The Health Significance Of The Long Term Complications Of Diabetes Mellitus
Cardiovascular Complications Of Diabetes Mellitus
Since the pathogenesis of microangiopathy in diabetes is not fully understood, it has not been possible to eliminate this complication completely. In addition to metabolic factors, genetic and environmental factors also seem to play a role in determining the severity and progress of microangiopathy. In general, the long term complications are dependent on the duration of diabetes and proper management.
Cardiovascular system: Atherosclerosis sets in early and it tends to be diffused and extensive. Ischemic heart disease is common. The factors contributing to this increase are the early onset of atherosclerosis, greater prevalence of obesity, hypercholesterolemia, increased platelet adhesiveness and increased viscosity of blood. Ischemic heart disease in the diabetic differs from that in the non-diabetic by the involvement of the sexes in the same proportion and the occurrence of painless infarctions. Some diabetics develop congestive cardiac failure in the absence of hypertension and demonstrable coronary artery disease. It is suggested that a specific diabetic cardiomypathy is possible in them.
Peripheral vascular disease: Occlusion of the femoral artery and its branches may occur. The foot becomes ischemic. Intermittent claudication may be experienced. Associated sensory neuropathy predisposes minor trauma, leading to fulminant infection and gangrene. Calcification of the arteries in the legs and feet may be demonstrable in X-rays. Monekeberg’s sclerosis affects several arteries.
Diabetic nephropathy: The earliest clinical manifestation is proteinuria which may be intermittent, later becoming established. Loss of 1g or more of protein in 24 hours is indicative of definite nephropathy. As the condition proceeds, it gives rise to edema and hypertension. In the later stages, progressive renal failure sets in and proceeds at a variable rate. Young diabetics develop renal failure much more commonly than those with late onset diabetes.
Tuberculosis In Diabetes Mellitus
Skin Complications Of Diabetes Mellitus
Tuberculosis And Skin Complications
Tuberculosis: The diabetic state probably predisposes tuberculosis and in developing nations, especially in Africa and India, this is a common complication. Most frequent manifestations are pulmonary and pleural tuberculosis, but other systems may also be affected. It is a golden rule to thoroughly investigate for the presence of diabetes mellitus in all patients developing tuberculosis and vice versa.
Skin Manifestations: The diabetic is subjected to several cutaneous disorders. Among them, pyodermas and fungal infections, monilial balanoposthitis, vulvovaginitis, intertrigo and superficial mycoses are common. Necrobiosis lipoidica diabeticorum and granuloma annulate usually preced the onset of florid diabetes. The former develops over the shin and are seen as violaceous plaques which atrophy in course of time. Granuloma annulare appears as erythematous or skin coloured papules over the knuckles and around the knees and elbows. The term bullosa diabeticorum is given to bullae which develop containing clear or blood stained serum. In hyperlipidemic subjects, xanthomas may develop.
© 2014 Funom Theophilus Makama