Long Term Complications of Diabetes
A diabetic person cannot make normal use of sugar, and so sugar builds up in the blood. The kidneys discharge some of the excess sugar in the urine. In severe cases of diabetes, fats and proteins cannot also be used normally.
The type 1 diabetes strikes some people so suddenly that the lack of insulin causes an emergency condition called diabetic ketoacidosis. There is excess urination, thirst, loss of appetite, nausea, vomiting and difficulty in breathing. If the patient is not treated promptly, he may go into diabetic coma with fatal results.
In type 2 diabetes, the patient has normal or even above normal production of insulin. But their bodies do not respond efficiently to the insulin. Symptoms of type 2 diabetes are excessive urination, great thirst, hunger and loss of weight and strength.
Complications of Diabetes
It is very important to take care of diabetes as improper care can give rise to several complications. If the blood sugar level is kept under control, one can prevent many health problems. Many people come to know of their diabetes only when they develop one of its complications.
1. The structural and functional abnormalities of diabetic complications are the glycation of structural proteins and the production of advanced glycation end products with their deposition in various tissues.
2. Most patients with type 2 diabetes also tends to be obese and hypertensive.
3. Angina is a long term complication of diabetes.
4. Difficulty in walking with chronic ulceration of feet due to diabetic neuropathy and also diabetic microangiopathy and diabetic nephropathy due to small blood vessel disease.
5. Diabetic patients are at higher risk of developing atheroscelerosis.
6. Wound healing is delayed in diabetics because of neuropathy, and hyperglycaemia.
7. Intermittent claudication and gangrene due to atherosclerosis
8. Blindness due to diabetic retinopathy
9. Diabetes affects the blood vessels, the blood and the heart.
10. Cardiac failure is also another long term complication of diabetes.
I hope this article has covered some of the long term complications of diabetes. Knowing these complications will help you to prevent them.
Control your blood glucose level for more controlled life!
Disclaimer: This article is not meant to provide health advice and is for general information only. Always seek the insights of a qualified health professional before embarking on any health program.
Copyright © Nick Mutt, All Rights Reserved. If you want to use this article on your website or in your ezine, make all the urls (links) active.
Are you looking for some Home remedies for cellulite? Know effective Home remedies for weight loss. Read useful Home remedies for erectile dysfunction for more intimate relationship.
Nick Mutt
http://www.articlesbase.com/diseases-and-conditions-articles/long-term-complications-of-diabetes-670039.html
December 7th, 2009 at 10:33 pm
initial complaints and long term complications diabetes?
December 8th, 2009 at 3:35 am
Diabetes:
Warning Signs
Because diabetes can cause serious complications, it’s important to be on the lookout for signs that you may have diabetes. The symptoms of type 1 diabetes may include:
Increased thirst.
Increased hunger (especially after eating).
Dry mouth.
Frequent urination.
Unexplained weight loss (even though you are eating and feel hungry).
Fatigue (weak, tired feeling.
Blurred vision.
Headaches.
Loss of consciousness (rare).
Type 2 diabetes is usually not diagnosed until complications have occurred. Most often, there are no symptoms or a very gradual development of the above symptoms. In fact, about a third of all people who have type 2 diabetes don’t know they have it. When hyperglycemia occurs, the symptoms can be the same as those listed above.
Other symptoms of type 2 diabetes may include:
Slow-healing sores or cuts.
Itching of the skin (usually around the vaginal or groin area).
Frequent yeast infections.
Recent weight gain.
Velvety dark skin changes of the neck, armpit and groin, called acanthosis nigricans.
Numbness and tingling of the hands and feet.
Decreased vision.
Impotency.
If you have any of these symptoms, contact your health care provider right away so you can get tested or screened. Even people with pre-diabetes can have the increased risk from heart disease seen in people with diabetes
How can I prevent long term complications of diabetes?
Over time, diabetes can sometimes lead to complications. Fortunately, research has shown that many of these complications can be prevented or delayed. Keeping your blood sugar and blood pressure as close to normal as possible may help prevent or delay eye, kidney, nerve, and heart and blood vessel damage caused by diabetes. Though it isn’t easy to hear about these complications, you need to know about early signs and detection so they can be found and treated early.
Diabetic Eye Disease (Retinopathy)
Diabetic eye disease or "retinopathy" causes changes to the back of the eye or retina. These changes are different than the eye changes that cause you to need glasses. These changes may be mild, or may become severe and can even lead to loss of vision. The changes to the retina may occur without any symptoms. It is found by having your eyes examined every one or two years by a eye care specialist. In order to look for retinopathy, the eye care specialist will use drops to dilate your pupils so that the blood vessels in the back of your eye can be clearly seen. If you haven’t had a dilated eye examine in more than one to two years, ask your provider for a referral.
Diabetic Kidney Disease (Nephropathy)
Diabetic kidney disease is also called nephropathy. Diabetes can damage the kidney’s ability to filter waste products in the blood. These waste products build up in the blood stream, instead of passing out of your body in the urine. There may be no symptoms until kidney disease is advanced. Fortunately there are simple urine tests that your health care provider can arrange that show the earliest signs of kidney damage. Keeping your blood sugar and blood pressure near normal and medications can slow the progress of kidney damage, and hopefully prevent kidney failure.
Diabetic Nerve Disease (Neuropathy)
Diabetic nerve disease or "neuropathy" is damage to the nerves that sense pain, temperature and position. Neuropathy may also affect nerves that regulate blood pressure, heart rate and stomach function. Some people with early neuropathy notice numbness or tingling (like a pins- and-needle sensation) in their toes and feet. Others have severe, stabbing or electric-shock type pain in their legs. Still, others lose all sensation in their feet. This increases the risk for foot injury which can lead to infection, and amputation if the infection doesn’t heal. The things you can do to take care of your feet are: look at your feet daily for any signs of redness, blisters, cuts or sores; wear well-fitting shoes; protect your feet from injury; and remove your shoes and socks at each diabetes visit so your feet can be examined.
What other complications should I be aware of?
Diabetes can also affect the large blood vessels. People with diabetes have an increased risk for heart disease, heart attacks and strokes. Keeping your cholesterol and blood pressure levels near the normal range helps to decrease your risk. Ask your provider to arrange to have a cholesterol blood test done at least once a year and to take your blood pressure at each clinic visit.
References :
webmd
http://www.med.umich.edu/1libr/guides/diabcomp.htm
December 8th, 2009 at 3:37 am
There are 3 P’s that you have to remember when it comes to Diabetes. These are Polyphagia ( you tend to eat a lot and crave a lot), Polydipsia (thirst for water) and Polyuria (frequency in urination). There are a lot of complications brought about by Diabetes. The microvascular complications which includes retinopathy which may lead to visual loss, nephropathy which may lead to renal failure and neuropathy which may lead to sensory loss.The most common is neuropathy which eventually brings about the famous diabetic foot. Diabetics with neuropathy lose their sensory functions. Example, they could not feel their toes, therefore, even if they have a wound on their toe they neglect it because they are not able to feel anything. This eventually lead to infection of the entire foot.
The macrovascular complications includes atherosclerosis and peripheral vascular disease.
References :
December 8th, 2009 at 3:39 am
Initially you get frequency of micturition, intense thirst, with perhaps noturia, polyphagia, weight loss, Weakness and lassitude, pruritis vulvuae in females or balanitis in males, leg cramps, crops of boils, loss of libido and impotence in males and occasionally blurring of vision.
Late complications are Severe diabetic acidosis, hypertension, Arteriosclerosis of coronary, peripheral and cerebral arteries, microangiopathy, cataract, errors of refraction retinopathy, iridopathy, Tuberculosis, infectious gangrene, Pruritis vulvae, boils , carbuncles, polyneuropathy, , MULTIPLE VISCERAL INVOLVEMENTS, ,Renal involvement, delayed development of sexual characters, early menopause, reduced fertility and libido in females, complications in pregnancy, acute diabetic abdomen etc.
References :
December 8th, 2009 at 3:41 am
Diabetes and Dental Problems
People with diabetes are more vulnerable to the millions of germs that live in your mouth. As a result, people with diabetes are more likely to have infections of their gums and the bones that hold the teeth in place. Diabetes also causes a decrease in blood supply to the gums making them more susceptible to disease. In addition, high blood sugars may cause dry mouth and make gum disease worse. The decrease in saliva can cause an increase in tooth decaying bacteria and plaque build up.
What Are the Symptoms of Dental Problems?
Symptoms to watch for include bleeding and sore gums, frequent infections and bad breath.
How Can I Prevent These Dental Problems?
Taking good care of your gums and teeth is very important, especially if you have diabetes. Here are some tips:
Have a dental checkup every six months.
Tell your dentist that you have diabetes and ask him or her to show you how to take proper care of your gums and teeth.
Brush and floss your teeth at least twice a day
If you smoke, quit.
Maintain good glucose control.
If severe gum disease develops, surgery may save your teeth. But if that’s not possible, you may have to have teeth pulled to prevent the infection from destroying the bone around your teeth.
Diabetes:
Eye Problems Linked to Diabetes
If you have diabetes, don’t buy a new pair of glasses when you notice you have blurred vision. It could just be a temporary problem that develops rapidly and is caused by high blood glucose levels.
High blood glucose causes the lens of the eye to swell, which changes your ability to see. To correct this kind of blurred vision, you need to get your blood glucose back into the target range (90-130 milligrams per deciliter or mg/dL before meals, and less than 180 mg/dL one to two hours after a meal). It may take as long as three months after your blood glucose is well controlled for your vision to fully get back to normal.
Blurred vision can also be a symptom of more serious eye problems. The three major eye problems that people with diabetes may develop and should be aware of are cataracts, glaucoma and retinopathy.
Cataracts
A cataract is a clouding or fogging of the normally clear lens of the eye. The lens is what allows us to see and focus on an image just like a camera. Although anyone can get cataracts, people with diabetes get cataracts at an earlier age than most and the condition progresses more rapidly than in people without diabetes.
If you have a cataract, your eye cannot focus light and your vision is impaired. Symptoms include blurred or glared vision.
Treatment is usually surgery followed by placement of a lens implant, with glasses or contact lenses as needed to further correct vision.
Glaucoma
When fluid inside the eye does not drain properly from a build up of pressure inside the eye, it results in a disease called glaucoma. The pressure damages nerves and the vessels in the eye, causing changes in vision.
In the most common form of glaucoma, there may be no symptoms at all until the disease is very advanced and there is significant vision loss. In the less common form, symptoms can include headaches, eye aches or pain, blurred vision, watering eyes, halos around lights and loss of vision.
Treatment can include special eye drops, laser procedures, medicine or surgery. You can prevent serious problems by getting an annual glaucoma screening from your eye doctor.
Retinopathy
The retina is a group of specialized cells that convert light as it enters though the lens into images. The eye nerve or optic nerve transmits visual information to the brain.
Diabetic retinopathy is one of the vascular (blood-vessel related) complications related to diabetes. It is due to damage of small vessels and so is called a "microvascular complication." Kidney disease and nerve damage due to diabetes are also microvascular complications. Large blood vessel damage (also called macrovascular complications) includes complications like heart disease and stroke.
The microvascular complications have, in numerous studies, been shown to be related to high blood glucose levels. You can reduce your risk of these complications by improving your blood sugar control.
Diabetic retinopathy is the leading cause of irreversible blindness in industrialized nations. The duration of diabetes is the single most important risk for developing retinopathy. So the longer you have diabetes, the greater the risk. If retinopathy is not found early or is not treated, it can lead to blindness.
People with type 1 diabetes rarely develop retinopathy before puberty. In adults with type 1 diabetes, it is also rare to see retinopathy before 5 years duration of diabetes. The risks of retinal damage increase with progressive duration of diabetes. Intensive control of blood glucose levels will reduce your risks of developing retinopathy. The DCCT, a large study of people with type 1 diabetes showed that people with diabetes who achieved tight control of their blood sugars with either an insulin pump or multiple daily injections of insulin were 50%-75% less likely to develop retinopathy, nephropathy (kidney disease) or nerve damage (all microvascular complications).
People with type 2 diabetes usually have signs of eye disease when diabetes is diagnosed. In this case, control of blood sugar, blood pressure and blood cholesterol have important role in slowing the progression of retinopathy.
Types of Retinopathy:
Background retinopathy. Sometimes the blood vessel damage exists, but there is no vision problem. This is called background retinopathy. It’s important to carefully manage your diabetes at this stage to prevent background retinopathy from progressing to more serious eye disease.
Maculopathy. In maculopathy, the person has developed damage in a critical area called the macula. Because this occurs in an area that is critical to vision, this type of eye problem can significantly reduce vision.
Proliferative retinopathy. New blood vessels start to grow in the back of the eye. Because retinopathy is a microvascular complication of diabetes, a disease of small vessels, this type of retinopathy develops because of an increasing lack of oxygen to the eye from vascular disease. Vessels in the eye are thinned and occluded and they start to remodel.
Here, it is important to address the risks factors that can worsen the occluded vessels. Smoking cessation, hypertension control, cholesterol management and glucose control must take place in order to stop the progression of new vessels from forming into the orbit of the eye. These are fragile vessels that can bleed and eventually cause a clot to form in the orbit, which scars and causes detachment of the retina. This eventually leads to irreversible vision loss.
Treatment of diabetic retinopathy may involve laser procedures or surgery. In a study of people with diabetes with early retinopathy, laser therapy to burn the fragile vessel resulted in a 50% reduction of blindness.
To prevent retinopathy, have your eye doctor screen your eyes annually. Women with diabetes who later become pregnant should have a comprehensive eye exam during the first trimester and close follow-up with an eye doctor during the rest of their pregnancy. (This recommendation does not apply to women who develop gestational diabetes, since they are not at risk for retinopathy.)
How Can I Prevent Eye Problems?
The American Diabetes Association offers these eye care guidelines for people with diabetes:
People with type 1 diabetes should have a dilated eye exam by an ophthalmologist or optometrist within 3- 5 years after diagnosis.
People with type 2 diabetes should have a dilated eye exam by an ophthalmologist or optometrist shortly after diagnosis.
Annually eye exams should be done on both type 1 and type 2 diabetes by an ophthalmologist or optometrist; more frequently if necessary.
When considering pregnancy, women with a history of diabetes should have an eye exam prior and during pregnancy. This does not pertain to women with gestational diabetes.
In addition you should:
Control your blood glucose
Control high blood pressure
When to Contact Your Doctor?
Contact your doctor if any of the following occur:
Black spots in your vision.
Flashes of light.
"Holes" in your vision.
Blurred vision.
Diabetes:
Foot Problems Related to Diabetes
For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause some serious complications, including foot problems.
How Can Diabetes Affect My Feet?
Diabetes can cause two problems that can affect your feet:
Diabetic neuropathy. Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain. This lack of feeling is called "sensory diabetic neuropathy." If you do not feel a cut or sore on your foot because of neuropathy, the cut could get worse and become infected. The muscles of the foot may not function properly because the nerves that make the muscles work are damaged. This could cause the foot to not align properly and create too much pressure in one area of the foot. It is estimated that up to 10% of people will develop foot ulcers. Foot ulcers occur because of nerve damage and peripheral vascular disease.
Peripheral vascular disease. Diabetes also affects the flow of blood. Without good blood flow, it takes longer for a sore or cut to heal. Poor blood flow in the arms and legs is called "peripheral vascular disease." Peripheral vascular disease is a circulation disorder that affects blood vessels away from the heart. If you have an infection that will not heal because of poor blood flow, you are at risk for developing ulcers or gangrene (the death of tissue due to a lack of blood).
What Are Some Common Foot Problems of People With Diabetes?
Anyone can get the foot problems listed below. For people with diabetes, however, these common foot problems can possibly lead to infection and serious complications, such as amputation.
Athlete’s foot. Athlete’s foot is a fungus that causes itching, redness and cracking. Germs can enter through the cracks in your skin and cause an infection. Medicines that kill the fungus are used to treat athlete’s foot. These medicines may be pills and/or creams applied directly to the problem area. Ask your doctor to recommend a medication for athlete’s foot.
Fungal infection of nails. Nails that are infected with a fungus may become discolored (yellowish-brown or opaque), thick and brittle, and may separate from the rest of the nail. In some cases, the nail may crumble. The dark, moist and warm environment of shoes can promote fungal growth. In addition, an injury to the nail can put you at risk for a fungal infection. Fungal nail infections are difficult to treat. Medications applied directly to the nail are available, but they only help a small number of fungal nail problems. Oral medications (pills) may need to be prescribed by your doctor. Treatment also may include periodic removal of the damaged nail tissue.
Calluses. A callus is a build-up of hard skin, usually on the underside of the foot. Calluses are caused by an uneven distribution of weight, generally on the bottom of the forefoot or heel. Calluses also can be caused by improperly fitting shoes or by a skin abnormality. Keep in mind that some degree of callus formation on the sole of the foot is normal. Proper care is necessary if you have a callus. After your bath or shower, use a pumice stone to gently remove the build-up of tissue. Use cushioned pads and insoles in your shoes. Medications also may be prescribed to soften calluses. DO NOT try to cut the callus or remove it with a sharp object.
Corns. A corn is a build-up of hard skin near a bony area of a toe or between toes. Corns may be the result of pressure from shoes that rub against the toes or cause friction between the toes. Proper care is necessary if you have a corn. After your bath or shower, use a pumice stone to gently remove the build-up of tissue. Do not use over-the-counter remedies to dissolve corns. DO NOT try to cut the corn or remove it with a sharp object.
Blisters. Blisters can form when your shoes rub the same spot on your foot. Wearing shoes that do not fit properly or wearing shoes without socks can cause blisters, which can become infected. When treating blisters, it’s important not to "pop" them. The skin covering the blister helps protect it from infection. Use an antibacterial cream and clean, soft bandages to help protect the skin and prevent infection.
Bunions. A bunion forms when your big toe angles in toward the second toe. Often, the spot where your big toe joins the rest of the foot becomes red and callused. This area also may begin to stick out and become hard. Bunions can form on one or both feet. They may run in the family, but most often are caused by wearing high-heeled shoes with narrow toes. These shoes put pressure on the big toe, pushing it toward the second toe. The use of felt or foam padding on the foot may help protect the bunion from irritation. A device also may be used to separate the big and second toes. If the bunion causes severe pain and/or deformity, surgery to realign the toes may be necessary.
Dry skin. Dry skin can crack, which can allow germs to enter. Use moisturizing soaps and lotions to help keep your skin moist and soft.
Foot ulcers. A foot ulcer is a break in the skin or a deep sore, which can become infected. Foot ulcers can result from minor scrapes, cuts that heal slowly or from the rubbing of shoes that do not fit well. Early intervention is important in treatment. Ask your doctor for advice on how to best care for your wound.
Hammertoes. A hammertoe is a toe that is bent because of a weakened muscle. The weakened muscle makes the tendons (tissues that connect muscles to bone) shorter, causing the toes to curl under the feet. Hammertoes can run in families. They can also be cause by shoes that are too short. Hammertoes can cause problems with walking and can lead to other foot problems, such as blisters, calluses, and sores. Splinting and corrective footwear can help in treating them. In severe cases, surgery to straighten the toe may be necessary.
Ingrown toenails. Ingrown toenails occur when the edges of the nail grow into the skin. They cause pressure and pain along the nail edges. The edge of the nail may cut into the skin, causing redness, swelling, pain, drainage and infection. The most common cause of ingrown toenails is pressure from shoes. Other causes include improperly trimmed nails, crowding of the toes and repeated trauma to the feet from activities such as running, walking or doing aerobics. Keeping your toenails properly trimmed is the best way to prevent ingrown toenails. If you have a persistent problem or if you have a nail infection, you may need a doctor’s care. Severe problems with ingrown nails may be corrected with surgery to remove part of the toenail and growth plate.
Plantar warts. Plantar warts look like calluses on the ball of the foot or on the heel. They may appear to have small pinholes or tiny black spots in the center. The warts are usually painful and may develop singly or in clusters. Plantar warts are caused by a virus that infects the outer layer of skin on the soles of the feet. DO NOT use over-the-counter medications to dissolve the wart. If you are not sure if you have a plantar wart or a callus, let your doctor decide.
Can These Foot Problems Be Prevented?
Proper foot care can help prevent these common foot problems and/or treat them before they cause serious complications. Here are some tips for good foot care:
Take care of yourself and your diabetes. Follow your health care provider’s advice regarding nutrition, exercise, and medication. Keep your blood glucose level within the range recommended by your doctor.
Wash your feet in warm water every day, using a mild soap. Do not soak your feet. Dry your feet well, especially between the toes.
Check your feet every day for sores, blisters, redness, calluses, or any of the other problems listed above. If you have poor blood flow, it is especially important to do a daily foot check.
If the skin on your feet is dry, keep it moist by applying lotion after you wash and dry your feet. Do not put lotion between your toes. Your doctor can tell you which type of lotion is best to use.
Gently smooth corns and calluses with an emery board or pumice stone. Do this after your bath or shower, when your skin is soft. Move the emery board in only one direction.
Check your toenails once a week. Trim your toenails with a nail clipper straight across. Do not round off the corners of toenails or cut down on the sides of the nails. After clipping, smooth the toenails with an emery board.
Always wear closed-toed shoes or slippers. Do not wear sandals and do not walk barefoot, even around the house.
Always wear socks or stockings. Wear socks or stockings that fit your feet well and have soft elastic.
Wear shoes that fit well. Buy shoes made of canvas or leather and break them in slowly. Extra wide shoes are also available in specialty stores that will allow for more room for the foot for people with foot deformities.
Protect your feet from heat and cold. Wear shoes at the beach or on hot pavement. Wear socks at night if your feet get cold.
Keep the blood flowing to your feet. Put your feet up when sitting, wiggle your toes and move your ankles several times a day, and don’t cross your legs for long periods of time.
If you smoke, stop. Smoking can make blood flow problems worse.
If you have a foot problem that gets worse or won’t heal, contact your doctor for advice and treatment.
Make sure your diabetes doctor examines your feet during each check-up. An annual foot exam should be performed which should include an inspection of the skin — he or she may check for redness or warm of the skin. The exam will also be to check for pulses and temperature of your feet and an assessment of sensation to the foot with something called a monofilament.
See your podiatrist (foot doctor) every two to three months for check-ups, even if you don’t have any foot problems.
When Should I Contact My Doctor?
Contact your doctor if you experience any of the following problems:
Changes in skin color.
Changes in skin temperature.
Swelling in the foot or ankle.
Pain in the legs.
Open sores on the feet that are slow to heal or are draining.
Ingrown toenails or toenails infected with fungus.
Corns or calluses.
Dry cracks in the skin, especially around the heel.
Unusual and/or persistent foot odor
Diabetes:
Heart and Blood Vessel Disease
Heart disease is common in people with diabetes. Statistics from the American Heart Association estimate that heart disease and stroke are responsible for two-thirds to three-fourths of deaths amongst those with diabetes.
While all people with diabetes have an increased chance of developing heart disease, the condition is more common in those with type 2 diabetes.
One of the first pieces of evidence that showed that people with diabetes are more vulnerable to heart disease was a large study known as the "Framingham study." This study looked at generations of people to try to determine the factors for developing heart disease. It showed that multiple factors could increase the possibility of developing heart disease. One obvious risk was having diabetes. Other things include high blood pressure, smoking, high cholesterol levels and a family history of early heart disease.
The more risks factors a person has, the higher the chances that they will develop heart disease and die from it. Just like anyone else, people with diabetes have an increased risk of dying from heart disease if they have more risk factors. However, the probability is dramatically higher in a person with diabetes. So, while a person with one risk factor may have a certain chance of dying from a heart attack, a person with diabetes has double or even quadruple that risk of dying.
For example, one study found that people with diabetes who had no other risk factors for heart disease were 5 times more likely to die of heart disease than those without. Another study shows that people with diabetes, no matter the number of other heart disease risk factors, were as likely to have a heart attack as a non-diabetic who has already had a heart attack.
Therefore, diabetes is considered a heart disease equivalent. And experts recommend that all people with diabetes have their heart disease risk factors treated as aggressively as people who have already had heart attacks.
What Causes Heart Disease?
The most common cause of heart disease in a person with diabetes is hardening of the arteries or atherosclerosis, which is a buildup of cholesterol in the blood vessels that supply oxygen and nutrition to the heart.
This build up usually begins before the increase in blood sugars that occurs in type 2 diabetes. In other words, heart disease almost always has established itself prior to the diagnosis of type 2 diabetes.
These cholesterol plaques can break apart or rupture, causing blood clots and blocking the blood vessel. This can lead to a heart attack. The same process can happen in all of the arteries in the body, resulting in lack of blood to the brain, causing a stroke or lack of blood to the feet, hands or arms causing peripheral vascular disease.
People with diabetes are also at higher risk for heart failure, a condition in which the heart is not able to pump blood adequately. This can lead to fluid build-up in the lungs that causes difficulty breathing, or fluid retention in other parts of the body (especially the legs) that causes swelling.
What Are the Symptoms of Heart Disease?
The symptoms of heart diease include:
Shortness of breath.
Feeling faint.
Feeling dizzy.
Excessive and unexplained sweating.
Pain in the shoulders, jaw and left arm.
Chest pain or pressure (especially during activity).
Nausea.
*If you are experiencing any of these symptoms, you should call your doctor or go to the nearest emergency room immediately.
Peripheral vascular disease has the following symptoms:
Cramping in your legs while walking (intermittent claudication).
Cold feet.
Decreased or absent pulses in the feet or legs.
Loss of fat under the skin of the lower parts of the legs.
Loss of hair on the lower parts of the legs.
How Is Heart Disease Treated?
There are several treatment options depending on the severity of the condition, including:
Aspirin therapy* to reduce the risks of clots that lead to heart attacks and strokes.
Diet.
Exercise not only for weight loss, but to improve glucose control, high blood pressure, cholesterol levels and to decrease abdominal fat, a risk factor of heart disease.
Medicines.
Surgery.
How Is Peripheral Vascular Disease Treated?
Participation in a regular walking program (45 minutes per day, followed by rest).
Special footwear.
Aspirin therapy.*
Medicines.
Stopping smoking.
*Low-dose aspirin therapy is recommended for men and women with diabetes who are over age 30 and are at high risk for heart disease and peripheral vascular disease. Talk to your doctor to determine if aspirin therapy is right for you. If you have certain medical conditions, aspirin therapy may not be recommended.
How Can Heart Disease Be Prevented in a Person With Diabetes?
The best way to prevent heart and blood vessel disease is to take good care of yourself and your diabetes.
Keep your blood glucose as normal as possible.
Control your blood pressure, with medication if necessary. The target for people with diabetes is under 130/80.
Get your cholesterol numbers under control. You may need to take medication to do this.
Lose weight if you are obese.
Ask your doctor if you should take an aspirin a day.
Exercise regularly.
Eat a heart-healthy diet low in fat and salt.
Quit smoking
Diabetes:
Hyperglycemic Hyperosmolar Nonketotic Syndrome
Hyperglycemic hyperosmolar nonketotic syndrome or HHNS is a serious complication that can happen to a person with type 2 diabetes who is ill or stressed. This condition occurs when the blood sugar gets too high and the body becomes severely dehydrated. Unlike ketoacidosis, which produces similar symptoms, no ketones are formed in HHNS. So rarely is there an acid build up in the blood. Ketoacidosis rarely occurs in people with type 2 diabetes.
The CDC reports that HHNS occurs most often among people who are older than 60. This may be because older people often have an altered sense of being thirsty and are more likely to become dehydrated. Most sufferers have a history of diabetes, but for some, the disease is undiagnosed or untreated.
In most cases, there is a history of excess thirst and urination for weeks prior to diagnosis. Excess urination and extreme elevations of glucose levels in the blood lead to dehydration throughout the body, including cells becoming dehydrated. The severe loss of body water can lead to shock, coma and death. Death rates can be as high as 50%.
People who are especially at risk include those who are chronically ill or disabled.
What Causes HHNS?
Causes include:
Infection
Heart attack
Kidney failure
Medicines (diuretics, heart medication, or steroids)
Illness
Bleeding ulcer
Blood clot
Uncontrolled blood sugar
What Are the Symptoms of HHNS?
Symptoms include:
Increased thirst
Increased urination
Weakness
Drowsiness
Altered mental state
Headache
Restlessness
Inability to speak
Paralysis
If you have any of these symptoms, test your blood glucose and call your doctor if your blood glucose is high. HHNS typically occurs when blood glucose reaches 600 mg/dL (milligrams per deciliter) or more.
How Is HHNS Treated?
Treatment of HHNS requires fluids as ordered by your doctor and may require insulin. You may be put in the hospital unless HHNS is noticed in the early stages. HHNS can result in coma and death if left untreated.
Can HHNS Be Prevented?
Yes. HHNS can be prevented if you follow these guidelines:
Check your blood glucose regularly, as recommended by your health care provider.
Check your blood glucose every four hours when you are sick.
Take special care of yourself when you are sick.
Diabetes:
High Blood Pressure
Hypertension is an important risk factor for the development and worsening of many complications of diabetes, including diabetic eye disease and kidney disease. It affects up to 60% of people with diabetes.
Having diabetes increases your risk of developing high blood pressure and other cardiovascular problems, because diabetes adversely affects the arteries, predisposing them to atherosclerosis (hardening of the arteries). Atherosclerosis can cause high blood pressure, which if not treated, can lead to blood vessel damage, stroke, heart failure, heart attack, or kidney failure.
Compared to people with normal blood pressure readings, men and women with hypertension have an increased risk of:
Coronary artery disease (heart disease)
Strokes
Peripheral vascular disease (hardening of the arteries in the legs and feet)
Heart failure
Even high yet normal blood pressure or pre-hypertension (defined as 120-139/ 80-89) impacts your health. Studies show that people with normal yet high range blood pressure readings, over a 10 year period of follow up time, had a two to three fold increased risk of heart disease.
What Should Blood Pressure Be if You Have Diabetes?
Blood pressure readings vary, but in general your blood pressure should not go above 130/80. The first number is the "systolic pressure" or the pressure in the arteries when your heart beats and fills the arteries with blood. The second number is the "diastolic pressure" or the pressure in the arteries when your heart rests between beats, filling itself with blood for the next contraction.
Having a normal blood pressure is as important to managing diabetes as having good control of your blood sugars when it comes to preventing diabetes complications.
What Are the Symptoms of High Blood Pressure?
Usually, high blood pressure has no symptoms. That’s why it’s so important to have your blood pressure checked on a regular basis (during all visits with your health care provider) and to follow your health care provider’s recommendations on home blood pressure monitoring.
How Is High Blood Pressure Treated?
ACE (angiotensin converting enzyme) inhibitors are a group of medications that are often used to treat high blood pressure in people with diabetes. Although other high blood pressure medicines are available, ACE inhibitors have been shown to not only to be a useful drug to treat high blood pressure, but it has been shown to prevent or delay the progression of kidney disease in people with diabetes.
Other drugs used to treat high blood pressure in people with diabetes include a class of drugs known commonly as ‘water pills’ or diuretics.
Because adequate control of blood pressure usually requires more than one medication, most doctors use ACE inhibitors first then add other anti-hypertension drugs.
Note: Some blood pressure medicines may adversely affect your blood glucose level. Blood pressure medicines can also cause impotence. Talk with your doctor about the side effects of prescribed medicines.
Some blood pressures medications also seem to work better on certain populations of people. Diuretics for example seem to be particularly beneficial in the elderly and may also be beneficial in people with hypertension that is salt sensitive as is frequently seen in African Americans.
How Do You Prevent High Blood Pressure?
To help prevent high blood pressure:
Stop smoking
Eat healthy
Maintain a healthy body weight
Exercise
Limit salt intake in the diet
Diabetes:
Infections Linked to Diabetes
Diabetes can slow down your body’s ability to fight infection. High blood glucose leads to high levels of sugar in your body’s tissues. When this happens, bacteria grow and infections can develop more quickly. Common sites of infection are your bladder, kidneys, vagina, gums, feet, and skin. Early treatment of infections can prevent more serious complications.
Warning Signs of Infection
While most infections can be successfully treated, you must be able to recognize an infection’s symptoms in order to get proper and effective care. Notify your health care provider immediately if you have any of the following symptoms:
Fever over 101 degrees F (38.3 degrees C)
Sweating or chills
Skin rash
Pain, tenderness, redness, or swelling
Wound or cut that won’t heal
Red, warm, or draining sore
Sore throat, scratchy throat, or pain when swallowing
Sinus drainage, nasal congestion, headaches, or tenderness along upper cheekbones
Persistent, dry, or moist cough that lasts more than two days
White patches in your mouth or on your tongue
Nausea, vomiting or diarrhea
Flu-like symptoms (chills, aches, headache, or fatigue) or generally feeling "lousy"
Vaginal itching
Trouble urinating: pain or burning, constant urge, or frequent urination
Bloody, cloudy, or foul-smelling urine
Diabetes:
Ketoacidosis
If hyperglycemia is left untreated, it can lead to an emergency condition called ketoacidosis (sometimes called DKA or diabetic ketoacidosis). Ketoacidosis can be a life-threatening situation.
A person with type 1 diabetes has the greatest chance of developing ketoacidosis. If you have type 2 diabetes, your risk of developing ketoacidosis is less — as long as you still make insulin. However, you are still at risk for developing HHNS, a condition that occurs when blood glucose goes very high and you become severely dehydrated.
What Is Ketoacidosis?
When there isn’t enough insulin, your body is unable to use glucose for energy. To continue functioning, your body switches to starvation mode and releases fat to use for energy. However, the fat that gets released is converted to ketones which are utilized more slowly than they are made. As a result, ketones in your blood rise and spill over into your urine. To make matters worse, the high glucose that is also leaking into your urine pulls water out of your body causing dehydration.
Remember, ketoacidosis occurs when hyperglycemia is not treated promptly. It usually develops slowly over several hours. By recognizing and treating the early symptoms of hyperglycemia, you can avoid ketoacidosis, a potentially life-threatening condition.
What Are the Symptoms of Ketoacidosis?
The symptoms of hyperglycemia include:
Dehydration and excess thirst.
Excess urination, especially weeks or days before the diagnosis of new onset type 1 diabetes.
Vomiting.
Abdominal pain.
Drowsiness.
Difficulty breathing.
Fruity smell to the breath.
Ketones in your urine.
Call your health care provider immediately if you have any of the above listed symptoms.
How Is Ketoacidosis Treated?
Treatment of ketoacidosis requires insulin and fluids as ordered by your doctor. They may suggest that you increase the dose of your insulin or change your insulin type to a more rapid or short acting form. They will also suggest drinking more fluids – sugar free, of course. You will need to check your sugars frequently and repeat the measure of your urine ketones.
Ketoacidosis can result in coma and possibly death if left untreated.
How Can Ketoacidosis Be Prevented?
Take your medicines as directed. If you are on an insulin pump always check your tube connections for air bubbles and make sure that there are no leaks of insulin. Also, check your insulin to make sure it has not expired and make sure no clumps have formed. Insulin should always be either clear or uniformly cloudy with particles.
Follow your meal plan closely.
Follow your exercise program.
Test your blood glucose on a regular basis.
Know when to contact your health care provider if you have repeated abnormal blood glucose levels.
Diabetes:
Kidney Disease
Diabetes is the number one cause of kidney failure. Almost a third of people with diabetes develop kidney disease (also called diabetic nephropathy).
People with diabetes and kidney disease do worse overall than people with kidney disease, alone. This is because people with diabetes tend to have other long-standing medical conditions, like high blood pressure, high cholesterol and blood vessel disease (atherosclerosis). People with diabetes also tend to have other kidney-related problems, such as bladder infections, and nerve damage to the bladder.
Kidney disease in type 1 diabetes is slightly different than in type 2 diabetes. In type 1 disease, kidney disease begins acutely and may start at an early or young age. Overt disease, when present, is obvious after about 15 years of having type 1 diabetes.
In type 2 diabetes, many patients have kidney disease at the onset, when they are diagnosed with diabetes. Because type 2 diabetes is frequently found in the middle or older aged person with other chronic medical conditions, kidney disease may have been caused by other conditions.
What Are the Symptoms of Kidney Disease?
Although there are often no symptoms with early kidney damage, they may include:
Swelling of the hands, feet and face.
Weight gain.
Itching (end-stage kidney disease) and extremely dry skin.
Drowsiness (end-stage kidney disease).
Blood in the urine (rare).
Abnormalities in the hearts’ regular rhythm, because of increased potassium in the blood.
Muscle twitching.
As kidney damage progresses, your kidneys cannot remove the waste from your blood. The waste then builds up in your body and can reach poisonous levels, a condition known as uremia. People with uremia are often confused or comatose. Uremia is worsened by high blood pressure.
How Is Kidney Disease Diagnosed?
The disease is detected by finding protein in the urine. That’s why you should have your urine tested every year.
How Is Kidney Disease Treated?
Lowering blood pressure and maintaining blood glucose control are absolutely necessary to slow the progression of kidney problems. Some medicines called angiotensin converting enzyme (ACE) inhibitors can help slow down the progression of kidney damage. Although ACE inhibitors — including Altace, Lotensin and Capoten — are usually used to treat high blood pressure and other medical problems, they are often given to people with diabetes to prevent complications, even if their blood pressure is normal.
If a person has side effects from taking ACE inhibitors, another class of drugs called angiotensin receptor blockers can be given instead.
If not treated, the kidneys will continue to fail and larger amounts of proteins can be detected in the urine. Advanced kidney failure requires treatment with dialysis or a kidney transplant.
Get the Facts
Risks and Prevention
Diabetes: Tests You Take
Monitoring Diabetes
Treatments
Complications of Diabetes
Dental Problems and Diabetes
Eye Problems and Diabetes
Foot Problems and Diabetes
Heart Disease and Diabetes
Hyperglycemic Hyperosmolar Nonketotic Syndrome
High Blood Pressure and Diabetes
Hyperglycemia
Hypoglycemia
Infections and Diabetes
Ketoacidosis and Diabetes
Kidney Damage and Diabetes
Nerve Damage and Diabetes
Skin Problems and Diabetes
Stroke and Diabetes
Living With Diabetes
Diabetes: Smart Eating
Diabetes Bookshelf
To the Diabetes Center
Diabetes:
Neuropathy
A common complication of diabetes is damage to the nerves that allow you to feel sensations such as pain. This is called neuropathy. There are a number of ways that diabetes damages the nerves, but they all seem related to blood glucose being too high for a long period of time.
Diabetes-related nerve damage can be painful, but it isn’t severe pain in most cases.
There are four types of neuropathy: peripheral, autonomic, proximal and focal.
Peripheral Neuropathy
The areas of the body most commonly affected by peripheral neuropathy are the feet and legs. Nerve damage in the feet can result in a loss of foot sensation, increasing your risk of foot problems. Injuries and sores on the feet may go unrecognized due to lack of sensation. Therefore, you should practice proper skin and foot care. Rarely, other areas of the body such as the arms, abdomen, and back may be affected.
Symptoms of peripheral neuropathy may include:
Tingling
Numbness (severe or long-term numbness can become permanent)
Burning
Pain
In most cases, early symptoms will become less when blood glucose is under control. Medications can be taken to help control the discomfort if needed.
To prevent peripheral neuropathy:
Work with your doctor to keep your blood glucose under tight control
To help prevent the complications of peripheral neuropathy:
Examine your feet and legs daily.
Apply lotion if your feet are dry.
Care for your nails regularly. (Go to a podiatrist, if necessary)
Wear properly fitting footwear and wear them all the time to prevent foot injury.
Autonomic Neuropathy
Autonomic neuropathy most often affects the digestive system, especially the stomach, blood vessels, urinary system, and sex organs. To prevent autonomic neuropathy, continuously keep your blood glucose levels well controlled.
Symptoms of neuropathy of the digestive system may include:
Bloating
Diarrhea
Constipation
Heartburn
Nausea
Vomiting
Feeling full after small meals
Treatments may include:
Eat smaller meals
Medicines
Symptoms of neuropathy of the blood vessels may include:
Blacking out when you stand up quickly
Increased heart rate
Dizziness
Low blood pressure
Treatments may include:
Avoid standing up too quickly
Medicines
Wearing special stockings
Symptoms of neuropathy of the male sex organs may include:
Unable to have or maintain an erection (erectile dysfunction)*
"Dry" or reduced ejaculations
Note: Impotence needs to be evaluated by your doctor. It may be caused by your medicines or factors other than diabetes.
Treatments include:
Counseling
Penile implant
Vacuum erection device
Penile injections
Medicine
Symptoms of neuropathy of the female sex organs may include:
Decrease in vaginal lubrication
Decrease in number of orgasms or lack of orgasm
Treatments include:
Counseling
Vaginal estrogen creams, suppositories and rings
Lubricants
Symptoms of neuropathy of the urinary system may include:
Unable to completely empty bladder
Bloating
Incontinence (leaking urine)
Increased urination at night
Treatments include:
Medicines
Self-catheterization (inserting a catheter into the bladder to release urine)
Surgery
Proximal Neuropathy
Proximal neuropathy causes pain (usually on one side) in the thighs, hips, or buttocks. It can also lead to weakness in the legs. Treatment for weakness or pain is usually needed and may include medication and physical therapy. The recovery varies, depending on the type of nerve damage. Prevention consists of keeping blood glucose under tight control.
Focal Neuropathy
Diabetic neuropathy can also appear suddenly and affect specific nerves, most often in the head, torso, or leg, causing muscle weakness or pain. This is known as focal neuropathy. Symptoms may include:
double vision
eye pain
paralysis on one side of the face (Bell’s palsy)
severe pain in a certain area, such as the lower back or leg(s)
chest or abdominal pain that is sometimes mistaken for another condition such as heart attack or appendicitis
Focal neuropathy is painful and unpredictable, however, it tends to improve by itself over weeks or months and does not tend to cause long-term damage.
Other Nerve Conditions Seen With Diabetes
People with diabetes can also develop other nerve-related conditions, such as nerve compressions (entrapment syndromes).
Carpal tunnel syndrome is a very common type of entrapment syndrome and causes numbness and tingling of the hand and sometimes muscle weakness or pain.
Prevention of Diabetic Neuropathy
Keeping tight control of your blood sugar levels will help prevent many of these diabetes-related nerve conditions. Talk to your doctor about optimizing your individual diabetes treatment plan
Diabetes:
Skin Problems
For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause serious complications, including skin problems. In fact, as many as a third of people with diabetes will have a skin condition related to their disease at some time in their lives. Fortunately, most skin conditions can be prevented and successfully treated if caught early. But if not cared for properly, a minor skin condition can turn into a serious problem with potentially severe consequences.
Skin Conditions Linked to Diabetes
Scleroderma diabeticorum: This condition causes a thickening of the skin on the back of the neck and upper back. This condition is rare but can affect people with type 2 diabetes. The treatment is to bring your blood glucose level under control. Lotions and moisturizers may help soften the skin.
Vitiligo: Vitiligo is a condition that affects skin coloration. With vitiligo, the special cells that make pigment (the substance that controls skin color) are destroyed, resulting in patches of discolored skin. Vitiligo often affects the chest and abdomen, but may be found on the face around the mouth, nostrils and eyes. This condition is more commonly associated with type 1 diabetes. Current treatment options for vitiligo include topical steroids and micropigmentation (tattooing). You should use sunscreen with a SPF of 15 or higher to prevent sunburn on the discolored skin.
Problems associated with insulin resistance
Acanthosis nigricans. This is a condition that results in the darkening and thickening of certain areas of the skin especially in the skin folds. The skin becomes tan or brown and is sometimes slightly raised and described as velvety. Most often the condition, which typically looks like a small wart, appears on the sides or back of the neck, the armpits, under the breast, and groin. Occasionally the top of the knuckles will have a particularly unusual appearance. Acanthosis nigricans usually strikes people who are very overweight. There is no cure for acanthosis nigricans, but losing weight may improve the condition. Acanthosis nigricans usually precedes diabetes. There are other conditions that also are known to cause acanthosis of the skin and these include acromegaly and Cushing syndromes. It is thought that this condition is a skin manifestation of insulin resistance.
Problems associated with reduced blood supply to the skin
Skin problems linked to atherosclerosis: Atherosclerosis is the narrowing of blood vessels from a thickening of the vessel walls due to plaque buildup. While atherosclerosis most often is associated with blood vessels in or near the heart, it can affect blood vessels throughout the body, including those that supply blood to the skin. When the blood vessels supplying the skin become narrow, changes occur to the skin due to a lack of oxygen, such as hair loss, thinning and shiny skin especially on the shins, thickened and discolored toenails and cold skin. Because blood carries the white blood cells that help fight infection, legs and feet affected by atherosclerosis heal moreslowly when they are injured.
Necrobiosis lipoidica diabeticorum: Necrobiosis lipoidica diabeticorum (NLD) is thought to be caused by changes in the collagen and fat content underneath the skin. The overlaying skin area becomes thinned and reddened. Most lesions are found on the lower parts of the legs and can ulcerate if subjected to trauma. Lesion have fairly well defined borders between normal skin and affected lesions Sometimes, NLD is itchy and painful. As long as the sores do not break open, treatment is not necessary. If the sores do break open, see your doctor for treatment.
Diabetic dermopathy: Also called shin spots this condition develops as a result of changes to the blood vessels that supply the skin. Dermopathy appears as a shiny round or oval lesion of thin skin over the front lower parts of the lower legs. The patches do not hurt, although rarely they can be itchy or cause burning. Treatment generally is not necessary.
Digital sclerosis: Digital sclerosis is a condition in which the skin on your toes, fingers and hands become thick, waxy and tight. Stiffness of the finger joints also may occur. The treatment is to bring your blood glucose level under control. Lotions and moisturizers may help soften the skin.
Eruptive xanthomatosis: This condition may occur when blood glucose levels are not well controlled and when triglycerides rise to extremely high levels. Severe resistance to insulin makes it difficult for the body to clear the fat from the blood. With extreme elevations in these blood fats people are at risk for pancreatitis, an inflammation of the pancreas. Eruptive xanthomas appear as firm, yellow, waxy pea-like bumps on the skin. The bumps — which are surrounded by red halos and are itchy — usually are found on the face and buttocks. They also can be seen on the back side of the arms and legs as well as in the creases of the extremities. Treatment for eruptive xanthomatosis consists of controlling the level of fats in your blood. The skin eruptions will resolve over a few weeks. Drugs that control different types of fats in the blood (lipid-lowering drugs) may also be needed.
Rashes, Bumps and Blisters
Rashes and bumps: Allergic reactions to foods, bug bites and medicines can cause rashes, depressions or bumps on the skin. It is especially important for people with diabetes to check for rashes or bumps in the areas where they inject their insulin.
Diabetic blisters (bullosis diabeticorum): In rare cases, people with diabetes develop blisters that resemble burn blisters. These blisters can occur on the fingers, hands, toes, feet, legs or forearms. Diabetic blisters usually are painless and heal on their own. They often occur in people who have severe diabetes and diabetic neuropathy. Bringing your blood glucose level under control is the treatment for this condition.
Disseminated granuloma annulare: This condition causes sharply defined, ring or arc-shaped areas on the skin. These rashes most often occur on the fingers and ears, but they can occur on the chest and abdomen. The rash can be red, red-brown or skin colored. Treatment usually is not required, but some times a topical steroid medication, such as hydrocortisone, may help.
Bacterial and fungus infections
Bacterial infections: There are different kinds of bacterial infections affecting the skin. Skin infections with the bacteria known as Staphylococcus are more common and more serious in people with diabetes which is not under control. These bacteria can result in ‘boils’, an inflamed nodule from a hair follicle, which can occur in areas where hair follicles can be irritated. Other infections include styes, which are infections of the glands of the eyelids, and bacterial nail infections. Most bacterial infections require treatment with antibiotics in the form of pills and/or creams.
Fungal infections: A yeast-like fungus called "Candida albicans" is responsible for many of the fungal infections affecting people with diabetes. Women in particular are prone to infection with this fungus in the vagina. Other commonly seen areas of infection include the corners of the mouth with what is known as "angular cheilitis," which feels like small cuts on the corners of the mouth. Fungus also can occur in between the toes and fingers and in the nails (onychomycosis). This fungus creates itchy, bright red rashes, often surrounded by tiny blisters and scales. These infections most often occur in warm, moist folds of the skin. Three common fungal infections are: jock itch (red, itchy area on the genitals and the inside of the thighs), athlete’s foot (affects the skin between the toes), and ringworm (ring-shaped, scaly patches that can itch or blister and appear on the feet, groin, chest and abdomen, scalp or nails). Medicines that kill the fungus are usually needed to treat these infections. A potentially fatal fungal infection with Mucormycosis is seen in people with diabetes. The infection usually starts in the nasal cavities and can spread to the eyes and brain.
Problems with multiple causes
Itching: Itching skin, also called pruritus, can have many causes, such as a yeast infection, dry skin or poor blood flow. When itching is caused by poor blood flow, the lower legs and feet are most often affected. Using lotion can help to keep your skin soft and moist, and prevent itching due to dry skin.
Can These Skin Problems Be Prevented?
Keeping your diabetes under control is the most important factor in preventing the skin-related complications of diabetes. Follow your health care provider’s advice regarding nutrition, exercise, and medication. Keep your blood glucose level within the range recommended by your doctor. Proper skin care can also help reduce your risk of skin problems
Diabetes:
Stroke
Brain tissue needs a constant supply of oxygen and nutrients to keep nerve cells and other parts of the tissue alive and functioning. The brain relies on a network of blood vessels to provide it with blood that is rich in oxygen. A stroke occurs when one of these blood vessels becomes damaged or blocked, preventing blood from reaching an area of the brain. When that part of the brain is cut off from its supply of oxygen for more than three to four minutes, it begins to die.
There are two types of strokes: those that are caused by a rupture in an artery, also known as hemorrhagic stroke, and strokes which are caused by blockage of an artery, also known as ischemic stroke.
Risk Factors of Stroke
High blood pressure is the number one risk factor for stroke. Other risks include smoking and high "bad" LDL cholesterol.
People with diabetes are at increased risk of stroke because diabetes adversely affects the arteries, predisposing them to atherosclerosis. Multiple studies have shown that people with diabetes are at greater risk for stroke compared to people without diabetes regardless of the number of risk factors they have. Overall, the risk of cardiovascular disease (including stroke) is two-and-a-half times higher in men and women with diabetes compared to people without diabetes.
In addition, people with diabetes who have a stroke often fare worse than those without diabetes. When the oxygen supply is cut off, other arteries can usually deliver oxygen by bypassing the blockage. In people with diabetes, however, many of the bypass arteries are also affected by atherosclerosis, impairing blood flow to the brain. Other risk factors may be responsible for poorer outcomes following stroke, as well.
While death rates from strokes have decreased, it is unclear whether death rates from strokes have decreased in people with diabetes.
What Are the Warning Signs of Stroke?
A stroke is an emergency. If you experience any of these warning signs, call 911 immediately. You must get to the hospital as soon as possible.
Sudden numbness or weakness in the face, arm or leg (especially on one side of the body).
Difficulty speaking or understanding words or simple sentences.
Sudden blurred vision or decreased vision in one or both eyes.
Sudden difficulty swallowing.
Dizziness, loss of balance or becoming uncoordinated.
Brief loss of consciousness.
Sudden inability to move part of the body (paralysis).
Sudden, unexplainable, and intense headache.
How Is Stroke Treated?
One FDA-approved treatment for ischemic stroke is a clot buster drug called tPA. tPA must be given within the first three hours after stroke symptoms begin for it to work. This drug dissolves the clot that has clogged an artery and can reestablish blood flow to brain tissue. Also, there are several new and experimental drugs that may stop — and even reverse — the brain damage if administered immediately after a stroke.
Another option is carotid endarterectomy, or surgical removal of the plaque from inside the carotid artery (the artery that supplies much of the blood to the brain).
A less invasive treatment is a carotid angioplasty and stenting procedure, which may be appropriate for some patients who have blockages within the carotid arteries. This involves inserting a deflated balloon into the artery, inflating it to expand the artery walls and then inserting a mesh structure (stent) to hold the artery open.
Angioplasty of the cerebral arteries can also be performed.
Recently, FDA approved another technology, the Merci Retrieval System, which can remove the blood clot up to 8 hours after the stroke.
How Can Stroke Be Prevented?
If your doctor suspects that you have atherosclerosis (hardening of the arteries), he or she may suggest changes in diet and lifestyle, as well as certain medicines that may help to prevent the blockages that cause stroke. Other ways to reduce your risk of stroke include:
Don’t smoke.
Have your cholesterol checked (especially your "bad" LDL-cholesterol) and if necessary, lower your levels by limiting the amount of fat and cholesterol you eat. The target should be an LDL level of less than100 mg/dl (milligrams per deciliter). Some experts recommend even lower levels (less than 70 mg/dl) for those considered very high risk.
Limit the amount of alcohol you drink.
Have your blood pressure checked and control your blood pressure, if necessary.
Follow your health care provider’s instructions for changing your diet.
Follow your health care provider’s instructions for taking preventive medicines.
Take daily aspirin therapy* as prescribed by your doctor
*Low-doses of aspirin (81- 325 mg of aspirin a day) is recommended for men and women with diabetes who are over age 30 and are at high risk for heart disease, peripheral vascular disease, and stroke. Talk to your doctor to determine if aspirin therapy is right for you. If you have certain medical conditions, aspirin therapy may not be recommended.
References :
I hope this helps. It took a while to type, but, this is what information my doctor has given to me after I found out I was diabetic. Also remember you can prevent complications by sticking to a diabetic diet and lifestyle.
December 8th, 2009 at 3:43 am
my friends with diabetes use http://www.nutrihand.com
they tell me that their diabetes is doing great all because of http://www.nutrihand.com
They have a community of support…
References :