Introduction
Diabetes mellitus is a disease that becomes more and more common with increasing age. In the case of the disease, the body’s own hormone insulin is no longer sufficiently able to lower the blood sugar level, as insulin can either no longer be produced or the body has developed resistance to insulin. Too high a blood sugar level in the blood causes serious damage in the long term, which is why blood sugar should be closely monitored and conscientiously lowered by changing one’s lifestyle (in the case of type 2 diabetes) and, if this is no longer sufficient, additionally by medication.
Physical consequences
Increased sugar levels promote the calcification of blood vessels. In technical terms, calcification of arterial blood vessels is referred to as arteriosclerosis. The increasing calcification causes the diameter of the blood vessels to decrease, resulting in poorer blood circulation.
In principle, all vessels of the body are affected, but it can be particularly critical in the case of the coronary arteries and the carotid artery, as this can lead to a heart attack or stroke. The risk of a diabetic to suffer a heart attack or stroke is two to four times higher than for a non-diabetic. A heart attack usually manifests itself through relatively typical heart attack symptoms such as stabbing chest pain radiating into the left arm and accompanying shortness of breath.
However, since an elevated sugar level in the blood of diabetics also attacks the nerves in the long term, the pain of a heart attack is sometimes not fully perceived, but often only felt as a burning sensation. A felt burning sensation cannot then be correctly classified by those affected. The calcification of vessels can also lead to peripheral arterial occlusive disease (PAD), in which pain in the legs increasingly occurs during walking because they are not supplied with sufficient blood.
The vessels of the retina are also particularly affected by damage in the long term. At the retina, there can be vascular sacculation, fat deposits, bleeding and occlusion of vessels. As a result, new vessels often form, but they can easily tear open again and lead to retinal detachment.
In addition to a retinal detachment, the risk of developing glaucoma or cataracts is also increased. In the long run, diabetic damage to retinal vessels can lead to blindness. This process is called diabetic retinopathy.
In order to prevent blindness, diabetics should visit their ophthalmologist once a year for an ophthalmoscopy to check whether there has already been damage to the retinal vessels. With a well adjusted blood sugar level, these consequences can be prevented as far as possible. Similar to diabetic retinopathy, diabetic nephropathy can occur.
In diabetic nephropathy, the blood vessels of the kidney are damaged, so that in the long term the kidney can no longer properly drain and “cleanse” the body. Damage to the kidney due to diabetes is the most common cause of kidney weakness and even kidney failure. An early sign of incipient kidney weakness is the presence of small proteins in the urine (microalbuminuria).
Normally, proteins should not be able to cross the kidney barrier and enter the urine. So proteins in the urine are a sign that the filter function of the kidney is no longer functioning properly. In addition, the kidney is also continuously overloaded by the increased glucose concentration in the blood and can no longer absorb the glucose from the urine.
The sugar ends up in the urine, which is not the case in healthy people. As a result, people with diabetes more often develop urinary tract infections, since the sugar is the bacteria‘s favorite food. A combination of reduced blood flow due to vascular calcification and nerve damage to the feet can lead to a condition known as diabetic foot.
In this case, small injuries occur at the beginning, which on the one hand are not properly perceived by the affected person due to the nerve damage and on the other hand cannot heal properly due to the lack of blood supply. The wounds can also become infected. In order to fight the infection, the foot must be supplied with sufficient blood, which contains components of the immune system and can fight the pathogen.
In the long run, ulcers develop. If these ulcers develop massively and do not heal any further, it may sometimes be necessary to amputate the foot to prevent a life-threatening spread of the resulting infection.To avoid this, the feet, especially the spaces between the toes, should be checked regularly for small wounds. The attending physician will also want to look at the feet from time to time. Superinfection
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