DIABETIC MICROANGIOPATHY

Diabetic microangiopathy

Elevated blood sugar levels cause sugar to accumulate in the vessel walls, causing them to thicken and occlusion of the vessels. The small vessels of the retina, the kidneys and the nervous system with their small diameter are particularly affected by this.

Long-term effects on the eye: diabetic retinopathy
The blood supply to the retina is poor due to the vascular changes mentioned above, which leads to loss of vision. In addition to an unfavorable metabolic situation, high blood pressure and smoking also aggravate the course of diabetic retinopathy.
90% of type 1 diabetics and 25% of type 2 diabetics develop diabetic retinopathy after 15 years.

Long-term effects on the kidneys: diabetic nephropathy
The kidney blood flow and its filtering function are disturbed by sugar deposits on the small vessels of the kidney. This functional restriction becomes clinically visible through proteins that can be detected in the urine, which originate from the blood (microalbuminuria). This kidney damage can lead to kidney failure, which requires artificial blood washing (Dialysis) makes necessary. After 25 years of illness, 35% of diabetics develop kidney damage in the form of diabetic nephropathy, resulting in chronic kidney failure.

Long-term effects on the nervous system: diabetic neuropathyThe supply of the nerves is disturbed and the patients report a sensitivity disorder, especially in the feet and lower legs (e.g. burning sensation, decreased sensation), reflexes cannot be triggered in some cases, the sensation of temperature and pain are reduced. After 10 years of illness, half of diabetic patients suffer from diabetic neuropathy.
Read also: Burning in the fingers

Long-term effects on vessels and nerves: diabetic foot syndrome
Due to nerve damage (neuropathic diabetic foot syndrome) and / or vascular damage (ischemic diabetic foot), injuries to the foot lead to open wounds in 15% of older diabetics, which heal poorly and can even form ulcers.

In the neuropathic diabetic foot, the sensation on the feet is reduced, the feet are dry and warm, and the pulses are palpable. Painlessness is dangerous with this form of disease: Due to the damage to the nerves, patients do not feel when they have pressure or open spots on their feet. As a result, wounds are noticed and treated too late.

Also patients with ischemic, i.e. poorly perfused, diabetic feet have wound healing disorders so that small injuries can lead to ulcerations. In contrast to the nerve-related disease mentioned above, patients are in great pain and can therefore only cover a limited distance on foot. No pulses can be felt and the feet are usually bluish in color.

It is therefore important that older diabetics examine their feet daily for injuries and that they see a doctor if they notice a wound or an injury that is poorly healing.

Diabetic macroangiopathy

This complication goes hand in hand with an early one Arteriosclerosis. On the walls of the large vessels of the body settle down Sugar, cholesterol and Fats so that the vessels become narrower and the supply of the downstream organs deteriorates.
From this one can Heart attack result when the coronary arteries are seized by the disease process. If the leg arteries are narrowed or even blocked, the strain when walking is very painful and the walking distance is limited (peripheral arterial disease). If the vessels supplying the brain are affected by arteriosclerotic changes, a Stroke (apoplexy) possible consequence.

The nerve damage caused by diabetes mellitus can lead to erectile dysfunction and erectile dysfunction in men and to the absence of menstrual bleeding in women.