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Diabetes Vein Damage

About Diabetes

About Diabetes

Complications of diabetes Diabetes complications are divided into microvascular (due to damage to small blood vessels) and macrovascular (due to damage to larger blood vessels). Microvascular complications include damage to eyes (retinopathy) leading to blindness, to kidneys (nephropathy) leading to renal failure and to nerves (neuropathy) leading to impotence and diabetic foot disorders (which include severe infections leading to amputation). Macrovascular complications include cardiovascular diseases such as heart attacks, strokes and insufficiency in blood flow to legs. There is evidence from large randomized-controlled trials that good metabolic control in both type 1 and 2 diabetes can delay the onset and progression of these complications. Diabetic retinopathy (eye disease) Etiology Diabetic retinopathy is a leading cause of blindness and visual disability. It is caused by small blood vessel damage to the back layer of the eye, the retina, leading to progressive loss of vision, even blindness. Symptoms Usually the patient complains of blurred vision, although other visual symptoms may also be present. Diagnosis Diagnosis of early changes in the blood vessels of the retina can be made through regular eye examinations. Treatment Good metabolic control can delay the onset and progression of diabetic retinopathy. As well, early detection and treatment of vision-threatening retinopathy can prevent or delay blindness. This involves regular eye examinations and timely intervention Nephropathy (kidney disease) Etiology Diabetic kidney disease is also caused by damage to small blood vessels in the kidneys. This can cause kidney failure, and eventually lead to death. In developed countries, this is a leading cause of dialysis and kidney transplant. Symptoms Patients usually Continue reading >>

Blood Vessels

Blood Vessels

Tweet Blood vessels are vital for the body and play a key role in diabetes helping to transport glucose and insulin. Blood vessels can be damaged by the effects of high blood glucose levels and this can in turn cause damage to organs, such as the heart and eyes, if significant blood vessel damage is sustained. About blood vessels The three main types of blood vessels are: Arteries Capillaries Veins Arteries carry blood to the organs and muscles. Capillaries are very small blood vessels which transfer oxygen and nutrients to cells and collect waste products from the cells. Veins are the blood vessels which carry deoxygenated blood back to the heart. Blood vessels role in blood sugar levels Blood vessels play an important role in diabetes as they carry glucose in the blood as well as hormones such as insulin. Too much glucose in the blood leads to the symptoms of diabetes. The body requires insulin to enable glucose to pass from the blood vessels into the cells that need energy. In type 1 diabetes In untreated type 1 diabetes, there is not enough insulin in the blood to help transport glucose into the body’s cells. Type 2 diabetes In type 2 diabetes, the primary problem is that the body is unable to respond adequately to the presence of insulin, and this also prevents glucose from being transported out of the blood into cells. How diabetes damages blood vessels High blood glucose levels over long periods of time are known to lead to the blood vessels becoming damaged. How the damage occurs is not so well understood but researchers have hypothesised how the damage may occur. Medical theory notes that molecules known as advanced glycation end products (AGEs) are involved in the damage that is sustained by blood vessels. AGEs are the result of fats and proteins that have b Continue reading >>

Researchers Discover Root Cause Of Blood Vessel Damage In Diabetes

Researchers Discover Root Cause Of Blood Vessel Damage In Diabetes

A key mechanism that appears to contribute to blood vessel damage in people with diabetes has been identified by researchers at Washington University School of Medicine in St. Louis. Blood vessel problems are a common diabetes complication. Many of the nearly 26 million Americans with the disease face the prospect of amputations, heart attack, stroke and vision loss because of damaged vessels. Reporting in the Journal of Biological Chemistry, the Washington University researchers say studies in mice show that the damage appears to involve two enzymes, fatty acid synthase (FAS) and nitric oxide synthase (NOS), that interact in the cells that line blood vessel walls. “We already knew that in diabetes there’s a defect in the endothelial cells that line the blood vessels,” says first author Xiaochao Wei, PhD. “People with diabetes also have depressed levels of fatty acid synthase. But this is the first time we’ve been able to link those observations together.” Wei is a postdoctoral research scholar in the lab of Clay F. Semenkovich, MD, the Herbert S. Gasser Professor of Medicine, professor of cell biology and physiology and chief of the Division of Endocrinology, Metabolism and Lipid Research. Wei studied mice that had been genetically engineered to make FAS in all of their tissues except the endothelial cells that line blood vessels. These so-called FASTie mice experienced problems in the vessels that were similar to those seen in animals with diabetes. “It turns out that there are strong parallels between the complete absence of FAS and the deficiencies in FAS induced by lack of insulin and by insulin resistance,” Semenkovich says. Comparing FASTie mice to normal animals, as well as to mice with diabetes, Wei and Semenkovich determined that mice without F Continue reading >>

Diabetic Neuropathy: Preventing And Reversing The Damage

Diabetic Neuropathy: Preventing And Reversing The Damage

Imagine living with the haunting possibility that one day, you may lose all feeling in your feet and that this lost sensation could ultimately lead to ulceration, infection, and even amputation of your unsalvageable limbs. This grim but very real condition is called diabetic peripheral neuropathy (DPN), and according to the National Institute of Diabetes and Digestive and Kidney Disease 60-70 percent of diabetics suffer some kind of nerve damage. That means as the number of type 2 diabetics continues to spiral out of control, we are facing a growing population suffering from pedal disasters like these. What’s tragic is that with all we now know about diabetes, many of these conditions are preventable and largely reversible when they do occur. To help you prevent DPN or reverse the damage if you are already suffering, in today’s blog I will review some of the issues that lead to the onset of the condition and outline some simple dietary measures and supplements you can take to properly support your feet and reverse the damage. Sadly, these conditions typically begin with one major medical assumption: Diabetes can be controlled by medicine alone. Controlling Diabetes with Medication: Can it Be Done? In my opinion, one of the biggest misconceptions in modern medicine is the assumption that diabetes can be controlled by medication alone. The truth is that it simply can’t be. Somehow our culture has developed this fantasy that people can eat anything they want, do no exercise, and any health complications will be resolved with a few pills or injections. Nothing could be further from the truth. On the surface it may appear that diabetes can be successfully treated with pharmaceuticals. Fasting blood sugar and hemoglobin A1C levels both seem to improve. And while these a Continue reading >>

Against Diabetic Complications

Against Diabetic Complications

Benfotiamine European Supplement Protects When treating diabetes, today's doctors focus on establishing blood glucose control, but often overlook the need to protect against common diabetic complications such as blindness, stroke, endothelial dysfunction, and loss of limb.1 Fortunately, benfotiamine, a little-known fat-soluble form of vitamin B1, has been shown to help prevent the development and progression of many diabetic complications. As a result, benfotiamine has become a critical nutrient for those seeking to ward off the potentially lethal impact of sustained high blood sugar levels. Used for decades in Europe as a prescription medication, benfotiamine ameliorates the progression of diabetic nerve, kidney, and retinal damage, and relieves the painful symptoms of diabetic neuropathy.2-8 Diabetic neuropathy makes it difficult for nerves to carry messages to the brain and also impairs the function of the microvasculature (tiny blood vessels) in the extremities. The result of this pathological blood-vessel damage is numbness and painful tingling in the feet (and hands) that can eventually result in amputation of the lower extremities. Benfotiamine acts through a novel mechanism, blocking the biochemical pathways by which high blood sugar damages cells throughout the body.8 Now available as a low-cost dietary supplement, benfotiamine can help diabetes sufferers protect their nerves, kidneys, eyes, blood vessels, and heart. Benfotiamine’s multifaceted effects in preventing dangerous diabetic complications make it an essential supplement for people with elevated blood sugar levels. Benfotiamine Differs from Conventional Diabetes Drugs Diabetes drugs are among the most widely prescribed pharmaceuticals on the market today. Current medications for type II diabetes seek Continue reading >>

How High Blood Sugars Damage Blood Vessels

How High Blood Sugars Damage Blood Vessels

Researchers have gained fresh insights into how elevated glucose levels damage blood vessels. The mechanism could lead to novel strategies for blocking the destruction. High glucose levels reduce the levels of the powerful vasodilator nitric oxide in blood vessels, a shortfall that increases the risk of high blood pressure and eventually narrows down the vessels. Rita C. Tostes, physiologist in the MCG School of Medicine, found that decreased ability of blood vessels to relax resulted from increased activity of a natural mechanism for altering protein form and function. The researchers suspect that increased modification of proteins by a glucose-derived molecule is a player in vascular problems associated with hypertension, stroke and obesity as well. Tostes stated that, “We know diabetes is a major risk factor for cardiovascular disease and we think this is one of the reasons.” In the study conducted on healthy mice, the researchers found that there was an increased activity by O-GlcNAc in the blood vessels, which competes with another mechanism for modifying proteins called phosphorylation. In blood vessels, phosphorylation modifies the enzyme that produces nitric oxide, called nitric oxide synthase, so that it makes more of the blood vessel dilator. O-GlcNAc seems to beat phosphorylation to the punch so there is the opposite result. Victor Lima, a graduate student at the University of Sao Paulo working with Dr. Tostes stated that, “The longer O-GlcNAc levels were high, the worse the resulting problem.” An animal model of hypertension confirmed the finding that the more O-GlcNAc, the more blood vessels contract because these animals had higher O-GlcNAc levels. “Now we are trying to see why this is happening and what comes first. Is increased blood pressure l Continue reading >>

Bypass Best For People With Diabetes

Bypass Best For People With Diabetes

Surgery beats stenting if you have diabetes and heart disease, too. Both bypass surgery and its less invasive alternative, angioplasty plus stenting, are used to open severely narrowed coronary arteries. For most people, the two procedures have the same long-term benefits and risks. In people with diabetes, though, a new trial suggests that bypass surgery may be better than angioplasty plus stenting: it led to lower rates of heart attack and death over the next five years. In angioplasty, artery-blocking deposits of cholesterol-filled plaque are pushed aside with a balloon. A small metal cylinder, or stent, is left behind to hold the vessel open. The balloon and stent are maneuvered into the heart through an artery in the groin. In bypass surgery, which requires opening the chest, a surgeon uses spare blood vessels to reroute blood around the blockages. The results of the trial—Future Revascularization Evaluation in People with Diabetes Mellitus (FREEDOM)—were published in the New England Journal of Medicine on Nov. 6, 2012. It's considered one of the most important clinical trials of last year and sheds light on a longstanding controversy about which procedure is better for treating people with diabetes who have severely blocked coronary arteries. "This finding is really quite important, since the opposite strategy is used more often right now, because angioplasty is less painful and seems more convenient," says cardiologist Dr. Thomas Lee, co-editor in chief of the Harvard Heart Letter. The decision to perform angioplasty is often made while performing a diagnostic procedure known as cardiac catheterization. It's often convenient for the specialists performing the catheterization to think, "As long as we are here, let's fix this now," rather than stepping back and Continue reading >>

Retinopathy

Retinopathy

The Facts Retinopathy refers to damage to the blood vessels of the retina. The retina, at the back of the eye, provides a window to the circulatory system. By examining it, a doctor can inspect a sample of the body's blood vessels and detect early signs of complications of diabetes or high blood pressure, as well as many other diseases (e.g., sickle cell disease, anemia, lupus). Retinopathy can also be seen in premature newborns. Some of the kinds of damage that your doctor may see in your retina are hypertensive retinopathy, a complication of high blood pressure (hypertension), and diabetic retinopathy, a complication of long-term diabetes. It's unusual for hypertension to impair vision, but hypertensive retinopathy can lead to blockage of retinal arteries or veins, which in turn may eventually result in the loss of vision. Smoking and diabetes increase the risk of developing hypertensive retinopathy. Diabetic retinopathy is a deterioration of the blood vessels in the retina that usually affects both eyes. It is the leading cause of blindness in North America. Almost all people with diabetes show signs of retinal damage after about 20 years of living with the condition. Causes Retinopathy is usually a sign of another medical condition. Although several medical conditions (e.g., sickle cell disease, lupus) can cause retinopathy, the most common causes are diabetes and hypertension (high blood pressure). Diabetic retinopathy is a complication of diabetes. Diabetes causes high blood sugar levels, which can damage blood vessels. The damaged vessels around the retina can leak protein and fats, forming deposits that can interfere with vision. The damaged blood vessels are also not as effective at carrying oxygen to the retina, which can also cause damage. In the advanced sta Continue reading >>

Varicose Vein Issues And Diabetes

Varicose Vein Issues And Diabetes

People with diabetes are more prone to blood flow problems known as peripheral vascular disease and nerve ending issues known as neuropathy. Excess glucose creates damage to the blood vessels and nerves especially the smaller vessels and weakens the veins. Although there is no direct link between diabetes and varicose veins, many people suffer from these conditions simultaneously. “50% of people 50 and over have varicose veins.” Although not as troublesome as neuropathy or PAD, varicose veins can be painful and troublesome. They are more common in women due to their fluctuating hormone levels but are seen in men as well. Varicose veins can have a negative impact on blood circulation. Let’s examine varicose veins: What are Varicose Veins? Varicose veins are enlarged, elongated, bulging blue and purple veins that resemble cords and are twisted directly under the skin due to relaxed vein walls. The veins have a one-way valve “that prevents blood from flowing backwards due to the pull of gravity.” Over time, and for specific reasons, the vein valves become faulty and relax. Some of the blood, which should be traveling to your heart, backs up and pools in the veins. This then continues to weaken the vein walls. Besides large varicose veins, the relaxed valves can cause spider veins which are smaller, superficial and mostly cosmetic. They are usually found on the calves or on the insides of the thighs. Varicose veins can also cause venous insufficiency which is a true circulation problem that can occur in deeper veins and cause blood clots. What are the Risk Factors of Varicose Veins? One of the biggest risk factors is heredity and family history. Other risk factors are: being over the age of 50, being pregnant due to increased blood volume/hormones, and going throu Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

Overview Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated. However, it usually takes several years for diabetic retinopathy to reach a stage where it could threaten your sight. To minimise the risk of this happening, people with diabetes should: ensure they control their blood sugar levels, blood pressure and cholesterol attend diabetic eye screening appointments – annual screening is offered to all people with diabetes aged 12 and over to pick up and treat any problems early on How diabetes can affect the eyes The retina is the light-sensitive layer of cells at the back of the eye that converts light into electrical signals. The signals are sent to the brain and the brain turns them into the images you see. The retina needs a constant supply of blood, which it receives through a network of tiny blood vessels. Over time, a persistently high blood sugar level can damage these blood vessels in three main stages: tiny bulges develop in the blood vessels, which may bleed slightly but don’t usually affect your vision – this is known as background retinopathy more severe and widespread changes affect the blood vessels, including more significant bleeding into the eye – this is known as pre-proliferative retinopathy scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina – this is known as proliferative retinopathy and it can result in some loss of vision However, if a problem with your eyes is picked up early, lifestyle changes and/or treatment can stop it getting worse. Read about the stages of diabetic retinopathy. Am I at risk of diabetic retinopathy? Anyone with type 1 diabetes or type 2 diabetes i Continue reading >>

What Treatments Are Available For Diabetic Eye Disease?

What Treatments Are Available For Diabetic Eye Disease?

The first step in any treatment for diabetic eye disease is to maintain blood glucose, blood pressure, and blood cholesterol levels as close to normal as possible. Treatment of diabetic macular edema (swelling or the accumulation of blood and fluids in the macula, the part of the retina that provides sharp central vision), has evolved a great deal in the last five to ten years, and is based on the severity of the edema. At present, there are three options: laser treatment Avastin, Lucentis, or Eylea injection intravitreal steroids: Kenalog, Ozurdex, and Iluvien Laser Treatment This technique is used by retinal surgeons to treat a number of eye conditions, one of which is diabetic eye disease. A beam of high-intensity light is directed into the eye to seal off leaking blood vessels and prevent additional blood and fluid from leaking into the vitreous, which is the jelly-like substance that fills the inside of the back part of the eye. The doctor administers eye drops to dilate (open up) the pupil and numb the eye before treatment begins. Because lasers cannot restore lost vision, it is critical to maintain regular comprehensive eye examinations so that treatment can be initiated as soon as diabetic eye changes are detected. There are two types of laser treatments for diabetic eye disease: Focal laser treatment, also called photocoagulation: The retina is treated to stop or slow the leakage of blood and fluid from abnormal blood vessels within the eye. Focal laser, however, can also destroy surrounding healthy retinal tissue as it seals the leakage from abnormal blood vessel growth; therefore, it is not used on blood vessels directly under the macula, the center of the retina. Scatter laser treatment, also called panretinal photocoagulation: The areas of the retina away f Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

Diabetic retinopathy is a condition that occurs in people who have diabetes. It causes progressive damage to the retina, the light-sensitive lining at the back of the eye. Diabetic retinopathy is a serious sight-threatening complication of diabetes. Diabetes interferes with the body's ability to use and store sugar (glucose). The disease is characterized by too much sugar in the blood, which can cause damage throughout the body, including the eyes. Over time, diabetes damages the blood vessels in the retina. Diabetic retinopathy occurs when these tiny blood vessels leak blood and other fluids. This causes the retinal tissue to swell, resulting in cloudy or blurred vision. The condition usually affects both eyes. The longer a person has diabetes, the more likely they will develop diabetic retinopathy. If left untreated, diabetic retinopathy can cause blindness. Symptoms of diabetic retinopathy include: Seeing spots or floaters Blurred vision Having a dark or empty spot in the center of your vision Difficulty seeing well at night When people with diabetes experience long periods of high blood sugar, fluid can accumulate in the lens inside the eye that controls focusing. This changes the curvature of the lens, leading to blurred vision. However, once blood sugar levels are controlled, blurred distance vision will improve. Patients with diabetes who can better control their blood sugar levels will slow the onset and progression of diabetic retinopathy. Often the early stages of diabetic retinopathy have no visual symptoms. That is why the American Optometric Association recommends that everyone with diabetes have a comprehensive dilated eye examination once a year. Early detection and treatment can limit the potential for significant vision loss from diabetic retinopathy. T Continue reading >>

Eye Health Education

Eye Health Education

Retinal vein occlusion is the second most common cause of blindness due to retinal vascular disease after diabetic retinopathy. Retinal vein occlusion is a common eye problem. A major cause of retinal vein occlusions is arteriolosclerosis or the thickening of the blood vessel walls. Thickening of the walls of your blood vessels occurs in response to increased blood pressure. This arteriolosclerosis leads to a compression of the ocular veins which course under the arteries. This compression leads to partial occlusion of the vein, development of a blood clot, and damage to the blood vessel wall. When blood cannot drain properly, it leads to bleeding and leakage of fluid from blocked blood vessels. Oxygen delivery to the retina is reduced and problems such as blurred vision, blind spots, bleeding in the eye, or a painful type of glaucoma can ensue. What causes a retinal vein occlusion? Risk factors for retinal vein occlusion include age (your risk increases 10-fold from age 40 to age 65), hypertension, high cholesterol, diabetes, or elevated eye pressure. In the rare cases where retinal vein occlusion is not explained by these factors, lab work must be done to search for other, uncommon medical conditions that lead to an increased tendency for blood to clot. What does RVO mean? Ophthalmologists use different terminology to describe retinal vein occlusions, depending on where the blockage in the eye occurred. A BRVO, or branch retinal vein occlusion, occurs in one of the smaller veins in the eye. A BRVO may only affect one-quarter or one-half of the retina, leaving other parts of the retina to function normally. In contrast, a CRVO, or central retinal vein occlusion, affects the main venous drainage of the eye. Typically, a central retinal vein occlusion is more severe than Continue reading >>

The Connection Between Diabetes And Varicose Veins

The Connection Between Diabetes And Varicose Veins

Varicose veins are a sign of aging – enlarged, gnarled veins clearly visible through the skin. Is there a connection between varicose veins and diabetes? A lot of people think that diabetes causes varicose veins. The truth is rather more complicated than that. Does Diabetes Cause Varicose Veins? No. Diabetes does not “cause” varicose veins – not all diabetics develop them and varicose veins are also seen in other older individuals. The apparent correlation is, instead, the result of the risk factors for both being similar. Varicose veins are, in fact, caused by “venous insufficiency” – the flow of blood through the veins is slow and blood pools in the veins, causing the visible enlargement. The root cause is problems with the valves that keep blood flowing in the correct direction, towards the heart. This is why varicose veins are generally seen on the legs. Diabetes, on the other hand, is a result of insulin resistance or the production of insufficient insulin. (Type I diabetics have a chronic insufficiency from an early age, Type II develops in older adults). When the two occur together it is because both varicose veins and type II diabetes are seen in older, overweight individuals who have a family history of the disease. Both can also occur in pregnant women. These shared risk factors are often the reason why varicose veins are often attributed to diabetes. Both diabetes and varicose veins are possible health hazards for individuals who are: aging pregnant obese have a family history or genetic predisposition How Can Diabetics Prevent Varicose Veins? First of all, remember that the one does not cause the other – but the measures taken to prevent varicose veins can also help with circulation problems caused by diabetes. Patients should keep salt intak Continue reading >>

Diabetic Foot Pain

Diabetic Foot Pain

by Kenneth B. Rehm, DPM Includes photo of Dr. Kenneth B. Rehm, DPM Diabetes is one of the most common reasons people seek relief for painful feet. With diabetes, four types of foot problems may arise in the feet. Nerve Problems due to Diabetes The most common contributor to diabetic foot pain is a nerve problem called Peripheral Neuropathy. This is where the nerves are directly affected by the disease process. There are basically three types of peripheral neuropathy: sensory, motor, and autonomic neuropathy. A large percentage of pain diabetic patients complain of is due to sensory neuropathy. This can show up as "sensitive pain," where the amount of pain is not proportional to the amount of insult that is causing it. For instance, just touching the skin or putting a sheet over your feet in bed could be painful. This can be present at the same time as numbness in the feet. Sensory neuropathy symptoms can include burning, tingling or a stabbing pain. Relief is foremost on someone's mind when painful neuropathy has raised its ugly head. The first thing to do is to check your blood sugar for the past several weeks to see if there has been a trend toward high blood sugar (Editor's Note: The A1c test is traditionally employed to determine this, and should be repeated about every three months.) Persistent high blood sugar can contribute to this type of pain. Massaging your feet with a diabetic foot cream, or using a foot roller, often takes the edge off the pain. Vitamin B preparations are often recommended; and there are a variety of prescription medications that do work. Using cushioned, supportive shoes and foot support inserts is always needed to protect the feet from the pounding, rubbing and irritating pressures that contribute to neuropathic pain. Motor neuropathy can Continue reading >>

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