Diabetes Mellitus is a condition in which the body is not able to efficiently convert glucose in the blood into energy. As a result, blood-sugar levels start rising. This conversion is facilitated by a hormone called insulin secreted by the pancreas. Diabetes is of 2 types: In type-1 diabetes, not enough insulin is produced by the pancreas, while in type-2, the body is not able to use the insulin to convert the blood-sugar into energy. Irrespective of the type, diabetes leads to several complications, when detected late, when untreated for long or when the severity is high.
For no clear reason, high blood-sugar increases the likelihood of cholesterol depositing on the walls of the arteries. These deposits harden over time and form a plaque thereby narrowing the artery and constricting blood-flow. This condition is called atherosclerosis. Sometimes, unstable plaques crack and expose their lipid core that initiates a harmful sequence of events, Blood cells, particularly platelets, are attracted to the site creating a blood clot. In smaller arteries, the blood clot can restrict or completely cut-off the blood-flow. This means, that part of the body receives less oxygen than before, causing one or more tissues to fail. When this happens in the heart, it increases the risk of heart-attack and heart-failure, and if this happens in the brain, it increases the risk of stroke.
As discussed above, high blood sugar can affect circulation in both major and minor arteries. Some of these minor arteries supply blood to the nerves. When blood supply is restricted in such arteries, the nerve function is affected. Further, high blood-sugar is also known to interfere with the ability of the nerves to send signals. This result in a condition called diabetic neuropathy. When that occurs in the arms and legs, it is called peripheral neuropathy. When it happens in the major organ systems, it affects them, for e.g. the digestive and reproductive systems, causing a wide range of symptoms and complications. Any nerve in the body can be affected , even the involuntary nervous system ( over which we have no control) which is called the Autonomic Nervous System e.g the nerves of the heart.
As mentioned in point A, diabetes increases the risk of atherosclerosis in any part of the body, including the kidneys. In the kidneys, there are millions of tiny filters called nephrons which do not get enough oxygen-rich blood now, so their function starts failing slowly, and the condition is called early-stage kidney disease. Restricted blood-flow in the smaller arteries causes blood to accumulate in the larger arteries of the kidney increasing blood-pressure there. The combination of kidney function failing, high blood-pressure and high blood-sugar causes a vicious circle leading to chronic kidney failure. The consulting Diabetologist will educate the patient on signs and symptoms of kidney disease to look out for, so that quick medical action can be taken. Symptoms include swelling in parts of the body which is due to fluid retention in the body’s tissues, poor appetite, loss of sleep, trouble concentrating, fatigue and diarrhea.
Both neuropathy in the nerves of the eyes, and atherosclerosis in the arteries that supply blood to different parts of the eyes, are likely in diabetics. This leads to complications such as:
If diabetes is not kept in check, the above conditions can worsen leading to loss of vision in one or both eyes.
Atherosclerosis and neuropathy in tiny blood vessels that supply blood to the skin leads to several skin conditions over time. This includes but is not limited to: dryness or dry skin which causes pain and itchiness. The person may develop boils, rashes and blisters over time. There can be redness, cracks, skin tears and calluses. He/she may have inflamed hair-follicles and there may be styes on the eyelids. The person is also more prone to infection in any part of the body, including the skin. Diabetes is associated with appearance of darkly pigmented patches on the skin, called Acanthosis Nigricans.
Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.
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