As the recent work of scientists from the Joslyn Diabetes Research Center (USA) has shown, some "veterans" of diabetes manage to avoid the occurrence of all or almost all of the major complications of this terrible disease.
It turns out that many patients can live very long with type 1 diabetes without developing life-threatening complications from various organs and systems. Find this explanation was not so easy. The study revealed that the absence or minimal manifestation of complications may not be directly related to the control of blood glucose.
Experts do not at all detract from the importance of diabetes self-control, but other mechanisms may also be involved in protection against dangerous complications.
Scientists examined 351 patients. They all lived with type 1 diabetes for 50 years. The average age of study participants was about 68 years, and the diagnosis was made at the age of about 11 years. Endocrinologists searched for patients with typical complications of diabetes, such as retinopathy, neuropathy, nephropathy, cardiomyopathy.
It turned out that in 43% of patients there were no obvious eye complications, 87% of patients did not suffer from any kidney abnormalities, 39% of study participants did not have neurological disorders, 52% of patients did not develop cardiovascular complications. In general, about 20% of patients managed to avoid the development of complications from the eyes, kidneys and nervous system.
All volunteers blood sugar levels remained within the normal range. The content of glycated hemoglobin (HbA1C), which reflects the average level of glucose over the past three months, was also assessed. It was about 7.3%. Endocrinologists advise to keep the level of glycated hemoglobin in type 1 diabetes mellitus within 7% and below. Thus, the self-control of diabetes in all patients was good.
However, researchers were interested in another explanation of such a favorable course of the disease. To do this, they evaluated the content of proteins of a special family, the final products of enhanced glycosylation (CPUG), for all participants in the experiment. Their level increases with increasing glucose in the blood. It turned out that in those patients who had a high level of two specific CPUG, complications occurred seven times more often.
For scientists, this was a surprise. After all, other combinations of KPUG molecules actually protect patients from the occurrence of eye complications. Therefore, scientists have suggested that some combinations of CPUG may not be as toxic to tissues, as previously thought, they protect the body from complications.
According to the researchers, some patients with an adequate course of type 1 diabetes over the years may have developed peculiar defense mechanisms against the aggressive effects of CCUG. These protective factors have made CPUG molecules less toxic.
In addition, we should not forget about the following: the “veterans” of diabetes mellitus who participated in the study take great care of themselves and their health. When they got diabetes, little was known about the disease. And even more so scientists did not know about the subtle mechanisms of aggression and protection from the disease.
At that time, doctors did not even tell their patients about the need for strict control of blood sugar. Therefore, further study of the features of the course of the disease in these patients can help other people with diabetes.
The reason for the occurrence of complications in diabetes in most cases becomes neglect of their health, improper treatment, or the complete absence of it. Sometimes a person may not be aware of his illness, and diabetes is already destroying his body. This is often found in type 2 diabetes.
Usually negative consequences develop gradually and become not immediately noticeable. Sometimes it takes 10-15 years before the complication somehow manifests itself, but disorders in the work of the immune system can appear immediately. A person begins to get sick often, on his body often appear boils, and any, even minor, wounds do not heal well. And these are only external manifestations, internal changes are harder to notice.
Some organs are more susceptible to the disease and in the first place some are less affected. The identified complications can be divided into acute and chronic. The first develop quickly, with pronounced symptoms, they can be prevented. These include ketoacidosis and hypoglycemia, lactic acidotic and hyperosmolar coma. Chronic is more difficult to detect and symptoms appear late, when violations are serious, they need to be treated longer. To prevent the development of complications is possible, but we must strictly follow the recommendations of the doctor and monitor the level of glucose.
In diabetes mellitus, the following organs and systems most often suffer:
- Blood vessels,
- Musculoskeletal system,
- Sensitivity of nerve endings disappears.
How do they appear, are there any measures preventing their development?
The most common complication is diabetic retinopathy. This is a retinal lesion in the form of pinpoint or spotted hemorrhage and edema, which over time can lead to retinal detachment and blindness. In 25% of diabetics, the disease is diagnosed immediately when diagnosing diabetes.
The cause of development is to constantly increase the level of glucose in the blood, which leads to an increase in the fragility of the vessels of the eyeball. If the changes have affected the central zone, then it becomes much easier to identify them, since the patient has a sharp loss of vision. If there is a disturbance in the peripheral fundus, if the retina does not start to exfoliate, the symptoms will be absent and complications will appear already in the later stages, when something cannot be changed.
The only means of prevention is to constantly monitor the level of glucose in the blood and avoid raising it. In order to recognize the beginning of the development of complications, one should regularly visit an oculist and conduct fundus examinations. A timely diagnosis will help keep a person’s eyesight.
The first treatment option is microcirculation enhancing agents, vitamins and antioxidants. Appointment will be effective if you do not forget to monitor the level of sugar. The second treatment option is laser photocoagulation, but it does not always give a 100% result.
In addition, there may be clouding of the lens and the earlier development of cataracts. Regular visits to the doctors and normalization of sugar levels will help to avoid this. Reception of vitamins, proper nutrition and preventive means will help the body to avoid the appearance of this disease.
Lower extremity injury
The most common complication of diabetes is a lesion of the lower extremities. This may be polyneuropathy, micro- and macroangiopathy, arthropathy, and diabetic foot. What it is?
- Angiopathy - disorders in the work of large and small blood vessels, increasing their fragility, the formation of blood clots and cholesterol plaques inside the veins, arteries and capillaries.
- Arthropia is the appearance of pain in the joints and a decrease in their mobility, an increase in the thickness of the articular fluid, the appearance of a “crunch” in the bones.
- Polyneuropathy - loss of temperature and pain sensitivity, most often in the lower extremities. Signs: numbness, burning, tingling and goosebumps. Due to the loss of nervous sensitivity, injuries may occur that a person does not immediately notice.
- Diabetic foot is a serious enough complication. It is characterized by the appearance of difficult-healing wounds with the presence of purulent-necrotic processes, ulcers and damage to bones and joints, skin and soft tissues. The most common cause of limb amputation in diabetics.
The reason for the development of complications becomes a decrease in the sensitivity of the nerve endings due to which minor injuries and abrasions go unnoticed. When bacteria and harmful microbes enter them, various inflammatory processes begin to develop. Since the immunity is reduced, and the skin is less elastic and is easily torn, an abscess is obtained. As a result, damage is noticed late, and treatment takes a long time.
There are 2 types of lesions: ischemic and neuropathic. The former is characterized by low temperature of the extremities, pale skin, no hair, the appearance of ulcers on the foot and in the area of the fingers. Pain when moving and at rest. All this will indicate violations in the blood vessel system. The second is characterized by the following signs: there is no pain, temperature, vibration and tactile sensations, the skin is hot, and keratinous skin and ulcers appear on the legs. This suggests that the nerves on the limbs are affected and atrophied.
As prevention and prevention, regular monitoring by a doctor and other specialists (neuropathologist, traumatologist, surgeon), strict adherence to the recommendations of the attending doctor, control of sugar level and nutrition are required. In addition, you should inspect the legs daily for wounds and other injuries. Feet need to be washed daily, horny skin is regularly removed in beauty salons or at home. Shoes should be bought comfortable and preferably leather, socks and stockings should be made only from natural materials. They also need to be changed daily.
You should consult with your doctor in advance about what and how to treat wounds. Clarify how to deal with dry calluses and dead skin on wounds. Do not self-medicate and do not use questionable recipes of traditional medicine.
The value of the kidneys in the human body cannot be underestimated. Through this natural filter most organic substances are removed. Increased glucose levels have a negative effect on them. This is due to the fact that the disease affects the small blood vessels and capillaries, as a result, the work of the transmission mechanism is disrupted and they begin to get rid of the beneficial substances of protein and glucose, and nephropathy develops.
To determine the presence of such changes can be using urine analysis. It is determined by the increased protein content of albumin. At the initial stage, this process is still reversible. If, however, not treated in a timely manner, this will lead to the development of renal failure.
This can be avoided only if the recommendations of the doctor are followed and the blood glucose level is normalized. To monitor the condition, urine should be regularly tested for analysis, at least once every six months. It is also necessary to follow the diet, it is desirable to reduce the consumption of animal protein and salt.
Completely avoid complications of diabetes, do not work out, but you can push as far as possible the moment of their development. To do this, it is enough to take care of your health, regularly visit doctors and monitor nutrition. Diabetes is not a sentence, you just need to learn to live with it correctly and then complications will not appear soon.
What complications of diabetes are possible?
High blood sugar can affect different parts of the body:
Eyes. Diabetes increases the risk of vision problemsincluding blindness. This disease can lead to: 1) cataract (the lens of your eye becomes cloudy), 2) glaucoma (nerve damage that connects the eye to the brain and provides good vision), 3) retinopathy (changes in the retina at the back of the eye).
A heart. High blood sugar can damage the blood vessels of your body. This increases the likelihood of heart disease, which can later cause a heart attack or stroke. High blood pressure and high cholesterol exacerbate problems.
Kidney. Diabetes can affect the blood vessels in the kidneys, causing them to stop performing their function. After many years of problems, they may stop working.
Legs. High blood sugar can damage blood flow and nerves. This can cause cuts, abrasions, or wounds to heal slowly. You may lose sensation in your legs, as a result of which you will not notice the wounds that have formed. If the infection becomes serious, you may have your leg removed.
Nerves. If high blood glucose damages your nerves, diabetic neuropathy occurs. You may feel pain, tingling or numbness, especially in the legs.
Leather. Diabetes can increase the risk of fungal infections, itching, or brown or scaly patches on the skin.
Erection problems. Men with diabetes may be at risk for sexual problems. After all, high blood glucose can damage the bloodstream and nerves.
How to reduce the risk of complications of diabetes?
Proper treatment and a healthy lifestyle are the main ways to prevent health problems that diabetes can cause. Observe the following guidelines:
Control blood sugar levels. This is the best way to avoid diabetes complications. Your glucose level should remain in healthy ranges: from 70 to 130 mg / dL before meals, less than 180 mg / dL 2 hours after meals, level glycated hemoglobin (HbA1c level) about 7%.
Control your blood pressure and cholesterol levels. If these rates are too high, then you have a high risk of cardiovascular diseases. Try to keep arterial blood pressure below 140/90 mmHg and total cholesterol at or below 200 mg / dl.
Regularly undergo medical examinations. Urine and blood tests will help identify any health problems. Regular inspection is especially important since many of the complications of diabetes do not have clear warning signs.
Do not smoke. Smoking damages your bloodstream and increases blood pressure.
Protect your eyes. Check your eyesight every year. Your doctor may look for any damage or illness.
Check your legs every day. Look for any cuts, sores, abrasions, blisters, ingrown toenails, redness or swelling. Wash and thoroughly dry your feet every day. Use lotion to avoid dry skin or cracked heels. Wear shoes on hot asphalt or on the beach, as well as shoes and socks in cold weather.
Take care of your skin. Keep it clean and dry. Use talc in places where friction is possible (like armpits). Do not take a very hot shower or bath. Moisturize your body and hands. Stay warm during the cold winter months. Use a humidifier in your bedroom if you feel dry.