Monday, March 9, 2009

What causes complications from diabetes?

High blood sugar causes changes in hormones and cells that can damage your blood vessels or nerves, or both. Damaged blood vessels are more likely to build up plaque, increasing the risk of coronary artery disease, heart attack, and stroke. Damage to smaller blood vessels can lead to loss of vision, kidney disease, and nerve problems. The complications from diabetes are:
  1. ഃഎഅര്ടൊr large blood vessel disease. These complications—sometimes referred to as macrovascular diseases—may cause peripheral arterial disease, stroke, or heart attack.
  2. Eye (diabetic retinopathy) and kidney (diabetic nephropathy) disease, which are sometimes referred to as microvascular diseases.
  3. Nerve disease (diabetic neuropathy), which can affect your internal organs as well as your ability to feel sensations and pain.

What are the symptoms of diabetes complications? Your symptoms will vary depending on the complication. You may have: Chest pain (also called angina) or shortness of breath when you exercise, if you have heart and large blood vessel disease. You may have other symptoms, such as dizziness or lightheadedness, shoulder or stomach pain, or a racing heartbeat. You also may have no symptoms until having a heart attack or stroke. If the large blood vessels in your legs are affected, you may have problems with blood circulation to your legs and feet, causing changes in the skin color, decreased sensation, and leg cramps during exercise (intermittent claudication). Vision problems, vision loss, or pain in your eyes (rare), if you have diabetic retinopathy. No symptoms, if you have early kidney disease. Symptoms of swelling (edema) in your feet and legs and later throughout your body and increasing blood pressure develop as the disease progresses.

Tingling, numbness, tightness, burning, or shooting or stabbing pain in the feet, hands, or other parts of your body, especially at night, if the nerves affecting sensation and touch are affected (peripheral diabetic neuropathy). If the nerves that control internal organs are damaged (autonomic neuropathy), you may have digestive problems (gastroparesis); profuse or reduced sweating; difficulty sensing when your bladder is full; sexual problems; dizziness, weakness, or fainting when you stand up (orthostatic hypotension); or difficulty knowing when your blood sugar is low (hypoglycemia unawareness). How are diabetes complications treated? The treatment for your complication focuses on stopping or at least slowing the progression of the damage. Depending on the complication, your treatment may involve medication, surgery, or other therapies. When complications are found early, only minor lifestyle changes may be necessary. For example, if you have early diabetic nephropathy, you can take a medication to slow the rate of further kidney damage. If you are age 30 or older, talk to your health professional about taking a low-dose, or baby, aspirin daily to help prevent heart attack, stroke, or other large blood vessel disease. People with diabetes are 2 to 4 times more likely than people who don't have diabetes to die from heart and blood vessel diseases. Early treatment for a complication and keeping your blood sugar levels within a normal or near-normal range can help slow the progression of your complication and may prevent other complications from developing. To keep your blood sugar tightly within a normal or near-normal range, spread carbohydrate in your diet throughout the day, get regular physical exercise, and take oral diabetes medication and/or insulin, as prescribed. See your health professional every 3 to 4 months, or more often if indicated. Have exams and tests that monitor your complication and screen for other complications regularly.You should treat high blood pressure and high cholesterol to help prevent other diabetes complications. What can happen as a result of complications? If diabetes is not treated, complications can develop that lead to serious disabilities, such as kidney failure, blindness, or a severe heart attack or stroke. You also may have a reduced ability to sense pain if the nerves in your arms and legs are affected. This can lead to injuries and bone fractures that you cannot feel, such as the deformity Charcot foot. These injuries also can cause reduced blood flow to bones and tissue death. If you have peripheral neuropathy, you may not notice an injury, especially on your foot, until a severe infection develops. Severe foot infections can spread up your leg and into your bones, and possibly lead to amputation.

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