Vascular damage in diabetes mellitus - prevention and treatment of diabetic angiopathy. Major complications of diabetes

Poor control of diabetes is the main cause of diabetes complications. Diabetic polyneuropathy and angiopathy (damage to nerves and blood vessels) prevent diabetics from detecting wounds, diaper rash, and infection in a timely manner lower extremities, which, with an unfavorable course of the disease, is fraught with amputation.

One in five diabetic hospitalizations is associated with foot involvement. Proper care foot care in diabetes can prevent these serious complications.

diabetes and infections

In diabetes, the body is more vulnerable to infectious and inflammatory diseases of soft tissues and other diseases. High content glucose in the blood and tissues creates favorable conditions for rapid development pathogenic bacteria. Diabetics often suffer from inflammation of the kidneys (pyelonephritis) and Bladder(cystitis), vagina, gums, infections of the skin and lower extremities.

signs of development infectious process in patients with diabetes mellitus:

Timely recognition infectious complications- pledge successful treatment. If you develop any of the following symptoms, contact your doctor immediately:

• Fever (increased body temperature above 38°C
• Chills or heavy sweating
• Skin rashes
• Pain, redness, swelling, soreness and local boost temperature skin
• Non-healing wounds or cuts
• Sore throat, itching, pain when swallowing
• associated with headache or pain in facial bones
• Persistent dry or wet cough for more than two days
• White patches in the mouth or on the tongue
• Nausea, vomiting or diarrhea
• Flu-like symptoms (chills, headaches, muscle aches, general weakness)
• Vaginal itching
• Problems with urination: pain, burning, constant urge and increased urination
• Blood in urine, urine cloudy or bad smell
• Insulin resistance and loss of control of diabetes.

Visual complications

Patients with diabetes must be regularly examined by an ophthalmologist. High blood glucose levels increase the risk of eye complications, with diabetes being the leading cause of blindness in adults aged 20 to 74 years.

Blurred vision in diabetes can also be a temporary problem associated with high blood sugar levels. High glucose levels can cause the lens to swell, which in turn causes the image to be out of focus on the retina. To correct the situation, it is necessary that blood glucose levels return to an acceptable range. Restoration of vision this case may take up to three months.

All patients with diabetes should be aware of three main eye complications: cataracts, glaucoma and diabetic retinopathy.

Cataract- this is the clouding of the lens (lens), which allows us to see and focus the image like a camera. Cataracts are not only found in diabetics, but in diabetics it occurs earlier and progresses more rapidly. It is characterized by blurring and decreased visual acuity. Treatment is usually surgical - implantation of an artificial lens inside the eye.

At glaucoma the normal circulation of fluid inside the eye is disrupted and intraocular pressure, which leads to damage to the vessels and nerves of the eye, causing changes in vision. In most cases, there may be no symptoms at all in the early stages until severe vision loss occurs as a result of the disease. Less often, the disease can manifest itself with headaches, eye pain, watery eyes, halos around light sources, and even complete loss of vision. For the treatment of glaucoma, topical eye drops taking medications, laser procedures and surgical interventions. To detect the presence of asymptomatic glaucoma, it is necessary to check the level of intraocular pressure with an ophthalmologist annually.

Diabetic retinopathy. The retina is a group of specialized cells that convert light into nerve impulses transmitted optic nerve in visual center brain. Damage to the small vessels of the retina in diabetes is called diabetic retinopathy.

Kidney disease, nerve damage, and diabetic retinopathy are among the microvascular complications of diabetes mellitus. Macrovascular complications of diabetes (as a result of lesions of large blood vessels) include cardiovascular disease, atherosclerosis large arteries lower limbs and strokes.

Diabetic retinopathy is the leading cause of irreversible blindness in developed countries. The duration of diabetes is the most an important factor risk of developing retinopathy: the longer you have diabetes, the higher the risk of this serious complication. Left undiagnosed and untreated, retinopathy can lead to blindness.

Cardiovascular diseases

Cardio risk vascular diseases and death from stroke in diabetic patients is 2-4 times higher than in other people. The more risk factors for cardiovascular disease a person has, the higher their chances of getting sick. The most common cause of heart disease in diabetics is atherosclerosis of the heart coronary arteries resulting from the deposition of cholesterol on inner surface vessel walls. In type II diabetes, cholesterol begins to be deposited in the vessels in the form of plaques even before a pronounced increase in blood sugar.

Atherosclerotic plaques can break down and lead to blockage coronary vessels blood clots, causing a heart attack. Blockage of other arteries in the human body can lead to impaired blood supply to the brain (stroke), lower and upper extremities.

In addition, diabetics are at high risk of heart failure, a condition in which the heart cannot pump. required amount blood. Symptoms heart failure there may be shortness of breath (in the event of pulmonary edema), edema of the lower extremities, accumulation of fluid in the abdomen (ascites), etc.

Symptoms circulatory disorders in the vessels of the extremities can be:

• Cramping and pain in the muscles of the legs when walking (intermittent claudication)
• Cold pale skin
• Decreased or absent pulse in the peripheral arteries
• Loss of subcutaneous fat and thinning of the skin of the legs and feet
• Loss of hair on legs.

Important components of the prevention of heart attacks and strokes in patients with diabetes are taking aspirin and other medicines, to give up smoking, proper nutrition, weight loss, physical exercises maintaining blood glucose levels and blood pressure within acceptable limits.

Arterial hypertension (increased arterial pressure)

High blood pressure (arterial hypertension) is an important risk factor for the onset and progression of many complications of diabetes, including diabetic retinopathy and kidney damage. Up to 60% of people with diabetes have high blood pressure. Diabetes and atherosclerosis harden the walls of the arteries, which can increase blood pressure and lead to damage to blood vessels, stroke, myocardial infarction, heart failure, or kidney failure.

Even with an increase in pressure in the range of 120-139 / 80-89 mmHg, which is not yet considered arterial hypertension, within 10 years it increases the risk of cardiovascular diseases by two to three times.

As a rule, high blood pressure (BP) causes almost no symptoms. That is why it is so important to follow the recommendations of your doctor and regularly monitor your blood pressure.

To avoid development arterial hypertension:

• Quit smoking
• Eat healthy food
• Maintain optimal body weight
• Reduce consumption table salt in the diet
• Accustom yourself to regular physical activity.

diabetic nephropathy develops in almost a third of patients with diabetes and is the main cause of renal failure. Kidney damage in type 1 and type 2 diabetes is different. In type I diabetes, kidney disease begins acutely and at a younger age.

Diabetic nephropathy in the early stages is often asymptomatic. However, in some cases it is accompanied by:

• Swelling of the face, hands and feet
• weight gain
• Itching and severe dryness of the skin (in terminal stage)
• Drowsiness (in the terminal stage)
• Blood in the urine (rare)
• Heart rhythm disturbances and convulsive twitching of muscles due to an increase in the amount of potassium in the blood.

With the progression of the disease, the kidneys increasingly remove toxic waste products from the body of their blood, which gradually accumulate (uremia) and poison the body. People with uremia are often confused or comatose. Uremia is exacerbated by high blood pressure.

One of the main signs of diabetic nephropathy is the presence of protein in the urine. That is why it is necessary to take a urine test at least once a year.

Lowering blood pressure and maintaining blood sugar within an acceptable range is essential to slow the progression of diabetic nephropathy. Some medications, such as angiotensin-converting enzyme (ACE) inhibitors, also help stop this process. Although ACE inhibitors commonly used to treat hypertension, they are often given to diabetic patients to prevent diabetic nephropathy, even if their blood pressure is normal.

Without treatment diabetic nephropathy leads to the development of kidney failure, when a person cannot live without dialysis (device artificial kidney) or a kidney transplant.

Diabetic polyneuropathy

Diabetic polyneuropathy is one of the most frequent complications diabetes mellitus. The risk of developing this complication is approximately the same for patients with type I and type II diabetes. Tingling, pain, or numbness in the legs and arms are the most common complaints of diabetic peripheral nerve disease. It is also possible to damage the nerves that innervate the heart, stomach, bladder, genital organs, called autonomic neuropathy.

Sometimes, neuropathy appears even before the diagnosis of diabetes. There is no cure for diabetic neuropathy, but you can slow it down. healthy image life and maintaining an acceptable blood glucose level for diabetic neuropathy, cardiovascular disease, stroke and other complications of diabetes.

High blood glucose level, long diabetic experience, excess weight, imbalance of blood lipoproteins, smoking and alcohol abuse are the main factors contributing to the progression of diabetic polyneuropathy.

Diabetes is dangerous chronic illness which seriously hinders human life. This ailment forces the patient to follow a diet and undergo regular treatment to prevent exacerbations. It is impossible to cure this disease, however, when the recommendations of doctors are followed, it is possible to achieve full compensation and get rid of symptoms by 80-90%. However, the complications of diabetes are more common than we would like. Each specific case is different characteristic features. To find out more about this, read on.

Causes of Complications in Type 1 and Type 2 Diabetes

Whatever the deterioration in the condition of a person with diabetes, it has its own reason. For several decades, doctors have been talking about the factors that causing complications However, it has not yet been possible to fully determine the nature of these phenomena. At the same time, a number of circumstances are known that favor the appearance of undesirable physiological changes. The most common ones are listed below:

• malnutrition, disturbing metabolism;
• excess glucose and / or sodium;
• increase in the concentration of sugar in the blood;
• accumulation of lactic acid in the body.

Types of complications

Diabetes mellitus, as a separate endocrine disease does not pose a threat to human health. This disease is dangerous because it causes a lot of serious complications that almost never go unnoticed. Thanks to high-tech scientific research medicine has received a lot useful information about each of options worsening condition.

Acute

Complications of diabetes, related to the category of acute, are a serious threat to life. These include processes that develop very quickly and cause a deterioration in the patient's condition up to a critical one. AT best case the onset of exacerbation takes several days. Complications that develop in a matter of hours are much more common. Both those and others in the absence of emergency medical care inevitably lead to death. The table below contains general information about each of the possible acute complications of diabetes:

Chronic (late)

Late complications of diabetes mellitus are characterized by gradual development over several months or even years. They do not threaten exacerbations, but at the same time slowly worsen general state health. Even with well-planned systematic treatment medications reliable protection from the complications of diabetes mellitus of this type is not always guaranteed. You can learn more about each of them by reading the table below.

What are the complications and consequences of diabetes in children and adolescents

Complications in children are manifested to a lesser extent, if only because of the small "experience". The death rate for those under 18 is close to zero. However, if a child has been diagnosed with diabetes, this means that the process of decompensation has already begun. Doctors note a number of complications characteristic of diabetes mellitus in childhood / adolescence:

• microalbuminuria;
• diabetic nephropathy;
• angiopathy (in rare cases);
• retinopathy.

Complications of diabetes at an early age are dangerous because of their secrecy. The symptoms noted in a child are often written off as other, more characteristic and common diseases. On condition timely treatment for qualified medical care is possible in short time achieve full compensation for diabetes and ensure complete elimination of anxiety factors.

Video about the treatment and prevention of complications of diabetes

The development of complications in diabetes mellitus reduces the standard of living of a person and shortens life expectancy. It is necessary to observe a number of measures to delay complications.

Diabetes mellitus brings many changes to a person's life, including a violation in all organ systems. Inevitably, complications of diabetes develop. And when they develop depends on the method of treatment and on how accurately prevention is performed.

What are the complications

The consequences of diabetes are divided into early and late. Under the early, or acute, understand the complications that occur quickly in response to a sharp decrease or increase in blood glucose. The main symptom of such acute condition is a coma.

Late complications of diabetes occur as a result of the damaging effects of hyperglycemia on blood vessels and nervous tissue. Vascular complications of diabetes mellitus, or angiopathy, depending on the caliber of the damaged vessels, are divided into macroangiopathy - damage to large arteries, and microangiopathy - small arteries, capillaries.

When amazed small vessels(microangiopathy) - the eyes and kidneys are affected. When we are talking about macroangiopathy in diabetes, then problems arise from the heart, brain, and peripheral tissues.

Neurological complications of diabetes mellitus, or neuropathy, in combination with angiopathy lead to the syndrome diabetic foot which includes many symptoms.

Acute complications

Coma in diabetes develops in response to an extreme drop in blood sugar. These conditions are life threatening. Some people think that a diabetic's sugar level can only rise, but this is not true. Often coma on the background of hypoglycemia.

Hypoglycemic coma

When the sugar level drops so much that the brain cells experience a lack of energy, then symptoms of an impending coma occur. Such a condition can occur against the background of normal or elevated glucose numbers (for example, 10 mmol / l), if there has been a “fall” from 30-25 mmol / l. Such hypoglycemia is called false. True hypoglycemia is characterized by blood sugar below 3.3 mmol/l.

Both forms of hypoglycemia in diabetes occur for the following reasons:

• inadequate insulin therapy or taking hypoglycemic agents;
• violation in the diet;
• physical activity without income enough carbohydrates;
• starvation;
• the use of alcoholic beverages;
• medication (Aspirin, sulfonamides, lithium preparations, beta-blockers).

The symptoms of a hypoglycemic state are characterized by a number of specific symptoms which are presented below.

1. Sweating, sometimes local (head, top part body) or throughout the body. The incidence of this symptom reaches 80%.
2. Trembling is also very common (up to 70% of cases) noted by patients. This creates a feeling internal trembling, tremor of the limbs, trembling of the chin.
3. Tachycardia (rapid heartbeat) for no apparent reason.
4. Strong feeling of hunger.
5. Numbness of the area around the lips.
6. Nausea.
7. Feelings of fear and anxiety.

These symptoms precede brain manifestations, therefore, undertaken medical measures during this period can prevent the development of coma. After these signs, brain symptoms occur: headache, decreased attention, disorientation, drowsiness, turning into loss of consciousness and coma.

The danger of coma lies in the damage to the brain tissue, as well as in the creation dangerous situations when a person loses consciousness due to hypoglycemia (driver while driving; climbing to a height without safety devices).

Hyperglycemic coma

Coma, caused by a significant increase in glucose levels, is divided into ketoacidotic (ketoacidosis), hyperosmolar, lactic acid.

Ketoacidosis is caused by an increase in glucose and metabolic products - ketones, which have a toxic effect on the body. The reason for this condition is:

• infection (flu);
• lack of treatment or errors in it;
• trauma;
• surgical interventions;
• violations in the diet;
• drug therapy and more.

Hyperosmolar coma, which is also dehydrating, develops when blood with increased osmolarity "attracts" fluid from the cells of the body, thereby dehydrating them. All this happens against the background of insulin deficiency. The reasons for the development of this type of coma are in many ways similar to those in ketoacidosis, plus this includes any diseases that lead to fluid loss in diabetes.

Typical signs that precede a coma are the following:

• selection a large number urine (up to 8 liters);
• severe thirst (drinking up to 8 liters of water per day);
• general weakness, fatigue, headache;
• when blood glucose changes, the result exceeds 16.5 mmol / l;
• skin and mucous membranes are dry, turgor is reduced;
• gradually (several days) there are signs of impaired consciousness, and coma occurs.

The above symptoms are characteristic of both ketoacidosis and the hyperosmolar state, but there are differences:

• with ketoacidosis, Kussmaul's breathing appears (rare, noisy, deep);
• ketoacidosis is accompanied by the smell of "rotten apples" from the patient;
• with ketoacidosis, attacks of an "acute abdomen" occur;
• with hyperosmolarity, hallucinations, paralysis and paresis, speech impairment are more common;
• the temperature rises with hyperosmolar coma.

Lactic acid coma develops on its own very rarely, often in conjunction with other forms of coma in diabetes. It occurs against the background of a decrease in the supply of oxygen to tissues in cardiac pathology, respiratory failure, anemia, blood loss, injuries and infections. Provokes lactic acid coma chronic alcoholism, age over 65 years, physical activity. Symptoms are similar to other comas, but there are no ketones in the urine and high hyperglycemia.

Late Complications

As a result of damage to the vascular bed, a violation of the normal trophism of various tissues occurs. First of all, organs such as the kidneys, eyes, heart, and brain are affected.

kidneys

Diabetic nephropathy is a complication of the kidneys that develops when the renal vasculature is damaged. The result of this disease is the insufficiency of kidney function, which develops 10-25 years after the onset of diabetes.

The kidneys are affected when the following conditions occur:

• poorly controlled sugar levels
• lipid metabolism disorder;
• arterial hypertension;
• smoking;
• diabetes experience.

When the capillaries of the kidney cease to function, toxins and waste products accumulate, poisoning the body. Over time, the wall of the kidney vessels loses its integrity, as a result, useful substances begin to be excreted in the urine.

The person feels unwell, and laboratory data correspond to this condition. It notes:

• weakness and fatigue;
• weight loss;
• loss of appetite, nausea;
• edema is pronounced, which gradually “rise”;
• the skin is gray, flabby;
• an ammonia smell is determined from the mouth;
• the work of all systems of the body is disrupted.

Prevention can save the kidneys from complications. It is necessary to constantly keep the sugar level no more than 9 mmol / l, regularly monitor the excretion of protein in the urine, the level of blood pressure, and do not break the diet.

Eyes

Diabetic retinopathy is the result of the influence of hyperglycemia on the vessels of the eye, while the retina is affected. It is the retina that is responsible for the perception of visual images, because the receptors of the organ of vision are located on it. Violation of the function of this structure can lead to complete blindness.

The following factors can accelerate the development of retinopathy:

• hypertension;
• pregnancy;
• elderly age;
• experience of diabetes;
• smoking;
• when the kidneys have already suffered;
• lipid metabolism disorder.

If the first signs of damage to the eye appear, then the disease has already gone too far. The patient complains of decreased visual acuity, flies, spots in the field of vision, double vision, and so on.

In this case, only prevention can help: observation by an ophthalmologist at least once a year, "retention" of sugar less than 9 mmol / l, treatment of hypertension, metabolism, exclusion of heavy loads.

Diabetes mellitus is a fairly common disease in modern world. This disease not only radically changes a person's life, but also entails some complications.

Diabetes mellitus is the result of a malfunction endocrine system and the amount of insulin produced. If there is not enough insulin to break down glucose, then this species diseases are classified as type 1 diabetes. An excess of insulin that cannot bind to certain receptors indicates the presence of type 2 diabetes.

Type 1 diabetes is most common in young people and children. The second type of diabetes is more often detected in older people. Early diagnosis can prevent the development of the disease drug treatment and dieting.

If the diagnosis is made incorrectly or treatment is started late, then this can cause complications. Moreover, they can arise as initial stage disease, and after several decades after the discovery of the disease. The reasons for this are individual.

Complications associated with diabetes mellitus can be divided into early and late pathologies.

Complications of early type

This type of complications, also called "acute", poses an immediate threat to human life. They are characterized by rapid development, taking a period of several hours to a week.

Neglect of medical care or untimely provision of it in most cases leads to death.

Among the acute complications, coma caused by the disease is distinguished. By coma is meant the condition of the patient, in which all the processes of a person's life activity slow down.

In this state, the activity of processes decreases, reflexes completely disappear, the work of the heart, its rhythm is disturbed, and spontaneous breathing is possible.

It is almost impossible to foresee the occurrence of such a state. It develops quite rapidly and therefore experts advise that someone should always be near the patient. This may be a relative who knows how to provide the first medical care or medical personnel.

Treatment of the patient is carried out only under the supervision of doctors at the hospital. The patient first enters the ward intensive care. After some improvement in his condition, he was transferred to a special department.

com types

AT medical practice comas are divided into two large groups:

• hyperglycemic coma;
• hypoglycemic coma.

Hypoglycemic coma occurs due to sharp decline blood sugar levels. Hyperglycemic coma is characterized by an increase in sugar in the body for short span time. Hyperglycemic coma are divided into ketoacidotic, hyperosmolar, hyperlactacidemic.

Ketoacidosis

This condition is characteristic of people with type 1 diabetes and is a metabolic disorder caused by a lack of insulin. It is manifested by an increase in sugar levels and ketone bodies in the blood, as well as an increase in the acidity of the blood.

The development of ketoacidosis occurs in several stages. In the initial stage of complications, laboratory analysis of urine in the material reveals sugar. In the absence of abnormalities, there is no sugar in the urine.

At the second stage of the development of complications, the activity of metabolic disorders is observed. Possible signs of intoxication of the body. The person is in a depressed state, the mind is confused. At laboratory research acetone is found in the urine.

The next stage is characterized by the following features:

• depressed state,
• loss of consciousness,
• state of stupor in a person.

The third stage of ketoacidosis is called ancestral.

The fourth stage is life threatening. This is a coma. In this state, there is a violation of the functioning of almost all organs, a complete loss of consciousness and a complete violation of the metabolic process.

The cause of this complication is a violation of the diet and medication. Self-adjustment of the dose of drugs or refusal of them. may occur for some time after stopping the intake of sugar-lowering drugs.

Also, ketoacidosis can be provoked by inflammatory or infectious diseases. During pregnancy, an acute shortage of insulin can occur, which will cause ketoacidotic coma.

Hypoglycemic coma

This complication occurs in patients with diabetes, regardless of its type. Unlike ketoacytosis, this type of coma provokes "extra" insulin. Although there are cases of hypoglycemic coma after intense physical exertion or alcohol intake.

This type of coma is characterized by complete loss of consciousness by the patient, profuse sweating and low level pupillary response to light. In the initial stage, the development of coma can be prevented by using the required amount of carbon.

Hypoglycemic coma occurs suddenly. It is preceded by the following symptoms: strong feeling hunger, anxiety and excessive anxiety, increased pressure and enlarged pupils. Rarely observed behavior that is not characteristic of a person, abrupt change mood, headaches, blurred vision.

There is a danger lethal outcome if within half an hour a person is not taken out of a coma. During this time, cerebral edema occurs, metabolic processes in him. The result is death cerebral cortex or its substance.

Hypermolar coma

This type of complications differs from all other types in its symptoms. With hypersmolyany coma, there is an increase in the blood of sodium compounds with glucose. As a result of obtaining such compounds, the nutrition of body cells, including the brain, is disrupted. Most often, this condition can occur in older people.

The initial stage of development of hypermolar coma is characterized by dehydration and lack of insulin. Prolonged dehydration leads to secondary symptoms such as impaired stool, nausea and vomiting, impaired work internal organs, blood loss.

Development this complication happens within a few weeks. At the beginning, symptoms appear as in diabetes mellitus, these are:

• intense thirst,
• weight loss,
• frequent urination,
• also, already at the initial stage, short-term convulsions or twitching of the limbs may occur,
• possible loss of consciousness.

In the future, the disease has a progressive character. Loss of consciousness may become more frequent and go into a coma. Some patients also experienced hallucinations.

Signs of hypersmolyany coma are quite diverse. It can affect the nervous system and manifest as seizures, partial or total absence movement, difficulty speaking. These signs are also characteristic of violations normal operation brain.

Treatment of such a complication consists in taking medications and detoxification solutions. Treatment must be comprehensive. Simultaneously with the decrease in the manifestations of hypertar coma, it is necessary to influence the causes that caused it.

Late complications of diabetes

To late complications diseases include diabetic nephropathy, retinopathy, diabetic foot syndrome. These complications occur over a long period of diabetes mellitus.

They may occur after 20 years from the date of diagnosis.

Such complications of diabetes do not occur suddenly. They appear gradually over a period of time. They are most common in patients with type 2 diabetes and rarely occur in children.

diabetic nephropathy

This complication of diabetes mellitus is manifested by a violation in the functioning of the kidneys and the occurrence of renal failure. This disease appears in a person 10 years after diagnosing diabetes mellitus. In type 1 diabetes, nephropathy is the leading cause of death for the patient.

Diabetic nephropathy goes through three stages:

1. Definition in urine a small amount proteins.
2. Determination of a significant amount of proteins in the urine.
3. Chronic renal failure.

Treatment must begin at the initial stage of the disease. Its purpose at this stage is to normalize the patient's blood pressure. To do this, use drugs that normalize blood pressure and improve blood flow in the kidneys.

At the next stage of the disease, insulin preparations are used, for patients with type 2 diabetes mellitus, and a salt-free diet is prescribed. They also take medications to normalize blood pressure.

The value of arterial pressure should be no more than 130/80 mm. mercury column. With the ineffectiveness of the prescribed medications, others are selected.

Chronic renal failure is divided into two types: conservative and terminal. In the first type, her treatment takes place without prescribing drugs. The basis of treatment is strict observance diet and salt restriction. In some cases, insulin may be prescribed.

Treatment of the second type of chronic renal failure is carried out in a hospital under the supervision of specialists. Treatment consists of hemodialysis or peritoneal dialysis. In severe cases, an organ transplant is recommended.

diabetic foot syndrome

This complication is expressed by damage to the nerve endings of the limbs, skin and tissues, as well as effects on bones and joints. The consequences of diabetic foot syndrome are:

1. acute and chronic ulcers,
2. purulent processes,
3. possible limb amputation.

In the neuropathic form of the disease, important points can be canceled:

• the longest nerves leading to the extremities of the legs are affected first.
• As a result, tissue supply is disrupted. nutrients, which leads to exhaustion and deformity of the feet.
• Also, as a result of the uneven distribution of the load on the foot, an increase in some of its parts occurs.
• Dense areas appear and tissues become inflamed.
• At the site of inflammation, ulcers subsequently form.
• The ischemic form of the disease leads to the development of atherosclerotic lesions of blood vessels and arteries.
• The foot becomes of blue color, in rare cases acquires a red-pink hue.
• Blood circulation is disturbed and the legs become cold to the touch.

The main direction in the prevention and treatment of this complication is timely and effective treatment diabetes mellitus. Also, moderate physical activity diet, and regular check-ups with a doctor.

Hygiene of patients with diabetes

Important! In case of diabetes, maintain personal hygiene, order in the home, as well as clean clothes.

Moderate physical activity and hardening will help reduce the likelihood of complications in diabetes. This increases the stamina and resistance of the body.

Atherosclerosis.

diabetic nephropathy.

Diabetic retinopathy.

Diabetic microangiopathy.

Diabetic neuropathy.

Infections.

Heart disease and stroke.

Atherosclerosis

Atherosclerosis is often seen in patients over 50 years of age. Adverse consequences development of atherosclerosis in diabetes mellitus are early ischemic disease heart disease, myocardial infarction, stroke and gangrene of the extremities, which are 100 times more likely to affect diabetics than other people.

Treatment consists of personal self-care and symptom relief.

Personal concern is:

Exercise should be balanced with rest.

You should stop smoking because smoking narrows the arteries and increases the chances of blood clots.

Foot care is very important in diabetes, so use good shoes. Keep your feet clean and use socks instead of a heating pad when you sleep. Look out for cuts, bruises, or other injuries, as tissue heals slowly in diabetes and is prone to infection.

Symptoms can be relieved with pain medications, anticoagulants, etc. Surgery is performed only in severe cases. Amputation is needed when there is absorption of toxins from necrotic tissue and infection that can kill the patient.

diabetic nephropathy

Nephropathy in diabetic patients can be controlled by normalizing blood sugar levels and controlling high blood pressure. Thus, angiotensin receptor blockers (ARBs) are used to treat high blood pressure and control of kidney damage in diabetics.

diabetic retinopathy

The treatment for retinopathy is the use of a laser that destroys and prevents microaneurysms and fragile blood vessels. Approximately 50% of "ten-year-old diabetics" are thought to have diabetic retinopathy.

The development of retinopathy occurs due to poor control of blood pressure and blood glucose levels. natural raw foods nutrition is best diet for this complication. Therefore, patients should eat fresh fruits, vegetables, dairy products, etc. Vitamin A - the best option to improve vision. Vitamin A is present in carrots, cabbage, soybeans, peas, raw spinach, etc. You also need to do exercises to relax and strengthen the muscles of the eyes. Eye movements such as looking up, down, left, right, and circular motions(clockwise and counter-clockwise) help in preventing eye complications. We also recommend that you have your eyes checked periodically.

Diabetic microangiopathy

Diabetic neuropathy

Diabetic neuropathy affects all parts of the nervous system, but peripheral nerves are more commonly affected. It influences cranial nerves and nerves spinal cord or their offshoots. In the early stages of the disease, the patient feels tingling or intermittent pain, especially in the extremities of the legs. At the next stage, the pain is already constant and more serious. Eventually, a painful neurosis develops, which ends with the loss of the sense of pain in the limb. At the same time, the possibility of severe tissue damage increases, because the pain does not warn the patient about the injury. General symptoms diabetic neurosis - tingling, decreased sensitivity of a certain part of the body, diarrhea, constipation, loss of bladder control, impotence, facial paralysis of the eyelids, drooping mouth, change in vision, weakness, slurred speech, etc. These symptoms usually develop gradually over a year.

Treatment consists of good blood glucose control to prevent progression. Topical treatment with capsaicin is commonly used to reduce symptoms. Drugs such as amitriptlyline and carbamazepine also have a successful result. Painkillers ( sedatives) are not useful in the treatment of painful neuropathy. You need to check your feet regularly. If any type of infection or injury goes unnoticed for a long time, amputation may be required.

infections

Cardiopathies and stroke

Risk factors for cardiovascular disease are mainly obesity, sedentary image life, high blood pressure, high level cholesterol, smoking, family history of coronary disease before the age of 55, etc.

Chest pain or angina occurs in about 3-5% of people. Pain or discomfort in the chest is felt due to the fact that the blood flow is partially or completely blocked. Excessive food intake, intense exercise, and stress require more blood flow, which can lead to angina. It most often occurs in men. The pain usually lasts about 15 minutes. Pain may radiate to the shoulder, arm, jaw, back, neck, or other areas. As a rule, the patient is shown rest or nitroglycerin. If pain or heaviness in the chest continues for more than 15 minutes, the patient should be taken to the hospital.

Important Steps in the treatment of heart disease, which the patient can take (Total voters: 1 )