Diabetes Complications .. continued...

Diabetes is associated with numerous microvascular and macrovascular complications . 
The major microvascular complications are 
Diabetic nephropathy 
Diabetic retinopathy 
Diabetic neuropathy 
Diabetic macro vasculopathy consists of accelerated atherosclerosis in large arteries (e.g. carotid arteries, aorta, and coronary and femoral arteries) and is associated with increased risk of cardiovascular diseases such as 
coronary artery disease  
peripheral vascular disease. 
Diabetes also affects cardiac structure and function in the absence of coronary artery disease, a complication referred to as DCM (diabetic cardiomyopathy)  

Complications of diabetes are attributed to prolonged levels of high blood glucose
The majority of these diabetes-related conditions occur as a result of uncontrolled blood glucose levels, particularly elevated blood sugar over a prolonged period of time.
With good diabetes control and living a healthy, active lifestyle, it is possible for people to go a number of decades complication free.
Why do complications occur?
Scientists still do not fully understand how complications develop.
What is known, however, is that high blood glucose levels cause damage to the blood vessels and nerves which supply our organs and therefore result in impaired functioning of any affected organs.

How do I prevent complications?
The risk of developing complications can be reduced by following a number of healthy lifestyle steps:
• Achieving good control of your blood glucose levels and HbA1c
• Losing weight - if you are currently overweight or obese
• Eating a healthy, balanced diet
• Taking regular physical activity - at least a total of 2 and a half hours each week
• Having a low alcohol intake
• Quitting smoking
Reducing your HbA1c
Large scale research studies have shown that the chances of developing the most common complications rises significantly in proportion to each 1% increase in HbA1c levels.
HbA1c, or haemoglobin A1c, is a molecule in the blood that can be measured to give clinicians an overall picture of a patient's average blood sugar levels over the previous 8-12 weeks.
This long-term measure of blood glucose is important for people with diabetes as the higher their HbA1c value, the greater the risk of developing serious diabetic complications.
By reducing HbA1c and keeping blood pressure and cholesterol levels well controlled, people with diabetes can reduce their risk of diabetic complications.
Treating complications
Whilst different treatments will be available for different complications, many of the most common diabetes-related condition can be better controlled, and their development limited, by following the healthy lifestyle steps for preventing complications.
If you have been diagnosed with one of the complications of diabetes, it can be possible to live unhindered by the condition at first. It is very important though to do whatever you can to follow the healthy lifestyle recommendations to prevent the complications becoming more damaging.

Diabetic retinopathy 
Diabetic retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. It is the most common cause of vision loss among people with diabetes and the leading cause of vision impairment and blindness among working-age adults.
People with diabetes can have an eye disease called diabetic retinopathy. This is when high blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell and leak. Or they can close, stopping blood from passing through. Sometimes abnormal new blood vessels grow on the retina. All of these changes can steal your vision

Diabetic peripheral neuropathy:
Neuropathy is an abnormality anywhere in a nerve pathway that disrupts nerve signals, causing the brain to misinterpret feelings or sensations.
Peripheral Arterial Disease (P.A.D.) - is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs.
Blocked blood flow to your legs can cause pain and numbness. It also can raise your risk of getting an infection in the affected limbs. Your body may have a hard time fighting the infection.
If severe enough, blocked blood flow can cause gangrene ( tissue death ). In

serious cases, this can lead to leg amputation.Blood circulation improvement and immunity development is essential to heal the wound Diabetic peripheral neuropathy is a long-term complication of diabetes. Exposure to high blood glucose levels over an extended period of time causes damage to the peripheral nerves – the nerves that go to the arms, hands, legs, and feet.DPN can affect small nerves that protect your body by sending signals about pain and temperature changes to your brain. This condition can also attack large nerves that detect touch, pressure and help you keep your balance. Symptoms are different for each type. Most people with DPN have damage to both types of nerves.DPN usually affects extremities—feet, hands, legs and arms where nerve fibers are the longest and most numerous. If your feet are numb, for instance, you may not notice small scrapes, blisters or cuts that can lead to serious infections and even to the need for amputation.

Sexual dysfunction and Diabetes :
Sexual dysfunction is more common in people with diabetes because poorly controlled diabetes can damage the blood vessels and nervous system causing reduced blood flow and loss of sensation in sexual organs. This can contribute to vaginal dryness in women and erection difficulties in men. Other problems associated with diabetes – such as heart disease and depression – together with some medications and surgery (eg bladder, bowel, prostate) can increase the chances of sexual dysfunction in people with diabetes.

Diabetic Gangrene 
Gangrene is a serious condition where a loss of blood supply causes body tissue to die. It can affect any part of the body but typically starts in the toes, feet, fingers and hands.
Gangrene can occur as a result of an injury, infection or a long-term condition that affects blood circulation.
Symptoms of gangrene include:
• redness and swelling in the affected area
• either a loss of sensation or severe pain in the affected area
• sores or blisters in the affected area that bleed or produce a foul-smelling pus
Anyone can develop gangrene, particularly after a serious injury, but there are certain groups of people who are more at risk.
These include people with long-term conditions that can affect the blood vessels, such as:
• diabetes – a lifelong condition that causes a person's blood sugar level to become too 

• atherosclerosis – where the arteries become clogged up with a fatty substance called plaque, narrowing them and restricting blood flow 
• peripheral arterial disease – where a build-up of fatty deposits in the arteries restricts blood supply to leg muscles
• Raynaud's phenomenon – where blood vessels in certain parts of the body, usually the fingers or toes, react abnormally to cold temperatures
In more severe cases, it may be necessary to remove an entire body part such as a toe, foot, or lower leg. This is known as amputation.
By increasing the blood supply and Immunity Gangrene can be curable.
How to Avoid Diabetic Complications
Complications can be avoided through good diabetes management
Long term diabetic complications are the result of one or more parts of your body becoming damaged as a result of diabetes.
Long term complications need not be inevitable and research indicates that it is possible to minimise complications or avoid or prevent them altogether.