in pregnancy, so if you have diabetes you should have a diabetic eye exam before getting pregnant and while pregnant.
Reduce Your Risk Of Diabetic Retinopathy
You can reduce your risk of developing diabetic retinopathy, or help prevent it getting worse, by:
- controlling your blood sugar, blood pressure and cholesterol levels
- taking your diabetes medication as prescribed
- attending all your screening appointments
- getting medical advice quickly if you notice any changes to your vision
Read more about how to prevent diabetic retinopathy.
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How Does Diabetes Cause Kidney Disease
When our bodies digest the protein we eat, the process creates waste products. In the kidneys, millions of tiny blood vessels with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood.
Diabetes can damage this system. High levels of blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak and useful protein is lost in the urine. Having small amounts of protein in the urine is called microalbuminuria.
When kidney disease is diagnosed early, during microalbuminuria, several treatments may keep kidney disease from getting worse. Having larger amounts of protein in the urine is called macroalbuminuria. When kidney disease is caught later during macroalbuminuria, end-stage renal disease, or ESRD, usually follows.
In time, the stress of overwork causes the kidneys to lose their filtering ability. Waste products then start to build up in the blood. Finally, the kidneys fail. This failure, ESRD, is very serious. A person with ESRD needs to have a kidney transplant or to have the blood filtered by machine .
Similarities And Differences In Vascular Cell Biology In Diabetes
The alterations in cellular homeostasis and regulation of vascular physiology which leads to vascular complications affect all major functions of vascular cells . Increased vascular permeability and apoptosis of specific vascular cells, including retinal pericytes and glomerular podocytes, are prominent features of diabetic nephropathy and retinopathy. Macrophage apoptosis is important for plaque necrosis in atherosclerosis. Vasular beds in most tissues are affected by increased leukocyte adhesion which may participate in the pathogenesis of all these complications and is certainly pivotal for development of atherosclerosis. Proliferation of vascular smooth muscle cells determines remodeling of atherosclerotic plaques and formation of fibrous caps and proliferation of capillary endothelial cells drives diabetic proliferative retinopathy. Alterations in hemostasis are most significant during development of thrombi associated with atherosclerotic plaques and in microscopic bleeding from retinal vessels. Finally, blood flow is increased early in diabetic nephropathy, but decreased in the retina due to capillary occlusion and in large arteries as a result of development of occlusive plaques . These general changes reflect that similar systemic factors such as hyperglycemia, insulin resistance and dyslipidemia are present in all vascular tissue. However, they also highlight the importance of tissue-specific differences in the response to common metabolic abnormalities.
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Mental Health And Diabetes
Living with and managing either type 1 or type 2 diabetes can lead to stress, anxiety and depression. This can affect your blood glucose levels and how you manage your diabetes in general. Over time, this can affect your health.It is important to talk to your doctor if you are going through times of stress, depression or anxiety. Your doctor can refer you to a counsellor or psychologist by providing a diabetes mental health plan. This is Medicare rebated.Other help is available, including:
- online resources
Questions To Ask Your Doctor About Ckd
If you have high blood pressure or diabetes, its important to start or continue a dialogue with your doctor about your risk for CKD. Here are some questions you may want to ask, depending on your current kidney disease status.
1. Am I at risk for kidney damage if I have high blood pressure?
High blood pressure can damage blood vessels in your kidneys. If youve had uncontrolled high blood pressure for some time, theres a good chance youre at an elevated risk for CKD and may benefit from kidney function screening.
2. Am I at risk for kidney damage if I have diabetes?
Diabetes is the leading cause of CKD. Depending on how well controlled your blood sugar levels have been, you may have an increased risk of kidney damage if you have type 1 or type 2 diabetes. Talk to your doctor about ways to keep your kidneys healthy and whether you should get tested for CKD.
3. Should I have my kidney function tested?
A common test for kidney function measures blood levels of creatinine a normal waste product from muscle breakdown and uses this number along with other data to calculate an estimated glomerular filtration rate . Other tests to screen for and evaluate kidney disease look at levels of protein and blood in urine.
4. Do I have CKD?
5. What is my kidney function number?
Knowing your kidney function level and the stage of your CKD can help you and your doctor evaluate whether your current treatment strategy is working as well as it could.
6. Do I have protein in my urine?
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What Are My Options For Treatment
Prevention and awareness are very important to everyone with diabetes:
- Urinalysis : All diabetics should have a urine test at least once every year. This test looks for the presence of the protein albumin. This indicates possible kidney damage.
- Blood Sugar Control: Keeping blood sugar levels well controlled helps maintain kidney health. In a recent study, diabetic patients that kept their blood sugar below 150 mg/dl greatly reduced the risk of kidney disease. Some diabetics can manage blood sugar with just oral medication. Others need insulin. Doctors who specialize in diabetes can prescribe insulin. The American Diabetes Association recommends that blood sugars be kept between 90-130 mg/dl on an empty stomach. Blood sugar should be less than 180 mg/dl one hour after eating.
- Blood Pressure: High blood pressure is extremely common in diabetics. It is a major cause of kidney disease. Additionally, kidney disease can make high blood pressure even higher. This creates a vicious cycle. Often, it takes multiple medications to control high blood pressure. This is especially true for diabetics, obese patients, and the elderly. The American Diabetes Association recommends checking blood pressure twice every year. Keeping blood pressure below 130/80 is also recommended. Patients who cannot control their blood pressure with diet and exercise alone are usually prescribed blood pressure reducing medicine. This is known as an ACE inhibitor or an ARB.