Damage to the blood vessels in diabetes

June 22, 2012

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Diabetes   - A disease that occurs as a consequence of absolute or relative deficiency insulin . People who suffer from diabetes, problems with the cardiovascular system is manifested long before the time when the first symptoms of diabetes appear. People with diabetes, especially of the second type have a higher risk of developing cardiovascular disease.

Causes of diabetic vascular damage

Prove considered the fact that the more time a person is suffering from diabetes, the higher is the risk of damage to the vessels. The increase in the risk of vascular disease manifestations in diabetes is directly linked to high blood pressure Failure to comply with strict diet , Smoking, lack of sufficient exercise. In diabetes occurs more often atherosclerosis   as a consequence of accumulation in the vessel wall cholesterol . Over time, the formation of cholesterol plaques That impede the free transportation oxygen to the heart muscle. If separation occurs cholesterol plaque, the result on the site may occur clot That subsequently becomes a cause of serious diseases - stroke . gangrene As a consequence of insufficient blood circulation in the limbs.

Symptoms of diabetic vascular damage

People who are ill diabetes , If there are problems with blood vessels can be seen a variety of symptoms. Damage to the blood vessels in diabetes mellitus may be expressed problems with sight: a man sees everything blurred, he periodically flashed before my eyes "flies." Very often, patients have swelling of the limbs and face, sores appear on his feet, loses its sensitivity as the hands and feet. Sometimes while walking manifests intermittent claudication and pain in the legs. In addition, patients with vascular lesions may occur turbidity and frothy urine, regularly appears high blood pressure, periodically there are pains in the chest.

Diabetic angiopathy

Diabetic angiopathy   - A diabetic vascular injury in which first of all observed the so-called capillaropathy . This pathology is specific just for diabetes. In the human body at the level of capillaries occurs transporting necessary substances in the tissue, as well as the reverse transport of waste products from the tissue cells. When broken capillaries, this process slows down, causing the whole body suffers.

Diabetic patients earlier than others, manifested atherosclerosis. The disease occurs in diabetics is heavier than the other patients. Atherosclerosis in diabetes can develop in people of both sexes and at any age, while it is often combined with microangiopathy . Atherosclerosis affects the arteries of the heart, blood vessels of the brain, the arteries of the upper and lower extremities.

Diabetic angiopathy patient develops as a consequence of poor treatment of diabetes. This results in violation fat   and protein metabolism Strong and frequent fluctuations content Glucose   in the blood, a significant breach of the hormonal balance. As a result, affected vessels: it becomes less active oxygen supply of tissues, is a disturbance of blood flow in small vessels.

Development angiopathy occurs under the influence Autoimmune processes . In humans, autoimmune reactions occur as a consequence of the use for the treatment of long-acting insulin. In addition, a very negative impact on the progression of angiopathy has patients use alcohol and tobacco.

Vascular disease of the legs in diabetes mellitus

Regardless of how it is manifested diabetic vascular disease, diabetic patients often observed symptoms such as intermittent claudication, ulceration of the feet. Subsequently, the disease can trigger the development of gangrene . According to medical statistics, in patients with diabetes gangrene develops in 50 times more likely than healthy people. Most often gangrene in diabetes develops in women who suffer from diabetes.

Typically, the first stage of development of angiopathy legs pronounced changes and signs of disease are observed. The presence of certain changes can only be determined in the course of the study using the methods tahoostsillografii, capillaroscopy, rheography.

In the second stage of the disease vessels of the legs, which is called a functional, a person has periodically manifested pain in the distal. Initially, the pain may be concerned only with long walking. Later, the pain starts to occur periodically and at rest, while from time to time in the patient having paresthesia, burning sensation, or chill. At night can disturb convulsions   feet.

In the process of examination of the patient at this stage of the expert he points out that he has a place of blanching and cooling stop. On palpation there is a surge on the back of weakness and posterior tibial arteries.

If the disease progresses, then it gradually passes into a third organic phase. At this time, the person has manifested a syndrome of intermittent claudication, which is actively progressing. After a while, the pain becomes constant and unabated, day or night. However, if the patient is dominated by phenomena diabetic microangiopathy, the pain can be so severe. Therefore, the manifestation of severe trophic changes may seem abrupt and sudden man.

The skin on your feet is also changing its structure: it becomes thinner and dry, it is very easy to injure. Initially, the skin gradually becomes pale purple-cyanotic hue. There weakening of pulsation of the popliteal artery and dorsalis pedis artery. If it is heard, it is very weak. Sometimes the big toe or in the other fingers, and soles appear bubbles Filled serosanguineous liquid . Later, the patient has sores That do not heal for a long time.

At the same time the defeat of the iliac and femoral arteries seen more rarely. This pathology is an indication that the patient has developed a very severe form arteriosclerosis obliterans .

Very dangerous complication of vascular disease becomes eventually gangrene, which may develop as a result of atherosclerotic lesions, and as a complication of diabetic microangiopathy. Gangrene complicates serosanguineous bladder or trophic ulcers. Gangrene often begins with the place where previously there was a crack corn or other wound. Gangrene can occur in different ways. With "Dry" gangrene   necrotic masses slowly mummified and rejected. With "Wet" gangrene   patient appear very severe general symptoms, and is actively developing septic condition.

Diabetic vascular injury in different people can proceed quite differently. In some cases, the process develops gradually, over the years, sometimes decades. But sometimes in patients with diabetes for diabetic macro- and microangiopathy progresses very rapidly and gangrene may develop in this case almost immediately. Features of the process is directly dependent on what the nature of diabetes mellitus is observed in the patient.

Diagnosis of vascular disease in diabetes

In the process of diagnosis expert, first of all, the patient is conducting a survey to find out about his complaints, the history and characteristics of diabetes, symptoms of the disease. The doctor is very important to determine whether the patient's place of periodic jumps in blood pressure if the patient smokes. After that, a thorough examination, during which the doctor determines the location of disturbing symptoms of the patient, finds out how often they cause concern.

To confirm diabetes, in the diagnostic process it is obligatory to define the amount of sugar in the blood, using a certain pattern, which tells endocrinologist. Also in the process is determined by laboratory analysis of blood cholesterol and other lipids . If the doctor suspects that the patient has broken the kidneys, he also conducted a urine test to determine whether it squirrel .

To determine the state of the vessels of the lower extremities and their functions, comprehensive study, which includes several tests that involve physical activity, and duplex ultrasound vessels. To evaluate the performance of the heart, the patient is held electrocardiogram and stress test, ECG involves a process of increasing load. Ultrasound study of blood flows to evaluate the condition of vessels.

To detect damage to blood vessels of the retina ( retinopathy ) Special investigations - ophthalmoscopy or fluorescein angiogram - should only be a specialist ophthalmologist.

Treatment of diabetic vascular damage

Treatment of vascular disease in diabetes involves maintenance of the control over the level of blood pressure, as well as ongoing support normal blood sugar levels. For this it is essential to follow a diet recommended by your doctor, and constantly taking medication correctly selected medications.

Regular intake of drugs that lower blood glucose, or insulin for diabetics is required. In order to reduce blood pressure in diabetes used betaadrenoblokatory . angiotensin converting enzyme inhibitors . Calcium channel blockers , and drugs, diuretics . Reduce blood cholesterol levels is possible using statins .

If the patient there is a risk of blood clots, he can be assigned to drugs that decrease the level of interaction Platelet . This can be aspirin . Plavix .

If the skin foot ulcers formed, they must be treated surgically. To prevent the appearance of new ulcers and infection the patient is assigned to receive antibiotics . Lack of adequate treatment may eventually lead to further infection, gangrene and amputation. To prevent amputation   performed angioplasty, stenting, bypass surgery. The method of treatment is individually appoints a vascular surgeon.

When retinopathy is sometimes carried out a special operation using a laser. With it carried out excision of pathological blood vessels, which provoke impairment in patients with diabetes.

Prevention of diabetic vascular damage

Diabetics should pay vascular disease prevention focus. We must try as much as possible to change your own life. It is especially important to do this if you have vascular disease is diagnosed at an early stage.

To prevent the occurrence of ulcers, every day a person should very carefully examine the feet. In severe dry skin should apply lanolin-containing agents. It is important to avoid injury to the leg skin, stick to a diet, do not miss the time of receiving the drugs that have been prescribed by a doctor for the combination therapy.

The main factor in the prevention of diabetic vascular injury is to maintain normal blood sugar levels.

In addition, patients with diabetes is extremely important to completely quit smoking, to reduce the amount of fat in the diet and savory, to prevent weight gain, as well as to monitor blood pressure and blood levels of cholesterol. Your doctor may recommend taking aspirin, which helps to prevent the occurrence of blood clots.

It is equally important for the prevention of vascular disease of the legs every day to walk at least 45 minutes, only wear comfortable shoes.