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New Evidence Of How High Glucose Damages Blood Vessels Could Lead To New Treatments

Complications Of Diabetes Mellitus

Complications Of Diabetes Mellitus

The complications of diabetes mellitus are far less common and less severe in people who have well-controlled blood sugar levels. Acute complications include hypoglycemia and hyperglycemia, diabetic coma and nonketotic hyperosmolar coma. Chronic complications occur due to a mix of microangiopathy, macrovascular disease and immune dysfunction in the form of autoimmune disease or poor immune response, most of which are difficult to manage. Microangiopathy can affect all vital organs, kidneys, heart and brain, as well as eyes, nerves, lungs and locally gums and feet. Macrovascular problems can lead to cardiovascular disease including erectile dysfunction. Female infertility may be due to endocrine dysfunction with impaired signalling on a molecular level. Other health problems compound the chronic complications of diabetes such as smoking, obesity, high blood pressure, elevated cholesterol levels, and lack of regular exercise which are accessible to management as they are modifiable. Non-modifiable risk factors of diabetic complications are type of diabetes, age of onset, and genetic factors, both protective and predisposing have been found. Overview[edit] Complications of diabetes mellitus are acute and chronic. Risk factors for them can be modifiable or not modifiable. Overall, complications are far less common and less severe in people with well-controlled blood sugar levels.[1][2][3] However, (non-modifiable) risk factors such as age at diabetes onset, type of diabetes, gender and genetics play a role. Some genes appear to provide protection against diabetic complications, as seen in a subset of long-term diabetes type 1 survivors without complications .[4][5] Statistics[edit] As of 2010, there were about 675,000 diabetes-related emergency department (ED) visits in the 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 >>

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 >>

Endothelial Dysfunction And Diabetes: Effects On Angiogenesis, Vascular Remodeling, And Wound Healing

Endothelial Dysfunction And Diabetes: Effects On Angiogenesis, Vascular Remodeling, And Wound Healing

Go to: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by inappropriate hyperglycemia due to lack of or resistance to insulin. Patients with DM are frequently afflicted with ischemic vascular disease or wound healing defect. It is well known that type 2 DM causes amplification of the atherosclerotic process, endothelial cell dysfunction, glycosylation of extracellular matrix proteins, and vascular denervation. These complications ultimately lead to impairment of neovascularization and diabetic wound healing. Therapeutic angiogenesis remains an attractive treatment modality for chronic ischemic disorders including PAD and/or diabetic wound healing. Many experimental studies have identified better approaches for diabetic cardiovascular complications, however, successful clinical translation has been limited possibly due to the narrow therapeutic targets of these agents or the lack of rigorous evaluation of pathology and therapeutic mechanisms in experimental models of disease. This paper discusses the current body of evidence identifying endothelial dysfunction and impaired angiogenesis during diabetes. Go to: 1. Introduction Endothelial cell dysfunction (ECD) is a broad term which implies dysregulation of endothelial cell functions, including impairment of the barrier functions of endothelial cells, vasodilation, disturbances in proliferative capacities, migratory as well as tube formation properties, angiogenic properties, attenuation of synthetic function, and deterrence of white blood cells from adhesion and diapedesis [1]. Several factors contribute to ECD including smoking, high blood pressure, diabetes, high cholesterol levels, obesity, hyperglycemia, advance glycation end products (AGEs), and genetic factors [1, 2]. Diabetes is a chronic metab Continue reading >>

Sodium-rich Diets Can Cause Damage Beyond High Blood Pressure

Sodium-rich Diets Can Cause Damage Beyond High Blood Pressure

Holiday brunches, buffets, dinners, and parties are often laden with salty food. For some people, a high-salt diet leads to high blood pressure, which makes the heart work harder and increases the risk of having a heart attack or stroke, or of developing heart failure or kidney disease. Other people are blessed with genes or physiology that lets them eat foods high in sodium without ever seeing a bump in their blood pressure. If you’re in the latter camp, is it OK to blithely eat ham, cheese logs, and other salty holiday foods? No. As my colleagues David Edwards, Claudine Jurkovitz, William Weintraub, and I wrote in the Journal of the American College of Cardiology, too much sodium in the diet can damage health even when blood pressure stays normal. By weight, salt is about 40 percent sodium. The human body needs some sodium to transmit nerve impulses, contract and relax muscles, and balance fluids throughout the body. The average person needs less than 500 milligrams of sodium a day to survive, but gets about 3,400 milligrams, nearly seven times what’s needed. Very high dietary sodium appears to be especially harmful to blood vessels. It damages their innermost layer, called the endothelial layer. This thin sheet of cells helps blood vessels dilate to increase blood flow when the need arises. Damage to the endothelial layer sets the stage for atherosclerosis, the main artery-clogging disease process underlying nearly all cardiovascular problems, including heart attacks and poor blood flow to the legs and brain. Atherosclerosis can also cause kidney problems and vascular dementia. Even when sodium doesn’t boost blood pressure, too much of it in the diet can: Harm the heart. Too much sodium can increase the size and the thickness of the left ventricle, the heart’ Continue reading >>

The Connection Between Type 2 Diabetes And Hearing Loss

The Connection Between Type 2 Diabetes And Hearing Loss

How common is hearing loss in people with diabetes? About 30 million people in the United States have diabetes, a disease characterized by high blood sugar levels. Between 90 and 95 percent of people with diabetes have type 2, which can develop at any age. Management of this disease is crucial. When blood sugar levels aren’t well-controlled, your risk of developing hearing loss may increase. Read on to learn more about the connection between type 2 diabetes and hearing loss and what you can do about it. Studies show that hearing loss is twice as common in people who have diabetes than in those who don’t. In a 2008 study, researchers analyzed data from hearing tests of adults between the ages of 20 and 69. They concluded that diabetes may contribute to hearing loss by damaging nerves and blood vessels. Similar studies have shown a possible link between hearing loss and nerve damage. The study’s authors made no distinction between type 1 and type 2, the two main types of diabetes. But almost all participants had type 2. The authors also cautioned that noise exposure and presence of diabetes was self-reported. In 2013, researchers analyzed studies carried out from 1974 to 2011 on diabetes and hearing loss. They concluded that people with diabetes were twice as likely to have hearing loss than people without diabetes. However, these researchers did note several limitations, such as the data being based on observational studies. What causes or contributes to hearing loss in people with diabetes isn’t clear. It’s known that high blood sugar can damage blood vessels throughout the body, including your ears. If you’ve had diabetes for a long time and it isn’t well-controlled, there could be damage to the vast network of small blood vessels in your ears. Research s Continue reading >>

Why Does Diabetes Cause Headaches?

Why Does Diabetes Cause Headaches?

Diabetes is a condition where the body cannot make enough of the hormone insulin, or cannot use it properly, causing glucose to build up in the blood. According to the Centers for Disease Control and Prevention (CDC), over 29 million people in the United States have diabetes. Diabetes does not usually cause headaches. But, while headaches are not dangerous, they may be an indication of poor blood sugar control in a person with diabetes. Over time, periods of continuous high or low blood sugar can lead to serious and even life-threatening health complications, such as heart disease and kidney failure. This article looks at the connection between diabetes and headaches and suggests ways to relieve diabetes-induced headaches. Contents of this article: Types of headache According to the International Classification of Headache Disorders, published by the International Headache Society, there are over 150 types of headaches. Broadly speaking, headaches can be classified as either primary or secondary: Primary headaches are ones that are not linked to another medical condition. Examples of primary headaches include migraines and tension headaches. Secondary headaches are caused by underlying medical conditions or health issues and include the type of headache often experienced by people with diabetes. Other causes of secondary headaches include: hormone fluctuations infection nerve disorders overuse of medication trauma The pain associated with either primary or secondary headaches can vary in severity and duration. Some people may not experience headaches often, while others can get a headache several days each week. Depending on the type of headache, other symptoms may be present. For example, migraines can be linked with nausea and increased sensitivity to sound or light. Continue reading >>

Controlling Blood Sugar In Diabetes: How Low Should You Go?

Controlling Blood Sugar In Diabetes: How Low Should You Go?

Diabetes is an ancient disease, but the first effective drug therapy was not available until 1922, when insulin revolutionized the management of the disorder. Insulin is administered by injection, but treatment took another great leap forward in 1956, when the first oral diabetic drug was introduced. Since then, dozens of new medications have been developed, but scientists are still learning how best to use them. And new studies are prompting doctors to re-examine a fundamental therapeutic question: what level of blood sugar is best? Normal metabolism To understand diabetes, you should first understand how your body handles glucose, the sugar that fuels your metabolism. After you eat, your digestive tract breaks down carbohydrates into simple sugars that are small enough to be absorbed into your bloodstream. Glucose is far and away the most important of these sugars, and it's an indispensable source of energy for your body's cells. But to provide that energy, it must travel from your blood into your cells. Insulin is the hormone that unlocks the door to your cells. When your blood glucose levels rise after a meal, the beta cells of your pancreas spring into action, pouring insulin into your blood. If you produce enough insulin and your cells respond normally, your blood sugar level drops as glucose enters the cells, where it is burned for energy or stored for future use in your liver as glycogen. Insulin also helps your body turn amino acids into proteins and fatty acids into body fat. The net effect is to allow your body to turn food into energy and to store excess energy to keep your engine running if fuel becomes scarce in the future. A diabetes primer Diabetes is a single name for a group of disorders. All forms of the disease develop when the pancreas is unable to Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Type 2 diabetes occurs mostly in people aged over 40 years. However, an increasing number of younger people, even children, are being diagnosed with type 2 diabetes. The first-line treatment is diet, weight control and physical activity. If the blood sugar (glucose) level remains high despite these measures then tablets to reduce the blood glucose level are usually advised. Insulin injections are needed in some cases. Other treatments include reducing blood pressure if it is high, lowering high cholesterol levels and also using other measures to reduce the risk of complications. Although diabetes cannot be cured, it can be treated successfully. If a high blood sugar level is brought down to a normal level, your symptoms will ease. You still have some risk of complications in the long term if your blood glucose level remains even mildly high - even if you have no symptoms in the short term. However, studies have shown that people who have better glucose control have fewer complications (such as heart disease or eye problems) compared with those people who have poorer control of their glucose level. Therefore, the main aims of treatment are: To keep your blood glucose level as near normal as possible. To reduce any other risk factors that may increase your risk of developing complications. In particular, to lower your blood pressure if it is high and to keep your blood lipids (cholesterol) low. To detect any complications as early as possible. Treatment can prevent or delay some complications from becoming worse. Type 2 diabetes is usually initially treated by following a healthy diet, losing weight if you are overweight, and having regular physical activity. If lifestyle advice does not control your blood sugar (glucose) levels then medicines are used to help lower your Continue reading >>

High Blood-sugar Levels May Harden Heart Valves

High Blood-sugar Levels May Harden Heart Valves

(Medical Xpress)—Rice University bioengineers have found new evidence of a possible link between diabetes and the hardening of heart valves. A Rice lab, in collaboration with the University of Texas Health Science Center at Houston (UTHealth) Medical School, discovered that the interstitial cells that turn raw materials into heart valves need just the right amount of nutrients for proper metabolic function. The surprise was that feeding them too much glucose, a sugar, slowed the cells down. Diabetes is a metabolic disease characterized by high blood-sugar levels over a long period; a 2006 study of atherosclerosis by University of Washington researchers found a correlation between diabetes and aortic-valve calcification. In the new work by the lab of Jane Grande-Allen of Rice's bioengineering department, recently ranked No. 5 in the nation by U.S. News & World Report, researchers have directly seen the effect of high blood-sugar levels on heart-valve cell metabolism for the first time. The study appears this month in the Journal of the Royal Society Interface. "The most significant result of the study is that high glucose concentration can actually be detrimental to the aortic-valve cells and their behavior in interacting with the extracellular matrix," said lead author Peter Kamel, who carried out the experiments as a Rice undergraduate. He is in his third year at Baylor College of Medicine, where he is completing a dual-degree program offered by the neighboring Houston institutions. "We've seen in a variety of other cell types, like cells in the kidney, the retina and nerves, that high glucose concentrations can directly damage those cells and their activities," he said. "That results in patients with diabetes having problems with vision and with their nerves and kid Continue reading >>

Sugar's 'tipping Point' Link To Alzheimer's Disease Revealed

Sugar's 'tipping Point' Link To Alzheimer's Disease Revealed

For the first time a "tipping point" molecular link between the blood sugar glucose and Alzheimer's disease has been established by scientists, who have shown that excess glucose damages a vital enzyme involved with inflammation response to the early stages of Alzheimer's. Abnormally high blood sugar levels, or hyperglycaemia, is well-known as a characteristic of diabetes and obesity, but its link to Alzheimer's disease is less familiar. Diabetes patients have an increased risk of developing Alzheimer's disease compared to healthy individuals. In Alzheimer's disease abnormal proteins aggregate to form plaques and tangles in the brain which progressively damage the brain and lead to severe cognitive decline. Scientists already knew that glucose and its break-down products can damage proteins in cells via a reaction called glycation but the specific molecular link between glucose and Alzheimer's was not understood. But now scientists from the University of Bath Departments of Biology and Biochemistry, Chemistry and Pharmacy and Pharmacology, working with colleagues at the Wolfson Centre for Age Related Diseases, King's College London, have unraveled that link. By studying brain samples from people with and without Alzheimer's using a sensitive technique to detect glycation, the team discovered that in the early stages of Alzheimer's glycation damages an enzyme called MIF (macrophage migration inhibitory factor) which plays a role in immune response and insulin regulation. MIF is involved in the response of brain cells called glia to the build-up of abnormal proteins in the brain during Alzheimer's disease, and the researchers believe that inhibition and reduction of MIF activity caused by glycation could be the 'tipping point' in disease progression. It appears that as Al Continue reading >>

Managing Diabetes: New Evidence On Targets For Blood Pressure And Blood Glucose

Managing Diabetes: New Evidence On Targets For Blood Pressure And Blood Glucose

Key messages: 1. Current evidence does not support blood pressure targets lower than the standard targets for people with raised blood pressure and diabetes 2. Better evidence is needed to guide the choice between targeting intensive or conventional glycaemic control in people with type 2 diabetes but intensive control increases the risk of both mild and severe low blood sugar Today is World Diabetes Day and there’s a big emphasis on knowing the complications of diabetes and trying to avoid them. Maintaining healthy blood pressure levels and blood sugar levels are important ways to reduce the risk of damage to the heart and blood vessels, kidneys, nerves and eyes. We have new evidence from Cochrane systematic reviews which helps shed some light on which approaches might be best when it comes to setting targets for blood pressure and blood glucose levels. Blood pressure targets: how low should you go? When treating high blood pressure (BP), doctors and patients will want to know what levels they’re aiming for. For some time the advice has been that a target of 140/90 mmHg is right for the general population being treated for high blood pressure. The first number, 140 here, is the systolic blood pressure (SBP) and the second, 90, the diastolic blood pressure (DBP) and these are generally considered separately in clinical practice. The National Institute for Health and Care Excellence recommends 140/90 mmHg as the target BP levels for those aged under eighty in their Hypertension Guideline, with no alternative recommendation for people with diabetes. Other guidelines have recommended lower BP targets for diabetics, including recent European guidelines which recommend a target lower than 140/85mmHg. There was no consistent evidence to recommend a target SBP of below 130 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 FAS, and with low Continue reading >>

Three New Treatment Options For Type 2 Diabetes Recommended By Nice

Three New Treatment Options For Type 2 Diabetes Recommended By Nice

The drugs will help to control blood sugar in those patients who cannot take more commonly prescribed medicines meaning their condition remains stable for longer. An estimated 31,000 people may be eligible for the three recommended treatments: canagliflozin (Invokana), dapagliflozin (Forxiga) and empagliflozin (Jardiance). The three drugs can all be used on their own if a person can’t use metformin, sulfonylurea or pioglitazone, and diet and exercise alone isn’t controlling their blood glucose levels. In the UK, almost 3.5 million people who have been diagnosed with diabetes and it’s estimated that about 90% of adults with the condition have type 2 diabetes. Type 2 diabetes causes elevated blood sugar levels which damages blood vessels leading to increased risk of heart attack, stroke and limb amputation. Sugar levels rise because their body doesn’t produce enough insulin – the hormone which controls the amount of glucose in blood – or their body doesn’t use insulin effectively. Professor Carole Longson, director of the NICE Centre for Health Technology Evaluation, said: “Type 2 diabetes is long-term condition that has a serious impact on people who live with it, and the treatments given should be tailored for the individual. “For many people whose blood glucose levels aren’t controlled by diet and exercise alone, metformin is the first drug treatment that they’ll be offered. But some people may experience nausea and diarrhoea, and they may not be able to take it if they have kidney damage. For people who can’t take a sulfonylurea or pioglitazone, then the three drugs recommended in this guidance can be considered. This is as an alternative to the separate group of drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors. “The committee agreed th Continue reading >>

How Diabetes Harms The Brain

How Diabetes Harms The Brain

TIME Health For more, visit TIME Health. When blood sugar levels start to climb in diabetes, a number of body systems are harmed—and that list includes the brain, since studies have linked diabetes with a higher risk of stroke and dementia. Now, a new study published in the journal Neurology reports that changes in blood vessel activity in the brains of diabetics may lead to drops in cognitive functions and their ability to perform daily activities. Dr. Vera Novak, associate professor of neurology at Harvard Medical School and Beth Israel Deaconess Medical Center, and her colleagues followed a group of 65 older people. About half had type 2 diabetes, and half did not. After two years, the diabetic patients had lower scores on cognitive tests compared to when they began, while people without diabetes showed little change on the tests. MORE: The Strange Way a Diabetes Drug May Help Skin Scars What drove the decline, says Novak, were changes in the brains of the diabetic patients. Diabetes can cause blood vessels to be less responsive to the ebb and flow of demand in different parts of the brain. Normally, flexible vessels will swell slightly to increase blood flow and oxygen to areas that are more intensely active, such as regions involved in memory or higher reasoning during intellectual tasks. But unchecked blood sugar can make these vessels less malleable and therefore less responsive. “When doing any task, from cognition to moving your fingers, you need to increase blood flow to that specific area of the brain,” says Novak. “With diabetes, however, that vasodilation ability is reduced, so you have fewer resources to perform any task.” MORE: Statins May Seriously Increase Diabetes Risk In the study, Novak measured the changes in the flexibility of the blood v Continue reading >>

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