Complications in type 2 diabetes

Types of complications in type 2 diabetes

Eye diseases

Diabetics may develop retinopathy – damage to the blood vessels that feed the retina. If left unchecked, the disease can lead to blindness, which is why it is important for people with type 2 diabetes to see an ophthalmologist regularly. If retinopathy is detected early, complications can be prevented.

Diseases of the oral cavity

Diabetics who do not maintain their target glucose levels are at greater risk of developing periodontitis, an inflammation of the tissues around the tooth. Because of this disease, you can lose teeth, and periodontitis can also provoke the development of cardiovascular diseases. Prevention of periodontitis is extremely important for people with diabetes – you need to properly care for the oral cavity and teeth and control blood glucose levels. This will help prevent future tooth loss.

Cardiovascular diseases

Cardiovascular disease is the most common cause of disability and death in people with diabetes. Diabetes is associated with conditions such as angina (pain or discomfort in the chest), myocardial infarction (heart attack), stroke, peripheral arterial disease (reduced blood flow to the extremities), and congestive heart failure (heart weakness leading to fluid buildup in the lungs). and surrounding tissues).

Kidney

In diabetes, kidney disease (nephropathy) is more common than usual. Moreover, diabetes is one of the main causes of chronic kidney disease. In type 2 diabetes, damage to small blood vessels occurs, which can lead to decreased efficiency or complete failure of the kidneys. However, if you keep your blood glucose levels and blood pressure normal, you can significantly reduce the risk of developing nephropathy.

Complications during pregnancy

Women with any type of diabetes are at risk of developing complications during pregnancy because high blood glucose levels can affect the development of the fetus. To reduce risks, expectant mothers need close attention before and during pregnancy. High blood glucose can lead to changes in the development of the fetus – it can grow to an abnormally large size and gain excess weight, which in turn can lead to complications during childbirth, including injury to the baby and mother, as well as low glucose levels in the blood (hypoglycemia) in a newborn. In the future, such children are at risk of developing type 2 diabetes more than their peers.

Leg injury

In the legs with type 2 diabetes, it is not small, but large vessels (arteries) that suffer.

If nerve damage occurs due to prolonged high blood glucose levels, then arterial damage is a manifestation of atherosclerosis and is often associated with an increase in such an indicator as blood cholesterol levels. At the same time, an increased level of glucose in the blood aggravates the severity of the atherosclerotic process.

The predominance of arterial lesions leads to a violation of the blood supply to the legs. This is more common in older patients. A sign of such a lesion at pronounced stages is pain in the legs when walking. They occur in the lower legs even after a short walk, and the person must stop and wait for the pain to pass before continuing the journey.

People with diabetes are 25 times more likely to have amputations than those without the disease. However, with proper control of blood glucose levels, a significant number of amputations can be avoided, and with regular examination of the legs, problems can be detected and treated at an early stage.

How can acute complications of diabetes be prevented?

Most complications can be avoided or their progression stopped. A patient with type 2 diabetes should monitor their condition:

• control of glucose levels in blood and urine;
• weight control;
• control of glycated hemoglobin (HbA1c);
• control of blood cholesterol levels (preferably also other indicators of lipid metabolism);
• control of blood pressure;
• protein in the urine (microalbuminuria);
• examination by an ophthalmologist and a medical examination of the legs.

Most indicators should be monitored at least once a year. If a problem is detected, recommendations are prescribed by a doctor, then they must be observed and not neglected.

Treatment of complications in type 2 diabetes

Most patients with type 2 diabetes are treated with oral antidiabetic drugs. Sulfonylureas remain the main hypoglycemic therapy. Any sulfonylurea drug, after oral administration, binds to a specific protein on the pancreatic b-cell membrane and stimulates insulin secretion. Also, some sulfonylurea drugs restore the sensitivity of b-cells to glucose.

For patients with type 2 diabetes mellitus with well-preserved function of insulin secretion, the combination of a sulfonylurea drug with biguanide is effective. Interest in the biguanide metformin has now increased dramatically. This is due to the peculiarities of the mechanism of action of this drug. It can be said that the main action of metformin is to increase the sensitivity of tissues to insulin, suppress the production of glucose by the liver and, naturally, reduce fasting glycemia, slow down the absorption of glucose in the gastrointestinal tract. There are additional effects of this drug that have a positive effect on fat metabolism, blood clotting and blood pressure.

Treatment for type 2 diabetes mellitus should be strictly prescribed only by a doctor..

Diagnostics

Aisyla Latypova, an endocrinologist, dietitian, nutritionist, comments:

— Diagnosis of complications of type 2 diabetes mellitus is carried out by an endocrinologist and narrow specialists. Mandatory are: dispensary observation (registration) at the endocrinologist – 2-4 times a year, depending on the severity of the disease. Examination by an ophthalmologist once a year – measurement of visual acuity, intraocular pressure, ophthalmoscopy, biomicoroscopy with a dilated pupil. Diabetes mellitus increases the risk of developing cardiovascular diseases by two to four times, so an ECG (electrocardiography) once a year is an obligatory examination method. If complications are suspected, consultation with a cardiologist is recommended.

Diagnosis of complications such as diabetic nephropathy (kidney damage), diabetic neuropathy, diabetic angiopathy of the vessels of the lower extremities is carried out both by an endocrinologist at the appointment during examination and analysis of annual preventive studies, and by narrow specialists (nephrologist, neurologist, vascular surgeon), depending on the severity of the complication.

Prevention of complications in type 2 diabetes at home

– Prevention of complications of diabetes is self-monitoring of glycemia, blood pressure, constant monitoring by an endocrinologist, constant medication if necessary, increased physical activity, rational nutrition. But the first priority is to quit smoking. At home, the treatment of complications such as ulcers on the lower extremities, the rejection of drugs in favor of dietary supplements is unacceptable. The doctor should deal with the treatment of complications, says the doctor.

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