Chronic complications of diabetes

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1. Chronic complications of diabetes

Chronic complications of diabetes include two main groups: macrovascular complications (cardiovascular disease, peripheral vascular disease, cerebrovascular disease) and microvascular complications of diabetes (eye, kidney complications) , nerve).
1.1 Major Vascular Complications Arteriosclerosis is common in patients with diabetes, occurring earlier and more often than in people without diabetes. Cardiovascular disease: Diabetes mellitus is considered an independent risk factor for coronary heart disease. It is the leading cause of death in patients with diabetes. Coronary damage in patients with diabetes is often scattered and affects many branches, making coronary intervention more difficult. A common symptom in coronary heart disease due to diabetic complications is angina pectoris, typically occurring with exercise, and silent myocardial ischemia. Atypical symptoms of myocardial infarction such as confusion, shortness of breath, fatigue, nausea, vomiting. Peripheral vascular disease: manifests as lower extremity arteritis, occurs with equal proportions in men and women, the disease easily leads to ulceration, leg necrosis. Symptoms of peripheral vascular disease are similar to those of atherosclerotic arteritis: claudication, leg pain in the lying position, cold feet, cyanosis, atrophy of the intervertebral muscles, progression to necrosis, ulceration due to local anemia.

1.2 Microvascular complications Complications occur in small blood vessels, less than 30 micrometers, diffuse. Mainly affects 3 organs: retinopathy, glomerular disease and neuropathy. Retinopathy is the leading cause of blindness in people under 60 years of age with diabetes. Retinopathy is common in patients with diabetes for more than 20 years. This disease occurs in 90% of patients with type 1 diabetes and about 60% of patients with type 2 diabetes. Strict control of blood sugar in patients with both type 2 diabetes and control of blood pressure in patients with type 2 diabetes will reduce and delay this risk. This is especially important in patients with gestational diabetes. Kidney disease: kidney damage is defined by the presence of albumin in the urine. The clinical presentation of diabetic nephropathy becomes more apparent as the patient develops massive proteinuria and gradually increases serum creatinine levels. Sometimes manifests as complete nephrotic syndrome with hypoalbuminemia, hypertension, edema. It is also one of the leading causes of death from diabetes. Peripheral neuropathy is the degeneration of peripheral nerve fibers leading to loss of nerve function. Diabetic peripheral neuropathy involves symptoms of sensory, motor, and autonomic disturbances. The disease occurs in both types of diabetes and all ages but is more common in the elderly with type 2 diabetes. The most common manifestations are pain, decreased coordination of movement, especially coordination with complex activities. . Autonomic nerve damage in peripheral neuropathy can cause impotence in men, loss of bladder tone leading to bladder dilatation, decreased gastric contractility that can cause vomiting, delayed emptying, affect the absorption of food, interfere with the patient's use of insulin. Autonomic dysfunction causes decreased sweat secretion, skin atrophy, dry skin, and aggravated foot complications. Autonomic disorders also disrupt the functioning of the circulatory and respiratory systems.

1.3 Infectious complications in diabetic patients Diabetic patients are very susceptible to infections due to the reduced resistance of the body. Skin infections are usually caused by Staphylococcus aureus. Candida infection in the genitals or between fingernails and feet. Urinary tract infections are often caused by E.coli causing cystitis, acute and chronic pyelonephritis, papillary necrosis. Foot ulcers in diabetic patients are often caused by a combination of neurological complications, vascular complications, and infectious complications. The bacteria that cause foot infections are rarely one type, but often a combination.

2. Prevention of chronic complications of diabetes

Diabetes is a metabolic disorder that affects many organs in the body. Therefore, to treat diabetes, in addition to the goal of blood sugar control, it is also necessary to adjust blood lipids, manage blood pressure, and body mass index (BMI) to slow the occurrence of complications.
In addition to regular drug use, diet and exercise also play an important role in the treatment of diabetes, especially type 2 diabetes. Patients need to adjust their nutrition accordingly such as: : eat more fiber, reduce fat, reduce salt, consume a moderate amount of carbohydrates.
Patients should increase physical activity as this helps lower blood sugar, reduce insulin resistance and reduce risk factors for cardiovascular disease. Regular exercise is also important for long-term weight loss.
To prevent chronic complications of diabetes, you should monitor and check your condition regularly to make appropriate adjustments in the treatment regimen. Currently, Vinmec International General Hospital offers a Diabetes Outpatient Management Package to help limit serious complications caused by diabetes.
For more information, please contact the nationwide Vinmec Health System Hotline, or register online HERE.