Diabetes mellitus: complications of hyperglycemia

Disruption of carbohydrate metabolism in the body leads to the emergence of such diseases as diabetes. The growth of this disease has become truly rampant in economically prosperous countries. By the end of the last century, up to 15% of the population in these countries suffered from diabetes. Given the annual growth of the disease (up to 10%) every 10-15 years there is a doubling of the number of patients with diabetes. MedAboutMe portal will talk about the danger of hyperglycemia and complications of diabetes.

Neuropathy is a major complication of diabetes

Medical advances in the field of study and diagnosis   diabetes, as well as glycemic control and explanatory work, gave a positive result in the form of a significant increase in the life expectancy of diabetics. But this same fact has led to the fact that cases of late complications, diabetic neuropathy, have become more frequent. It is observed in almost 90% of patients with diabetes mellitus and leads to damage to the nervous system with all the ensuing negative consequences: social activity decreases, self-isolation occurs, the quality of life suffers. Effective diagnosis and timely treatment of diabetic neuropathy can reduce the number of severe forms of complications.

Pathogenesis of diabetic neuropathy

There is no doubt that hyperglycemia leads to the development of diabetic neuropathy, triggering a cascade of multiple metabolic disorders. The mechanism of interaction of these two pathological conditions is not fully understood. However, modern neurodiabetology states that it is impossible to stop the progression of diabetic neuropathy by adjusting the sugar level to normal. It affects neurons and their processes in the central and peripheral nervous system.

The variety of clinical symptoms of neuropathy in diabetes has led scientists to conclude that several interconnected biochemical processes are involved in its occurrence, the study of which continues. It has been proven that the mechanisms of pathogenesis of such diseases as atherosclerosis, macroangiopathy, dyslipidemia, and arterial hypertension are closely interrelated with the development of diabetic neuropathy.

Consequences of hyperglycemia in diabetes

Hyperglycemia is observed when the glucose content in the serum is above the boundary value. Depending on the value of the indicator, it is mild, moderate and severe. With repeated excess of sugar in the blood, extremely difficult and life-threatening conditions develop: precoma or hyperosmolar coma. But even mild hyperglycemia can cause irreparable damage to metabolic processes. What mechanisms triggers an excess of glucose in the body of a diabetic patient?

  • The state of hyperglycemia activates aldose reductase – an enzyme that decomposes glucose to acyclic alcohol – sorbitol. It, in turn, produces fructose in the process of oxidation, and together they damage nerve cells through intracellular osmotic changes.
  • Glucose   under hyperglycemia, it binds with certain types of proteins in a non-enzymatic way (protein glycosylation). In patients with diabetes mellitus, embedding of glucose in cell membranes, lipoproteins, neurons, collagens, as well as in blood serum proteins is observed. This all entails tissue hypoxia, a decrease in the functional activity of cellular metabolism. The process of glycosylation of proteins is fatal, it triggers irreversible changes in the tissues.
  • Autoantibodies to the proteins of the vascular walls are formed, which is a significant factor in the development of small blood vessel lesions (microangiopathy).
  • A high release of glucose into the bloodstream triggers oxidative stress, which in many cases of diabetes mellitus makes the course of the disease heavier and is the root cause of the development of comorbidities.

Micro- and macroangiopathy in diabetes

The difficulty of microcirculation in blood vessels is caused by the accumulation of low-density lipoproteins on their walls, the activation of lipid peroxidation of cell membranes, and the release of free radicals at elevated concentrations. In addition to the above, diabetes leads to the suppression of the synthesis of prostacyclin, a highly active matabolite, which has a vasodilator and antiaggregate effect. All these changes can lead to the formation of such a severe complication as a diabetic foot.

Since a cascade of metabolic disorders also affects medium and large-caliber arteries (macroangiopathy), diabetics significantly increase the risk of stroke, myocardial infarction, arterial hypertension, kidney disease, and gangrene of the lower extremities.

Glucometer – the first step in the treatment of patients with diabetes

Diabetes, fortunately, is not always complicated by neuropathy. And its presence does not always entail disability. Timely diagnosis and therapy of diabetic vascular lesion leads to reversibility of processes, neural connections are restored, the passage of nerve impulses is getting better, and sensitivity in the limbs returns.

Of course, the main condition for the effectiveness of treatment – patients with diabetes should constantly monitor their blood glucose levels using   glucometer. In addition to adequate glycemic control, vasoactive and metabolic therapy is used.

Vasoactive drugs are prescribed for the treatment of micro-and macroangiopathy. They improve blood flow in the capillaries, lower blood viscosity, increase the volume of circulating fluid and normalize diuresis.

Metabolic therapy involves the use of preparations of thioctic acid, B vitamins, antioxidants and nootropic drugs. Have antihypoxic effect   vitamins   A, C, E, which is also prescribed in the complex treatment.

For patients, it is necessary to develop a special diet to maintain the level of sugar and a program of physical activity. For obese people, you need to adjust the diet for weight loss. Welcome to the rejection of the use of alcohol and smoking, reducing the consumption of saturated animal fats and salt. Patients with diabetes must comply with medical instructions, implement preventive measures, observe diet and lead a healthy lifestyle. And to do it not from time to time, but on a regular basis.

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