NEPHROPATHY
Nephropathy tends to develop in people who have had diabetes for 20 years or more. People with type 2 diabetes develop nephropathy infrequently.
Nephropathy is caused by high blood-sugar levels. Also, high blood pressure, arteriosclerosis, smoking, and high cholesterol increase the likelihood of kidney complications. Blood tests also detect high levels of urea nitrogen and creatinine, another indication of kidney damage.
Handling the Problem
If signs of developing kidney problems are detected, doctors often recommend a regimen of tight blood-sugar control and a low-protein diet to ease stress on the kidneys.
CARDIOVASCULAR DISEASE
The word cardiovascular means "of the heart and blood vessels." Cardiovascular disease is the most common complication of type 2 diabetes. In fact, people with diabetes have a risk of cardiovascular disease that is two to five times that of people without the condition.
Just as diabetes changes the shape of the small blood vessels (known as microvascular changes), it also appears to thicken and obstruct the walls of the large blood vessels, thus restricting blood flow. There's no doubt about it: Cardiovascular complications are very debilitating side effects of diabetes. However, the risk for such complications can be decreased by tight blood-sugar control.
Recognizing Risk Factors
High blood pressure alone is a major cause of strokes.
Heart attacks and strokes are more common in people with type 2 diabetes than in those with type 1 diabetes, yet medical science is not sure exactly why this is. Experts believe it could be because people with type 2 diabetes tend to be overweight. Compared with men without diabetes, men with diabetes have about two times the average risk of developing cardiovascular disease; women with diabetes have three to five times the average risk of developing cardiovascular disease compared with women without the disease.
Handling the Problem
Because the rates of cardiovascular disease are so high in those with diabetes, the American Diabetes Association recommends and screening tests and intervention for heart disease for everyone with diabetes over age thirty.
Traditional screening tests include having your blood pressure taken with a blood pressure cuff and having your cholesterol evaluated with a blood test. What you may not know is that people with diabetes tend to have higher blood-cholesterol levels than other people. People with diabetes tend to have high levels of triglycerides, too. Combined and massive hyperlipidemia are found in over 30 percent of all people with diabetes--approximately two to three times more often than in people without diabetes.
Evidence suggests that for every 1 percent reduction in blood-cholesterol level, there is a 2 percent reduction in coronary-artery disease for all people, regardless of whether they have diabetes.
Designed to gauge the effects of aspirin on diabetic retinopathy, the study included 3,700 people with type 1 and type 2 diabetes.
NEUROPATHY
Neuropathy is nerve damage. The culprit may be uncontrolled blood-sugar levels (although many people with good control develop this complication), or it may be that the nerves are somehow damaged during the metabolic changes associated with diabetes.
It's estimated that some form of nerve damage affects 60 to 70 percent of people with diabetes at some point in their lives. Autonomic neuropathy is a less common complication, perhaps experienced by 20 percent of people with diabetes. When it affects the nerves that control the contraction of blood vessels, a condition called orthostatic hypotension may develop. Handling the Problem
FOOT PROBLEMS
Cardiovascular complications damage blood vessels and diminish blood flow to the legs and feet. Once an inflammation or infection begins, its swelling compresses the blood vessels, which are already damaged or narrowed by diabetes itself. If blood flow were to be completely blocked, the cells served by the obstructed blood vessels would die.
Recognizing Risk Factors
As is true with all diabetic complications, certain factors increase risk of foot problems. According to the American Diabetes Association, of the people with diabetes who need amputations, almost all are smokers.
Handling the Problem
The trick to treating and preventing foot problems lies in finding out ifs a blood vessel is about to become blocked.
This article originally is written by : Authors: Janet Worsley Norwood and Charles B. Inlander
Excerpt from: Understanding Diabetes
Originally site is www.diabeteslibrary.org
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