Microvascular Complications of Diabetes

Vulnerability of our health increases with every illness that we suffer from. Among the various scenarios wherein one illness leads to another, diabetic or hyperglycemia patients are more prone to eye, kidney, neurons & heart problems.

Let’s delve deeper as to why people with diabetes are at higher risk of such complications.

So what is Hyperglycemia?

In patients suffering from diabetes, blood sugar is not consumed by the cells due to a lack of insulin production or insulin resistance by the cells. And in either case, this causes increased blood glucose levels called Hyperglycemia.

What are the risks associated with Hyperglycemia?

Ignoring or not being able to treat hyperglycemia for long periods, damages the nerves, blood vessels, tissues, and organs. This can lead to further severity and cause serious health problems like damage to the eyes, kidneys, nerves, and heart.

Vascular Complications of Increased Blood Sugar Levels, Hyperglycemia.

As discussed above, sustained increased blood sugar levels can cause damage to the body at the cellular or organ level. Damage caused to small blood vessels is called Microvascular damage.

Refer to the image below to understand the microvascular complications of Diabetes.

Understanding microvascular damage begins with knowing how diabetic microvascular complications occur.

As per UK Prospective Diabetes Study and Diabetes Complications Trial, there is a clear connection between microvascular diseases and blood sugar levels. This research is in line with various other landmark clinical trials validating microvascular disease as a predominant occurrence in tissues organs that experience an uptake in glucose, independent of insulin activity. For example, Retina, Kidney, and vascular endothelium. The glucose levels in these parts are close to the condition of blood glucose levels. The factors include direct glucose-mediated endothelial damage, oxidative stress arising out of superoxide overproduction – with production of sorbitol, and advanced glycation end-products – pertaining to hyperglycemia.

A major characteristic of our metabolism is that it therefore witnesses alterations in blood flow, endothelial permeability, extravascular protein deposition, and coagulation. This leads to organ dysfunction. These microvascular complications thereon, can be categorized under three heads.

Diabetic Retinopathy

What is Diabetic Retinopathy?
Retina forms almost 2/3rd of the back of your eye, which is responsible for receiving visual images. Retinopathy means disease of the retina.

The retina is nurtured by small blood vessels. In diabetic patients, increased good sugar levels can lead to the blockage of the small blood vessels that nourish the retina, cutting off its blood supply. To fight this off, the eye attempts to grow new blood vessels. These new blood vessels aren’t developed properly. Thus, causing thickening of vessels, irregularity in diameters, and leakage of fluids, among other problems.

Symptoms for Diabetic Retinopathy:

• Blurred/patchy vision
• Floaters in the vision
• Eye pain and redness
• Difficulty in seeing things that are central to your vision, especially when driving and reading
• Worsening vision
• Sudden loss of vision

Further classification of diabetic retinopathy is as follows:

1. Background retinopathy: A very early stage wherein tiny bulges appear in the retina, which may leak some blood; also, pretty common in diabetic patients.
2. Pre-proliferative retinopathy: Wherein new blood vessels aren’t growing; as a result, impacting one’s vision.
3. Proliferative retinopathy: Involves the blood vessels growing abnormally; this is risky and needs attention as it can lead to vision loss.

Diabetic Nephropathy

What is Diabetic Nephropathy?
Nephropathy is a dysfunction of the kidneys. The kidney contains clusters of tiny blood vessels called Glomeruli, which function to filter the blood. They get rid of extra fluid and waste products from your body through your urine.

The increased sugar level in blood can cause damage to these Glomeruli (blood vessels) and in turn affect the filtering capability of Glomeruli and reduces GFR (Glomerular Filtration Rate). At optimal functioning, GFR is considered to be 100%. For a healthy person, the GFR must be between 60-100%, but if it falls below 60%, it is considered Kidney disease/dysfunction. GFR below 15% is considered a renal failure.

The dysfunction of the kidney may also cause loss of extra protein from your blood into urine, called proteinuria.

The dysfunction of the kidney may also cause loss of extra protein from your blood into urine, called proteinuria.

Diabetic Nephropathy is considered to be the most common type of microvascular complication, which affects almost 30% of diabetic patients.

Diabetic Nephropathy Signs and Symptoms

• Swelling first observed in the feet then rest of the body
• Weakness
• Nausea and vomiting
• Poor appetite and/or weight loss
• Poor sleep routine

How to reduce or manage nephropathy?

• Keep your blood sugar in control.
• Consult your nutritionist to change your food habits.
• Keep your blood pressure under control.
• Avoid or stop smoking
• Manage your weight
• Keep cholesterol (TDL) under control.

3. Diabetic Neuropathy

What is Diabetic Neuropathy?
Diabetic Neuropathy is the nerve damage caused due to an increase in blood sugar level. The symptoms depend on what is negatively impacting the nerves in the body. Usually, it takes time to observe such symptoms.

Diabetic Neuropathy is a major microvascular issue and is found in almost 50% of patients with Diabetes. In most cases, the symptoms go unnoticed during the early stages. Hence, patients are prone to substantial nerve damage until they finally start seeing the symptoms, and then take relevant measures.

Diabetic Neuropathy Symptoms:

Patients could suffer from mild to severe symptoms such as pain and numbness in the limbs and problems in the digestive system, urinary tract, blood vessels, and heart.

Types:
1. Peripheral Neuropathy – In this neuropathy, the peripheral part of the body is affected. This means the ends of the nerves of the Feet and hands are affected first, followed by the hands & arms.

2. Proximal Neuropathy: Unlike Peripheral Neuropathy where the ends of nerves are affected, here It affects the thighs, buttocks, hips & legs. It may also affect the chest area.

3. Autonomic Neuropathy: Your blood pressure, heart rate, sweat glands, eyes, bladder, digestive system, and sex organs are controlled by The autonomic nervous system. In Autonomic Neuropathy the nerves associated with the autonomic nervous systems are affected.

4. Focal Or Mono-Neuropathy: This involves damage to a single nerve. The nerve may be in the face, arm, leg, or torso. This appears suddenly and can cause severe pain.

Can Microvascular complications be reversed?

By now, you must have understood & learned that most Microvascular complications are associated with an increase in blood sugar levels. One must understand the underlying reasons why blood sugar levels go up & how to control it.

Blood glucose is the primary source of energy for the human body and it is derived from the food we eat. Herein, Insulin is a hormone secreted by the pancreas that helps to get glucose from the food we eat, and then take it to the body cells. But when the pancreas fails to make enough insulin, the glucose then stays in the blood and isn’t carried to the cells. This is what we call diabetes. But mostly, people emphasize on reducing high blood sugars without knowing the root cause.

At Wellfinity, we keep our patients informed of the minute details that goes unnoticed or unknown. With an improved lifestyle that includes healthy food choices, exercise, nutrition supplements, keeping your gut healthy, enough sleep, among various other steps, one can ensure the right balance & order.

Moreover, if you are a diabetic patient, you should undergo ongoing check-ups to track any probable complications arising out of their vulnerability. Therefore, early detection of micro and macrovascular complications can help in controlling the complications.

At Wellfinity, we have designed a scientific, evidence-based, interdisciplinary holistic wellness program to reverse chronic illnesses by working on the actual root causes. The program protocol has helped hundreds of diabetic patients to reverse their diabetes and lead a medicine-free diabetes-free life.