Diabetic angiopathy is a group of diseases associated with damage to the blood vessels and impaired blood circulation.
The progression of diabetes mellitus gradually leads to the development of this pathology. First, the vascular tone decreases, the gaps in them narrow, and nutritional deficiencies occur.
Late access to a doctor can lead to amputation and even death.
What is diabetic angiopathy?
Subsequently, long-term hyperglycemia occurs pathogenic processes that develop in the nervous tissue and vascular walls. They are ensured by the fact that the breakdown products of glucose begin to fall into the proteins of the blood and tissues of the body. This can lead not only to angiopathy, but also angioneuropathy - damage to both blood vessels and nerves.
So what is diabetic angiopathy? This is a pathology in which the lumen of the walls of the blood vessels narrow or are completely blocked. As a result, blood circulation is disturbed. Pathological processes associated with blood vessels can develop in many organs, so diabetic angiopathy can occur in the legs, retina, kidneys, brain, and heart. Photo signs of this disease can be viewed on the Internet.
Depending on the vascular lesion, the disease is divided into several types:
- Microangiopathy affecting small vessels.
- Macroangiopathy is a pathology associated with large vessels.
- Combined angiopathy - the defeat of both small and large vascular structures.
The risk factors for the development of pathology are considered to be the “experience” of a diabetic, glycemia, age, comorbidities, obesity, smoking, increased blood clotting, hypertension, and constant footwork.
Each type of disease manifests itself with special symptoms that every diabetic needs to be aware of.
Symptoms of diabetic nephropathy
The progression of angiopathy in diabetes mellitus leads to the development of renal failure. This organ consists of a variety of nephrons that are designed to filter the blood. Nephrons consist of elements such as a capsule, tubules and glomerulus. When the walls of the capillaries in the glomeruli narrow, the normal functioning of the paired organ stops.
For a long time the disease can be almost asymptomatic. Its signs are the same as those of diabetes mellitus: dryness in the mouth, unquenchable thirst and frequent urge to go to the toilet. The progression of diabetic nephropathy leads to swelling, increased blood pressure and intoxication, which is manifested by drowsiness and irritability.
Ineffective treatment can cause even more serious consequences. With the prolonged progression of renal failure, toxic substances, one of which is ammonia, begin to accumulate in the body. It easily penetrates into the central nervous system, damaging it. The main symptoms of increased ammonia or hyperammonemia are vomiting, drowsiness, dizziness and convulsions.
It should be noted that the severity of intoxication depends on how impaired kidney function.
Signs of Diabetic Retinopathy
In the retina of the eyeball is its own network of capillaries. With the progression of diabetes, it is she who suffers the most. Arterioles, arteries, capillaries and veins pass through it. When the lumen in them decreases, blood circulation is disturbed, leading to the development of retinopathy.
In the diagnosis of this pathology, ophthalmologic and clinical symptoms are distinguished.
Ophthalmologic symptoms are those that are detected during an ophthalmologic examination, and the symptoms that the patient describes to the attending physician are considered clinical.
It should be noted that the development of retinopathy is almost asymptomatic, so very often it is diagnosed at a late stage. Complaints of the patient when referring to a specialist can be:
- veil before eyes;
- deterioration of the visual apparatus;
- dark dots or flashes.
The progression of the disease leads to a distortion of the size and shape of the image before the eyes. And when retinopathy is accompanied by a hemorrhage in the vitreous, dark, blurry spots appear in the diabetic. In the worst case, pathology leads to blindness.
During an ophthalmologic examination, the doctor checks the retinal vessels and nerves. Even if the patient does not experience any overt symptoms, the signs of retinopathy are already diagnosed. The doctor may see constricted vessels in the fundus, and sometimes microaneurysms.
In addition, in the large veins edema and fluid accumulation occur.
Lower extremity injury
To initially correctly diagnose angiopathy of the lower extremities in diabetes mellitus, it is necessary to know what symptoms a patient may experience. After all, late or ineffective therapy leads to irreversible consequences.
As a result of narrowing of the arteries of the lower extremities, ischemia develops, that is, oxygen deficiency and blood supply, which leads to dysfunction of the legs. Trophic changes of the skin and even necrosis or gangrene occur. In this case, the most affected foot, as they are the most distant place.
Symptoms of this pathology are caused by processes occurring in both "sweet disease" and atherosclerosis. In addition, doctors identify other factors that trigger the appearance of the pathological process of the legs and feet. These include smoking, hereditary predisposition and dangerous work with toxic substances.
Diabetic angiopathy of the lower extremities is often manifested by the following symptoms:
- Coldness and numbness of the legs.
- Trophic ulcers of the foot.
- Cramps and pain.
- Changes in the skin integument.
Depending on the degree of vascular lesion, there is macro- and microangiopathy of the lower extremities. In this case, the defeat of the upper extremities occurs much less frequently.
With a slight lesion of the blood vessels of the legs, the patient feels light tingling. Sometimes his legs are cold, and small sores appear on them. Progression of macro-angiopathy leads to numbness of the limbs, claudication, pallor of the skin, constant cramps, pain and fever.
Diabetic foot - a very dangerous complication that develops when the treatment of diabetic angiopathy of the lower extremities was ineffective. With this pathological process, certain changes occur in the joints and bone tissue. One of the consequences is diabetic arthropathy, which leads to fractures and dislocations of the foot bones. Such changes further lead to Menkeberg syndrome (calcination and hardening of the vessels of the legs) and foot deformities.
It should be noted that diabetic angiopathy of the vessels of the lower extremities itself almost never progresses.
This pathology develops in conjunction with nephropathy and retinopathy.
Signs of diabetic encephalopathy
When encephalopathy occurs in a diabetic, memory impairment and confusion begin. In addition, the patient complains of constant headache and fatigue. This pathology is a consequence of a violation in the brain's blood circulation.
At the beginning of the development of the disease, a person may not feel any symptoms. But over time, the patient becomes addicted to pain medication due to frequent headaches. This, in turn, leads to sleep and sleep disorders during the day. In the future, the patient becomes absent-minded and forgetful.
In addition to cerebral symptoms, focal symptoms develop, which include impaired motor coordination, abnormal reflexes, and a precarious gait. A dangerous sign is considered a disorder of convergence, that is, double vision, blurred images, blurred vision, abnormal posture adaptation. In addition, anisocoria occurs - a condition in which there is a different diameter of the pupils.
Such pathological processes are dangerous for the patient when performing work associated with various mechanisms, as well as driving a car.
Damage to the capillaries and coronary arteries of the heart
For continuous feeding of heart cells, there is a capillary network and coronary arteries.
Angiopathy in diabetes affects the right and left coronary artery. This process is called macroangiopathy, resulting from the development of atherosclerosis.
With the defeat of the capillaries develops diabetic microangiopathy.
When a pathology occurs, the patient complains of the following symptoms:
- Angina pain. Arises due to the formation of plaques and stripes in the lumen of blood vessels. As a result, the blood cannot flow in the required quantity, and the heart is deficient in oxygen. This process causes anoxic decomposition of glucose and the release of lactic acid. It irritates the nerve endings in the heart, so the person feels pain.
- Heart failure, manifested by coughing, contraction of heartbeats and shortness of breath.
- Heart rhythm disorder. Developed with the defeat of small vessels and their hardening in the myocardium. There are several types of rhythm disturbances: bradycardia (heart rate less than 50 beats / min), tachycardia (more than 90 beats / min), extrasystole (untimely contraction) and arrhythmia (normal rhythm disturbance).
It must be remembered that the defeat of the heart vessels is often accompanied by a lesion of the blood vessels of the legs, kidneys and retina.
Diagnosis and treatment of the disease
Diagnostic measures for the development of diabetic angiopathy should be carried out comprehensively. Therefore, not only biological fluids are investigated, but also organs that are prone to this pathology.
There are several methods for determining the disease.
Testing residual nitrogen in the blood. Increased nitrogen concentration indicates a violation of the kidneys. Also determine the level of urea and creatinine. Nitrogen level: from 14 to 28 mmol / liter. Urea content: 2.5 to 8.3 mmol / liter.
General urine analysis. Indicators such as glucose, ketone bodies and proteins are determined. Glucose content: up to 10 mmol / l. Protein level: up to 300 mg / day.
Study of glomerular filtration rate. The main indicator for the diagnosis of nephropathy. Glomerular filtration: up to 140 ml / min.
Urine determination of b2-microglobulin. Detection of b2-microglobulin is indicative of diabetic angionephropathy. A healthy person should not have urine.
Lipid blood spectrum. Detection in the blood of lipoproteins and cholesterol. Cholesterol level: not more than 5.5 mmol / l. Concentration of lipoproteins: from 1 to 2.9 mmol / l.
Diagnosis of the disease involves the use of other methods, namely:
- comprehensive ophthalmologic examination;
- Doppler and leg arteriography;
- coronary angiography;
- electrocardiogram (ECG);
- magnetic nuclear resonance of the brain.
After the doctor makes a diagnosis, the tactics of angiopathy therapy are developed. Effective treatment includes maintaining a balanced diet, maintaining an active lifestyle and alternating rest with work. In addition, the treatment of angiopathy is accompanied by the following medications:
- Diabetic drugs for glycemic control.
- Preparations for lowering cholesterol.
- Means lowering blood pressure.
- Diuretic medication.
- Means to improve blood circulation.
- Drugs that prevent thrombosis.
- Drugs that improve the metabolic process.
To treat such a serious disease should be under the strict supervision of a specialist, adhering to all his recommendations. The video in this article will continue the topic of diabetes complications.