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Progression Of Diabetes Complications

Avoiding Complications Of Diabetes

Avoiding Complications Of Diabetes

It can take work to get your diabetes under control, but the results are worth it. If you don't make the effort to get a handle on it, you could set yourself up for a host of complications. Diabetes can take a toll on nearly every organ in your body, including the: Heart and blood vessels Eyes Kidneys Nerves Gastrointestinal tract Gums and teeth Heart and Blood Vessels Heart disease and blood vessel disease are common problems for many people who don’t have their diabetes under control. You're at least twice as likely to have heart problems and strokes as people who don’t have the condition. Blood vessel damage or nerve damage may also cause foot problems that, in rare cases, can lead to amputations. People with diabetes are ten times likelier to have their toes and feet removed than those without the disease. Symptoms: You might not notice warning signs until you have a heart attack or stroke. Problems with large blood vessels in your legs can cause leg cramps, changes in skin color, and less sensation. The good news: Many studies show that controlling your diabetes can help you avoid these problems, or stop them from getting worse if you have them. Diabetes is the leading cause of new vision loss among adults ages 20 to 74 in the U.S. It can lead to eye problems, some of which can cause blindness if not treated: Glaucoma Cataracts Diabetic retinopathy, which involves the small blood vessels in your eyes Symptoms: Vision problems or sudden vision loss. The good news: Studies show that regular eye exams and timely treatment of these kinds of problems could prevent up to 90% of diabetes-related blindness. *CGM-based treatment requires fingersticks for calibration, if patient is taking acetaminophen, or if symptoms/expectations do not match CGM readings, and if not pe Continue reading >>

Long-term Complications Of Diabetes

Long-term Complications Of Diabetes

The long-term or chronic effects of diabetes include significant and permanent damage to a variety of organs and tissue, but most directly the kidneys and the nerves and blood vessels that feed the eyes, limbs and gastro-intestinal tract . These effects are known as microvascular complications because the injury to these organs stems from damage to the tiny blood vessels that feed these tissues and nerves. These complications can begin to develop early in the diagnosis of diabetes but generally take years to become clinically significant. There are also non-sugar related effects of diabetes mellitus which include heart disease, stroke, and peripheral vascular disease. Having diabetes increases the risks of these medical problems substantially. These are called macrovascular complications. The likelihood that these microvascular complications will arise seem to increase with the duration and severity of the diabetes- those with very high blood sugars for many years have a much higher chance of already having or developing microvascular complications than those with mild, new-onset diabetes. Even more importantly, studies have shown that controlling high-blood sugars with diet, exercise and medication over the long-term can drastically reduce the chances of developing these complications. Kidney damage from diabetes (known as Diabetic Nephropathy) is one of the most common and worrisome microvascular complications and is the most common cause of chronic kidney failure and the need for life-long dialysis in the United States . Generally it takes up to 10-15 years for clinically significant diabetic nephropathy to occur but . By the time damage to the kidneys from diabetes is detected (usually by way of testing the protein content of the urine), there has already been some Continue reading >>

Late Stage Complications Of Diabetes And Insulin Resistance

Late Stage Complications Of Diabetes And Insulin Resistance

1Department of Microbiology, Chaitanya Postgraduate College, Kakatiya University, Warangal, India 2Department of Biotechnology, Presidency College, Bangalore University, India *Corresponding Author: Department Of Microbiology, Chaitanya Postgraduate College affiliated to Kakatiya University, Warangal, India E-mail: [email protected] Citation: Soumya D, Srilatha B (2011) Late Stage Complications of Diabetes and Insulin Resistance. J Diabetes Metab 2:167. doi:10.4172/2155-6156.1000167 Copyright: © 2011 Soumya D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Diabetes mellitus is considered one of the main threats to human health in the 21st century. Diabetes is a metabolic disorder or a chronic condition where the sugar levels in blood are high. Diabetes is associated with long-term complications that affect almost every part of the body and often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. Also it is associated with significantly accelerated rates of several debilitating microvascular complications such as nephropathy, retinopathy, and neuropathy, and macrovascular complications such as atherosclerosis and stroke. In the present article it has been discussed about the resistance of insulin and its consequences in diabetic patients. Insulin resistance results in various disorders. Metabolic syndrome is predicted to become a major public health problem in many developed, as well as developing countries. Keywords Diabetes; Complications Continue reading >>

How Type 2 Diabetes Can Change Over Time

How Type 2 Diabetes Can Change Over Time

You probably already know that type 2 diabetes can cause long-term damage if you don’t control it, but it’s also important to understand that even well-controlled diabetes progresses over time — meaning you may have to adjust your treatment plan more than once. The key to learning about the progression of diabetes is to understand the role of your pancreas, which produces insulin. For people with type 1 diabetes, the pancreas does not make any insulin, so they must take it through injections. With type 2, the pancreas doesn’t make enough insulin or the cells don’t respond to it adequately, according to the American Academy of Family Physicians. This means that the body has trouble moving sugar from the blood into cells to be used for energy. Diet, exercise, and medication, if prescribed, can all help those with type 2 diabetes lower their blood sugar levels and help their bodies use insulin made by the pancreas, according to the American Diabetes Association (ADA). If blood sugar levels remain high, the ADA says, you may be at risk for such diabetes complications as vision loss, heart disease, nerve damage, foot or leg amputation, and kidney disease. However, proper diabetes management can help prevent or delay the onset of these complications. How Your Diabetes Treatment Plan Might Change Over time, your medications, diet, and exercise goals may need to be adjusted. “Initially the pancreas produces extra insulin to make up for insulin resistance, but in most people, the pancreas eventually is unable to make the extra insulin to keep blood sugar levels normal,” says Marc Jaffe, MD, a San Francisco endocrinologist in practice with Kaiser Permanente in Northern California. After a type 2 diabetes diagnosis, your doctor will set blood sugar goals for you, rec Continue reading >>

Role Of Adiponectin In Development And Progression Of Diabetic Complications

Role Of Adiponectin In Development And Progression Of Diabetic Complications

Role of Adiponectin in Development and Progression of Diabetic Complications Title: Role of Adiponectin in Development and Progression of Diabetic Complications Authors: Soher A. Mohammed Ismail, Ahmed Osman, Mustafa Abd El-Aziz M, Shaimaa Mohammed kamel, Iman A. Fahmy, Mohamed El Hefni, Safyea Mohamed Hussien This study aimed to elucidate the role of adiponectin in evolution of microvascular complication of type 2 diabetes mellitus, in particular retinopathy and nephropathy. In addition, we attempted to find a correlation between the serum levels of adiponectin and different parameters such as duration of diabetes, age, sex, glycemic state, insulin resistance, lipid profile and albumin-creatinine ratio in type 2 diabetic patients with retinopathy and nephropathy in order to understand more about these risk factors . This study involved sixty diabetic patients with type 2 diabetes mellitus with or without micro vascular complications involving either retinal or renal vasculatures or both. These patients were recruited from the outpatient clinic (A written consent was obtained from each case included in the study according to the Ethical Committee Approval of the Research Institute of Ophthalmology (RIO), Giza, Egypt. In addition to fifteen healthy subjects were involved and served as reference group. In addition to serum levels of adiponectin, routine diabetic diagnostic markers such as blood glucose levels, glycosylated Hb, insulin resistance, lipid profile, and kidney function tests were performed to all individuals included in the study. Full ophthalmological assessment including Fundus Fluorescein Angiography and clinical examinations (blood pressure, search for lower limb oedema, pallor, renal mass, etc.) have done for each subject. Data of this study revealed tha Continue reading >>

Complication Progression Rate

Complication Progression Rate

Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Does anyone know if there's a sort of standardised timeline of progression for complications? Not things like 'you WILL have screwy eyes after 10 years' etc. more like "retinopathy tends to show up before neuropathy' etc. The reason I ask is I've just had confirmation from my clinic that I don't show any signs of retinopathy, which frankly I think is bloody brilliant for 14 years with diabetes, high blood pressure and never having had what could be considered a non-diabetic A1c. I'm just wondering if retinopathy would be one of the usual first complications to show up in T1 - because it if so, it looks like I might be doing something right! I don't know if there is a stadardized timeline. I would doubt it, but who knows. I started showing some signs of retinopathy after 20 years or so. I am at year 26 and my eyes are no worse, actually a bit better. My first signs of retinopathy occurred in the mid/late 1990s, even though I was diagnosed in 1945. I was seeing my ophthalmologist every six months back then, and the little spots would come and go. My A1c's were very good (in the 6's back then). The problem never required laser treatment. In the new century my A1c's improved, and were consistently 6.1, or less. I started pumping in 2007 and had far fewer highs and lows. I have not had any signs of retinopathy for 5 years. This is strictly anecdotal...but I think retinopathy is like the canary in the coal mine. I think it's like a 'marker' that gets your attention far sooner than peripheral neuropathy would. I would acquaint it to getting the BSD, the 'blue screen of death' on a computer just afte Continue reading >>

Vascular Complication Of Diabetes

Vascular Complication Of Diabetes

Joseph I. Wolfsdorf, Katharine C. Garvey, in Endocrinology: Adult and Pediatric (Seventh Edition) , 2016 The vascular complications of diabetes are classified as either microvascular (retinopathy, nephropathy, and neuropathy) or macrovascular, which includes coronary artery, peripheral, and cerebral vascular disease. The microvascular complications can develop within 5 years of the onset of T1D, but infrequently develop before the onset of puberty. Clinically significant macrovascular complications are virtually never seen until adulthood. Intensive glycemic control decreases the risk of microvascular disease, retinopathy, nephropathy and neuropathy, and macrovascular disease.89 In addition to hyperglycemia, several other modifiable risk factors contribute to and influence the risk of vascular complications. Use of tobacco considerably increases the risk of onset and progression of nephropathy and macrovascular disease.90 Hypertension, likewise, is associated with increased risk and rate of progression of retinopathy, nephropathy, and macrovascular disease. Dyslipidemia contributes to the risk of macrovascular disease, nephropathy, and retinopathy. A family history of hypertension or nephropathy increases the risk of nephropathy. Development of diabetic complications is insidious, but can usually be detected years before the patient evidences symptoms or organ function is impaired. Systematic screening can detect abnormality at an early stage when intervention to arrest, reverse, or retard the disease process will have the greatest impact. Diabetic retinopathy is rare before the onset of puberty or in patients who have had T1D for less than 5 years. Therefore, annual dilated retinal examinations should begin 3 to 5 years after diagnosis after the child is 10 years old. Continue reading >>

Diabetes Update: The Untold Story Of Disease Progression

Diabetes Update: The Untold Story Of Disease Progression

CE credit is no longer available for this article. Originally posted March 2001 Pick up the paper. Turn on the radio. Diabetes is rapidly becoming a national epidemic. An estimated 18 million Americans have diabetes—and that number is growing, particularly among children. Certain ethnic groups, such as African-Americans, Hispanics, and Native Americans, have the highest incidence. Among those groups, one in four over the age of 45 will most likely develop diabetes. The Centers for Disease Control and Prevention (CDC) reports that between 1990 and 1998, the incidence of diabetes rose by 70% among people ages 30 - 39; by 40% among those 40 - 49; and by 31% among those 50 - 59. What may be even more disturbing is the percentage of people who don't even know that they have diabetes: About 33% of the population with Type 1 diabetes and up to 55% of people with Type 2 go undiagnosed. Many patients are hyperglycemic for up to six years before finding out they have diabetes. The toll diabetes takes is staggering. It is the leading cause of new cases of adult blindness, end-stage renal disease, and nontraumatic lower extremity amputations. And patients with diabetes have an incidence of cardiovascular morbidity and mortality four times that of non-diabetics. In fact, 65% of patients with Type 2 diabetes will die of a cardiovascular complication. The cost is enormous: $138 billion annually. The average per capita medical expenditure is $10,000 per diabetic patient, vs. $2,700 for the non-diabetic individual. The good news is that complications of diabetes can be limited and its progression slowed with strict control of blood sugar and new treatment protocols. New drugs provide more therapeutic options. Insulin sensitizers, insulin secretagogues, medications that alter the diges Continue reading >>

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 >>

Diabetes Mellitus: Management Of Microvascular And Macrovascular Complications

Diabetes Mellitus: Management Of Microvascular And Macrovascular Complications

The management of type 1 and 2 diabetes mellitus (DM) requires addressing multiple goals, with the primary goal being glycemic control. Maintaining glycemic control in patients with diabetes prevents many of the microvascular and macrovascular complications associated with diabetes. This chapter presents a review of the prevalence, screening, diagnosis, and management of these complications. Definitions Microvascular complications of diabetes are those long-term complications that affect small blood vessels. These typically include retinopathy, nephropathy, and neuropathy. Retinopathy is divided into two main categories: Nonproliferative retinopathy and proliferative retinopathy. Nonproliferative retinopathy is the development of microaneurysms, venous loops, retinal hemorrhages, hard exudates, and soft exudates. Proliferative retinopathy is the presence of new blood vessels, with or without vitreous hemorrhage. It is a progression of nonproliferative retinopathy. Diabetic nephropathy is defined as persistent proteinuria. It can progress to overt nephropathy, which is characterized by progressive decline in renal function resulting in end-stage renal disease. Neuropathy is a heterogeneous condition associated with nerve pathology. The condition is classified according to the nerves affected and includes focal, diffuse, sensory, motor, and autonomic neuropathy. Macrovascular complications of diabetes are primarily diseases of the coronary arteries, peripheral arteries, and cerebrovasculature. Early macrovascular disease is associated with atherosclerotic plaque in the vasculature supplying blood to the heart, brain, limbs, and other organs. Late stages of macrovascular disease involve complete obstruction of these vessels, which can increase the risks of myocardial infar Continue reading >>

Symptoms

Symptoms

Print Overview Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It's also your brain's main source of fuel. If you have diabetes, no matter what type, it means you have too much glucose in your blood, although the causes may differ. Too much glucose can lead to serious health problems. Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes — when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes — and gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered. Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms tend to come on quickly and be more severe. Some of the signs and symptoms of type 1 and type 2 diabetes are: Increased thirst Frequent urination Extreme hunger Unexplained weight loss Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin) Fatigue Irritability Blurred vision Slow-healing sores Frequent infections, such as gums or skin infections and vaginal infections Although type 1 diabetes can develop at any age, it typically appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it's more common in people older than 40. When to see a doctor If you suspect you or your child may have diabetes. If you notice any poss Continue reading >>

Defining And Characterizing The Progression Of Type 2 Diabetes

Defining And Characterizing The Progression Of Type 2 Diabetes

Type 2 diabetes is a progressive disease in which the risks of myocardial infarction, stroke, microvascular events, and mortality are all strongly associated with hyperglycemia (1). The disease course is primarily characterized by a decline in β-cell function and worsening of insulin resistance. The process is manifested clinically by deteriorations in multiple parameters, including A1C, fasting plasma glucose (FPG), and postprandial glucose levels. In this review, we will evaluate our current understanding of the role played by deteriorating β-cell function and other abnormalities linked with the progression of type 2 diabetes. An improved understanding of these abnormalities may provide the scientific groundwork for novel therapies that may help achieve and maintain good glycemic control. CHARACTERISTICS OF DISEASE PROGRESSION Progression from pre-diabetes to overt diabetes Because glucose is a continuous variable, the use of thresholds to make a diagnosis is somewhat arbitrary. The term “pre-diabetes” has become well established and implies a risk of progression to overt diabetes. However, although such progression is well studied in prevention trials, little is known about the rate of progression and the characteristics of such progression in the population at large. Table 1 summarizes some of the factors associated with such progression. Nichols et al. (2) studied the progression of pre-diabetes to overt disease and observed that 8.1% of subjects whose initial abnormal fasting glucose was 100–109 mg/dl and 24.3% of subjects whose initial abnormal fasting glucose was 110–125 mg/dl developed diabetes over an average of 29.0 months (1.34 and 5.56% per year, respectively). A steeper rate of increasing fasting glucose; higher BMI, blood pressure, and triglycer Continue reading >>

The Effect Of Intensive Treatment Of Diabetes On The Development And Progression Of Long-term Complications In Insulin-dependent Diabetes Mellitus

The Effect Of Intensive Treatment Of Diabetes On The Development And Progression Of Long-term Complications In Insulin-dependent Diabetes Mellitus

Long-term microvascular and neurologic complications cause major morbidity and mortality in patients with insulin-dependent diabetes mellitus (IDDM). We examined whether intensive treatment with the goal of maintaining blood glucose concentrations close to the normal range could decrease the frequency and severity of these complications. A total of 1441 patients with IDDM -- 726 with no retinopathy at base line (the primary-prevention cohort) and 715 with mild retinopathy (the secondary-intervention cohort) were randomly assigned to intensive therapy administered either with an external insulin pump or by three or more daily insulin injections and guided by frequent blood glucose monitoring or to conventional therapy with one or two daily insulin injections. The patients were followed for a mean of 6.5 years, and the appearance and progression of retinopathy and other complications were assessed regularly. In the primary-prevention cohort, intensive therapy reduced the adjusted mean risk for the development of retinopathy by 76 percent (95 percent confidence interval, 62 to 85 percent), as compared with conventional therapy. In the secondary-intervention cohort, intensive therapy slowed the progression of retinopathy by 54 percent (95 percent confidence interval, 39 to 66 percent) and reduced the development of proliferative or severe nonproliferative retinopathy by 47 percent (95 percent confidence interval, 14 to 67 percent). In the two cohorts combined, intensive therapy reduced the occurrence of microalbuminuria (urinary albumin excretion of ≥ 40 mg per 24 hours) by 39 percent (95 percent confidence interval, 21 to 52 percent), that of albuminuria (urinary albumin excretion of ≥ 300 mg per 24 hours) by 54 percent (95 percent confidence interval, 19 to 74 percent Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Print Overview Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel. With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level. More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy. Symptoms Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for: Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual. Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger. Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses alternative fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine. Fatigue. If your cells are deprived of sugar, you may become tired and irritable. Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus. Slow-healing sores o Continue reading >>

Defining And Characterizing The Progression Of Type 2 Diabetes

Defining And Characterizing The Progression Of Type 2 Diabetes

Go to: Progression from pre-diabetes to overt diabetes Because glucose is a continuous variable, the use of thresholds to make a diagnosis is somewhat arbitrary. The term “pre-diabetes” has become well established and implies a risk of progression to overt diabetes. However, although such progression is well studied in prevention trials, little is known about the rate of progression and the characteristics of such progression in the population at large. Table 1 summarizes some of the factors associated with such progression. Nichols et al. (2) studied the progression of pre-diabetes to overt disease and observed that 8.1% of subjects whose initial abnormal fasting glucose was 100–109 mg/dl and 24.3% of subjects whose initial abnormal fasting glucose was 110–125 mg/dl developed diabetes over an average of 29.0 months (1.34 and 5.56% per year, respectively). A steeper rate of increasing fasting glucose; higher BMI, blood pressure, and triglycerides; and lower HDL cholesterol predicted diabetes development. The Baltimore Longitudinal Study of Aging (3) concluded that although phenotypic differences in rates of progression are partly a function of diagnostic thresholds, fasting and postchallenge hyperglycemia may represent phenotypes with distinct natural histories in the evolution of type 2 diabetes. Does hyperglycemia evolve from normoglycemia gradually over time or as a step increase? Ferrannini et al. (4) measured plasma glucose and insulin levels during oral glucose testing at baseline and after 3 and 7 years of follow-up. In subjects with normal glucose tolerance on all three occasions (nonconverters), FPG increased only slightly over 7 years. In contrast, conversion to both impaired glucose tolerance (IGT) and diabetes among normal glucose tolerance subjects Continue reading >>

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