What is Diabetes?

The American Diabetes Association states that diabetes is a general term used to describe a group of metabolic health conditions that are associated with hyperglycemia that is caused by defects in insulin production (2010). Chronic hyperglycemia is characterized by different organs failure (particularly the nerves, eyes, blood vessels, and kidney).

There are numerous pathogenic processes that associated with the development of diabetes. One of them is insulin deficiency that occurs when the pancreas β-cells undergo autoimmune destruction.  Eventually, this leads to a lot of abnormalities including insulin resistance. Abnormalities in the metabolism of different organic compounds found in foods (proteins, carbohydrates, and fats) are caused by defects in insulin action.

Deficiency of insulin action occurs when the level of insulin production in the body is inadequate. It can also result from defects in tissue responses to insulin. Primarily, abnormalities and defects in insulin secretion and action is the leading cause of the diabetic hyperglycemia.

Hyperglycemia is linked to many signs and symptoms but the common ones include blurred vision, polyuria, polyphagia, weight loss, and polydipsia. Hyperglycemia and ketoacidosis are the life threatening consequences that occur if diabetes is uncontrolled.

Nephropathy that leads to retinal failure, peripheral neuropathy associated with lower limbs problems and amputations, retinopathy associated with loss of vision, sexual dysfunction and autonomic neuropathy are the potential long-term complications associated with diabetes. Cases of cerebrovascular health condition, atherosclerotic cardiovascular and peripheral arterial are also very common among diabetes patients.

Diabetes is divided into two etiopathogenetic groups that are referred to as type 1 and type 2 diabetes.  Type 1 diabetes is characterized by complete deficiency of insulin production. It is the least common type of diabetes.  Type 2 diabetes is the most prevalent and it occurs when cases of insulin action resistance combined with inadequate production of insulin are identified in a patient.

In type 2 diabetes, hyperglycemia leads to pathologic and functional changes most of the target tissues. The damage begins to occur very early before clinical diabetes signs begin to show.  In some cases the degree of hyperglycemia changes with time. This depends on the nature of progress that occurs to the underlying disease.

Individuals are usually assigned a type of diabetes depending on the signs and symptoms that they show during the time of diagnosis.  Most diabetic patients fit in more than one class of diabetes.  For example, a patient may be diagnosed with gestational diabetes and with type 2 diabetes later if the condition continues to be hyperglycemic. For individuals who develop diabetes because of continued use of exogenous steroids, the situation can become normoglycemic after they discontinue the use of the glucocorticoids. However, years later, they can develop diabetes again experiencing episodes of pancreatitis recurrently.

Type 1 Diabetes

According to the American Diabetes Association (2010), type 1 diabetes only affects approximately 5-10% of all the individuals suffering from diabetes.  It is commonly referred to as insulin-dependent diabetes or juvenile-onset diabetes.  It occurs when the pancreas β-cells experience autoimmune destruction.Complications Associated with Diabetes:

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Microvascular Complications

Microvascular complications is a term that brings together all the common challenges associated with diabetes. They include neuropathy, nephropathy, and retinopathy.

Most of the health complications that occur as a result of diabetes are primarily caused by oxidative stress and defects in the production of insulin (Papatheodorou et al., 2015). Oxidative stress is a complication that occurs when reactive oxygen species is overproduced.

Diabetic Neuropathy

Diabetic neuropathy is one of the leading complications associated with diabetes. It is very serious particularly because it can lead to death.  It is estimated that around 8 percent of newly diagnosed diabetes patients suffer with neuropathy whereas more than 50% of patients who have battled diabetes for a long-time suffer with the condition. Overall, neuropathy affects around 30-50 % of all diabetic individuals (Deli et al., 2013).

Related article: Walking shoes for diabetic foot

Hyperglycaemia is the primary cause of neuropathy.  Other factors that can lead to neuropathy include age, smoking, alcohol consumption, hypertension, duration of disease, high level of BMI, elevated triglycerides and taller height. According to Deli et al., (2013) population-based research has proven that peripheral is most common amongst diabetes mellitus patients. In addition, it is second highest in people who manifest defects in glucose tolerance.  Individuals who manifest impaired fasting glucose come in the third place whereas neuropathy is least common among subjects with normoglycaemia.

Investigative studies have linked oxidative stress with nerve damage in individuals suffering from diabetes.  Oxidative stress is mainly caused by vascular abnormalities. Nerve microangiopathy is a pathological process associated with oxidative stress and it leads to nerve damage.  Nerve injury leads to upregulation of receptor proteins such as “the transient receptor potential V1 (Deli et al., 2013).  It can also to other numerous issues that can lead to grievous health consequences.

Diabetic Retinopathy

Diabetic retinopathy is an eye disease that affects individuals with diabetes.  It occurs when high levels of blood sugars damage the blood vessels that are found in the retina.  In most cases, high blood sugars cause swelling in the blood vessels and sometimes the swelling can lead to leakage. There are incidences where the retina blood vessels close completely thereby blocking the movement of blood.  In other cases, abnormal vessels begin to grow in the retina. All these issues are extremely dangerous and can lead to loss of vision.

Diabetic retinopathy can occur in both type 1 and type 2 diabetes.  The probability of developing the condition is significantly influenced by the level of glycemic management and the duration of the disease.  Other factors that facilitate the risk of retinopathy include hypertension, neuropathy, and dyslipidemia.  In the recent years, several studies have shown that diabetic retinopathy is the leading cause of blindness in adults aged between 20 and 74 years in first world countries (Corcóstegui et al., 2017). The prevalence of eye-related health conditions such as cataracts and glaucoma is also relatively high among diabetes patients.

Retinopathy begins with mile nonproliferative abnormalities that are associated with an increase in the number of microaneurysms.  As the problem persists the condition deteriorates from mild to severe nonproliferative diabetic retinopathy to proliferative diabetic retinopathy.

Diabetic Nephropathy

This is a very serious complication among diabetics that affects the kidneys. It leads to kidney damage and dysfunction. The damage and failure of functioning are caused by persistently high levels of sugars in the blood. Nephropathy can be controlled by drugs and diet in its early stages. However, as it advances it becomes harder to control. The leading signs and symptoms associated with diabetic nephropathy include; loss of appetite, fatigue, nausea, and vomiting, and anemia. Nephropathy is more common in patients suffering from type 1 diabetes.  Approximately 30% to 40% of individuals suffering from type 1 diabetes suffer from the condition whereas the approximate figure of type 2 diabetes patients with nephropathy ranges between 20% and 30%.

Macrovascular Complications

In some cases, diabetes leads to large blood vessels. This is also known as macrovascular or cardiovascular complications.They include cerebrovascular problems, peripheral vascular condition, and coronary artery disease. In some cases, diabetes leads to large blood vessels. This is also known as macrovascular or. This exposes the body to risks such as stroke and heart attack.  It can also lead to poor circulation of the blood. Macrovascular problems are mainly caused by atherosclerosis. Atherosclerosis occurs when cholesterol and fats accumulate in the inner walls of the blood vessels. This makes the passage that allows the blood to flow efficiently narrower than normal. Sometimes the plague accumulated in the walls raptures thereby causing blood clot. This affects the supply of blood throughout the entire body

Depression

Lastly, depression is another challenge that is common among diabetes patients. It is mainly caused by poorer glycemic control, increased medical bills, recurrent and chronic health complications and deteriorated quality of life.  Healthcare professionals should ensure that they screen diabetes patients for depression often. This can be easily achieved through direct questioning. A standardized questionnaire can also yield the target results.  Diabetes patients should also take up the responsibility of avoiding depression. For example, if you notice signs of overthinking, always inform your doctor so that you can be informed about the next course of action. You can also for a counselling class to ensure that you cope with your problem more conveniently.

Body Parts at Risk

In summary, here are the body parts that are likely to be affected if you are suffering with diabetes.

Heart

Blood vessels with plague lead to reduced flow of blood. This increases the chances of developing a heart attack.  Heart attack is mainly caused by sudden blockage of any of the blood vessels that supply blood to the heart. This causes severe damage to the heart muscle. Some of the symptoms associated with heart attack include breathing problems and chest pain. Sometimes pain can move from the chest to the neck and to the left arm. Diabetes patients with nerve problems do not experience any symptoms during a heart attack.

Brain

Atherosclerosis increases the chances of developing stroke. When one of the blood vessels that supply blood to the brain is blocked, stroke is the health complication that follows. The common signs associated with stroke include talking difficulties, numbness in one side of the body and one-sided face droopiness.

Lower Limbs

Peripheral arterial disease is one of the most common conditions that affect the lower limbs in diabetic individuals. It occurs if the level of blood flowing to the legs and feet decreases beyond normal. As a result, the victims experience pain, discoloration, troubled walking, shiny legs and coldness in the feet. If this condition persists for a long time, it can lead to amputation. There many other challenges that can affect diabetic foot.  The most common ones include food ulcers and gangrene. All these complications are severe and if left untreated, they lead to amputation or death.

Eyes

Diabetes can easily lead to eye complications.  High level of blood sugars affect the small blood vessels that lead to retina found in the eyes.  If the blood vessels become damaged to a point of leaking or blocking the movement of blood to the retina, the condition is referred to as retinopathy.  However, the most common eye problems among diabetics are glaucoma and cataracts. Diabetic eye related problems are easy to treat if they are detected at an early stage. The easiest way to prevent yourself from developing permanent eye problems in to ensure that your eyes are regularly checked by an eye specialist (optometrist).

Read Also: The Best Medicare Certified Diabetes Shoes for Diabetics

Kidneys

High blood pressure and increased levels of blood glucose can lead to damage of the kidneys.  This occurs when the blood vessels associated with the kidneys begin to leak thereby disrupting the functioning of the kidney. Ensure that your kidneys undergo a medical checkup annually so that any problems that are likely to occur can be detected early.

Nerves

High level of glucose in the blood is associated with nerve damage. This can be worsened by consumption of large amounts of alcohol. Nerves found in the lower limbs are the ones that develop a lot of complications in diabetes patients. However, nerve related complications can also target the arms and hands. Tingling, numbness and pain are the most common symptoms associated with nerve problems.  In some cases, the nerves found in the stomach also become affected.  This leads to problems such as constipation, diarrhea and bladder problems.

Skin

Sometimes high level of blood glucose can cause skin problems. The most common skin problems associated with high levels of glucose include extremely dry skin and irritation.  To avoid such problems, always pay keen attention to shower products and moisturizers that you use. Use moisturizers and soaps that keep your skin supple and soft. Always ensure that you treat cuts and wounds that develop on your skin promptly to prevent persistent infections.

References

Litwak, L., Goh, S. Y., Hussein, Z., Malek, R., Prusty, V., & Khamseh, M. E. (2013). Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A 1 chieve study. Diabetology & metabolic syndrome5(1), 57.

Lehto, M., Wipemo, C., Ivarsson, S., Lindgren, C., Lipsanen-Nyman, M., Tuomi, T., … & Groop, L. (1999). High frequency of MODY and mitochondrial gene sequence variations in Scandinavian families with early-onset diabetes. Diabetologia42, 1131-1137.

American Diabetes Association. (2010). Diagnosis and classification of diabetes mellitus. Diabetes care33(Supplement 1), S62-S69.

Papatheodorou, K., Banach, M., Edmonds, M., Papanas, N., & Papazoglou, D. (2015). Complications of diabetes. Journal of diabetes research2015.

Deli, G., Bosnyak, E., Pusch, G., Komoly, S., & Feher, G. (2013). Diabetic neuropathies: diagnosis and management. Neuroendocrinology98(4), 267-280.

Corcóstegui, B., Durán, S., González-Albarrán, M. O., Hernández, C., Ruiz-Moreno, J. M., Salvador, J., & Rafael, P. U. Update on Diagnosis and Treatment of Diabetic Retinopathy.

 

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