Long Term Complications of Diabetes

Diabetes is often easy to ignore especially in the early stages. The body will appear to work well. But what actually happens is that the excess glucose in the blood keeps eroding the inner lining of the blood vessel threatening major organs like heart, nerves, eyes and kidneys. Though you may not feel the effects right away, you will eventually feel it.

Compared with people who don't have diabetes people with diabetes are

Two to four times more likely to die of heart attack
Two to four times more likely to have a stroke
Likely to become blind
Likely to suffer kidney failure
Likely to have gangrene of the feet

If the blood glucose is maintained close to normal you can reduce the risks of complications. Diabetes can cause both short term and long term complications.

The long term complications of diabetes include:

Coronary artery disease
Stroke
Peripheral arterial disease
Nerve Damage (Neuropathy)
Kidney damage ( Nephropathy)
Eye damage ( Retinopathy)
Increased risk of infection

Coronary artery disease

Coronary artery disease is the leading cause of death in people with diabetes. Diabetes causes narrowing of the blood vessels by a process called atherosclerosis. When the blood vessels to the heart get narrowed down the blood flow is obstructed and it causes chest pain and heart attack. It is usually treated with aspirin, cholesterol lowering drugs and blood pressure drugs.

Stroke

Stroke is another long term complication of diabetes which occurs when the blood supply to apart of your brain is interrupted or severely reduced and the brain tissue is deprived of oxygen and nutrients. Within a few minutes to few hours, brain cells begin to die. The interruption can be from a clogged or blocked blood vessel (ischemic stroke) or from a leaking or ruptured blood vessel (hemorrhagic stroke). Ischemic stroke is more common.

Peripheral arterial disease

With peripheral arterial disease the arteries supplying the limbs, more commonly the legs, becomes clogged or partially blocked due to atherosclerosis. It causes pain, cramping in the legs while walking. The treatment includes control of cholesterol and high blood pressure and surgery to bypass obstructed vessels.

Nerve damage (Neuropathy)

High levels of blood glucose can damage the delicate nerves. Excess glucose weakens walls of the tiny blood vessels that nourish the nerves.

Damage to the sensory nerves may leave you unable to perceive pain, warmth, coolness and texture.
Damage of the autonomic nerve can increase the heart rate and in men can interfere with their ability to have erection.
Damage of the motor nerves causes weakness of the muscles.

The symptoms include tingling feeling, numbness, burning pain, stabbing and aching pain, a crawling sensation. It is treated with pain relievers, Capsaicin, acupuncture, biofeedback and relaxation exercises.

Kidney Damage (Nephropathy)

Diabetes damages the filtering system of the kidneys. Up to 30% of the diabetics eventually develop kidney disease called nephropathy. The longer you have diabetes, the higher your risk of kidney damage. The signs and symptoms of this long term complication of diabetes include

Swelling of the ankles, feet and hands
Shortness of breath
High blood pressure
Poor appetite
Metallic taste

It is treated with drugs called ACE inhibitors, low protein diet, dialysis and in final stages kidney transplant.

Eye Damage (Retinopathy)

High blood glucose affects the tiny blood vessels in retina of the eye. In fact among the long term complications of diabetes, they are the first to be affected. Almost every one with Type I diabetes and 60% of those with Type II diabetes have some sort of eye damage. The signs and symptoms of this long term complication of diabetes include

Tiny specks floating in your vision
Blurred vision
Dark spot in the centre of the vision
Flashes of light
Poor night vision
Blindness

There are two types - non-proliferative which is more common and the proliferative types. The eye damage is treated with laser procedures and surgery.

Increased risk of infections

High blood glucose impairs the immune system putting you at a higher risk of infection. Your gums, lungs, skin, feet, bladder and genitals are the common infection sites. The signs and symptoms of this long term complication of diabetes depend on the site of infection.

Gums- redness and bleeding
Bladder - frequent urination and burning sensation while passing urine
Vagina- itching
Foot- redness and pus collection

They are usually treated with antibiotics. In severe infection of the foot, debridement is done.

DiabetesCondition.com provides information on diabetes management, diabetes treatment, diabetes supplies, glucose meters, diabetic testing supplies, self-help, identification and prevention of immediate and long-term diabetes complications, and other information to help with the prevention and management of diabetes.

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Causes and Complications of Chronic Pain - Adult Health and Wellness

Often called 'the fifth vital sign,' pain is as important as temperature, pulse, respiration, and blood pressure as a key indicator of a patient's medical status. The longer we live, the more likely it is that we will eventually experience some type of injury or disease that results in temporary or even chronic pain. Surgeries become more frequent, both elective and those deemed vital to our survival and well-being. Injury and surgery leads to scar tissue that may cause lingering pain, mar our outer appearance, and diminish certain movement capabilities. Many of us also take a variety of pharmaceuticals and/or recreational drugs to delay some disease process or to alleviate symptoms of chronic physical or emotional pain. These drugs, even properly prescribed prescription drugs, may sometimes exacerbate the problems and even create new unexpected painful side effects.

Sometimes, continuing to take pain medication actually perpetuates the pain when the medication is stopped or increased doses may be required to maintain the same effect. With body therapy, on the other hand, over a period of time, fewer and fewer treatments may be required because the body cells remember the sensations of neuromuscular letting go and previously over stimulated nerve receptor cells begin to quiet down.

Causes of Pain

A popular belief, even among medical professionals, is that the most common cause for pain is a pinched nerve. According to this belief, there are three types of pain:

*Nocioception - immediate, protective pain

*Inflammatory - local cellular damage

*Neuropathic - one or more nerves are affected, delayed in onset, becomes chronic pain, requires physical input to heal the injury...and is radiculopathic (nerve root impingement causing weakness, numbness, and difficulty controlling certain muscles)

Chronic pain is believed to be caused by shortened (contracted) muscles resulting from neuropathy and radiculopathy. This theory is based upon Cannon's 1949 Law of Dennervation Supersensitivity which states: "Any measure (such as a nerve impingement caused by radiculopathy) which blocks the flow of motor impulses and deprives an organ or tissue of excitatory input (motor impulses) for a period of time, will cause abnormal functioning (called 'disuse sensitivity') in the receptor organ or tissue.

Recent research, using magnetic resonance imaging (MRI's), has demonstrated that no matter how much a normal functioning spine is compressed or twisted, there is ample room in the space between the vertebrae for free movement of the nerve. Researchers are now suggesting that much of the pain may be caused by sensory receptor overload from postural imbalances. Through a process called "sensitization," a pattern may be set up in the body in which hyperexcited receptors feeding the central nervous system cause the brain to send signals to twist and torque the body to avoid pain.

The pain generating stimulus must be interrupted until the memory in the nerve cells has been forgotten. For many chronic pain cases, deep tissue therapy a few times every week can help these hyperexcited receptors feeding the central nervous system to quiet down and the sensation of pain to dissipate and even disappear.

Deconditioning Complications of Chronic Pain

Any part of the body that has severe and chronic pain will discontinue normal, symmetric, coordinated movement, and the person with pain will simply self-splint, immobilize, and decondition the area. Muscles, nerves and joints weaken and deteriorate leading to muscle atrophy, neuropathy, contracture, decreased movement, and gradual weight gain. To compensate for a weak, painful area, joints, nerves and muscles in other parts of the body will work overtime, leading to "overload and overuse syndrome.

Hormonal Complications of Chronic Pain

Chronic pain is a potent stressor that may affect every endocrine system in the body. Initially, the pain causes an excess of stress hormones (catecholamines and glucocorticoids) to help the body control pain and prevent damage. However, this excess may trigger hypertension and tachycardia, sometimes leading to cardiovascular death.

If severe pain continues and is not controlled, adrenal exhaustion and decreased stress hormone levels may result. The fluctuation between excess and deficient glucocorticoids, often called Cushing and Addison syndromes respectively, can lead to many severe symptoms, including: mental deficiencies, muscle weakness, edema, osteoporosis, diabetes, forming stones, tooth decay, and even testosterone deficiency. A further effect of pain and lowered levels of important hormones is a compromised immune system, lowered resistance to infections and slower healing of wounds when injured.

Neuropathic Complications of Chronic Pain

Persistent pain causes excess electrical activity in peripheral nerves, spinal cord and brain. This 'hot wire' effect appears to cause nerve tissue damage in the spine as well as the brain, which can lead to dementail and other organic brain problems.

Cardiovascular Effects of Chronic Pain

Pain increases blood pressure. This is not such a problem for a person with a normally low to average blood pressure. But for a person suffering from hypertension and high blood pressure, the increased blood pressure resulting from the body's pain response can lead to a more serious heart problem such as a stroke or aneurysm.

Pain, especially as we age, should not be taken lightly. There are all sorts of medications available to decrease the level of pain. And when needed, pain medication can literally save lives. But for chronic pain, there are so many diet, exercise and body therapy prescriptions that can not only be life saving but can transform the quality of a person's life.

Dr. Erica Goodstone has helped thousands of men, women, couples, and groups to develop greater awareness of the issues in their relationships and their lives, to overcome and alleviate stressors and discords, and revitalize their relationships and their own mind-body-spirit connection. Dr. Goodstone can be contacted through her web site at http://www.DrEricaWellness.com

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