Diabetes Mellitus is a metabolic syndrome that involves multiple organs of the body. The disease beginning with higher blood sugar levels than normal leads to multi-organ failure if not treated well in time.
Pathophysiology of diabetes mellitus
Insulin is the hormone that controls and regulates blood sugar levels. Insulin is produced by the beta cells of the pancreas present just below the stomach. Insulin is responsible for the regulation of other macronutrients like lipids and proteins. A decreased production of insulin by the pancreas or resistance to insulin at the receptor level causes unchecked levels of sugars in the blood. Blood sugar is not regulated and gradual increases in the level start affecting the other organs of the body.
The first and foremost organs which are affected by raised blood sugar levels are blood vessels themselves. Unchecked increased carbohydrates cause increased lipid accumulation in the blood vessels and lead to a condition called atherosclerosis. The lumen of blood vessels decreases, as a result, causing raised blood pressure and other cardiac issues.
Complications of diabetes mellitus
With the passage of time, raised blood glucose levels start affecting microcirculation. The retina, kidneys, and peripheral blood vessels all are affected at this level and three main effects start to appear namely, diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy.
Diabetic nephropathy is a condition in which the end arteries of the retina are affected, damaged, and ruptured leading to decreased vision.
In diabetic nephropathy, the microcirculation of the kidney is badly damaged which results in increased sugar levels in the urine. This term is called glycosuria and is almost always an alarming sign. The reason behind this is that the basement membrane and the structure of the nephron are damaged making the kidney the least functional for absorption and excretion both. As a result, acute and then chronic renal failure occurs showing its signs. Some of the prominent signs of chronic renal failure are anemia, vitamin D deficiency, and Glycosuria.
Diabetic neuropathy is again because of damaged microcirculation to the peripheral nerves which results in altered or loss of sensations at the peripheries. A patient with diabetic neuropathy may complain of burning sensations in the hands and feet which lead to no sensations with the passage of time. Diabetic foot is the result of diabetic neuropathy in which loss of sensation doesn’t alert the patient of the potential injury. Once the foot is injured, a high blood glucose level causes superadded infections leading to diabetic foot and then gangrene.
Hypoglycemia in diabetic patients and the Importance of diabetes information card
They say hypoglycemia in diabetic patients is more of an emergency than any of the above complications. Patients who are on hypoglycemic drugs sometimes suffer from very low blood glucose levels which leads to serious signs and symptoms.
To avoid such situations or prompt management of such patients, a diabetes care card is always kept in the wallets so that people who find this card know what to do with such patients. Fainting is the most obvious sign of severe and acute hypoglycemia and needs immediate attention.