The complications of diabetes (part 2)
In the article of Nov. 3, 2010, we discussed the effects of diabetes on the eyes, ears, mouth, the kidneys, the liver, and the nervous system. This week’s column will discuss the effects of diabetes on the arterial system, the musculoskeletal system, and the brain.
The arterial system
There are three types of arterial complications of diabetes; peripheral arterial disease, cardiovascular, and cerebrovascular. Peripheral arterial disease affects the legs and feet. The symptoms of peripheral arterial disease are intermittent claudication (leg cramps when walking), lack of hair on the shins of the legs because blood is not reaching the follicles, cold legs and feet, numbness in the legs and feet, a bluish or reddish cast to the legs and feet, sores or ulcers on legs that won’t heal.
I have a friend with diabetes who has the complications of both peripheral neuropathy and peripheral arterial disease. He used to be a runner because he thought running would be good for his circulation and blood sugar control, which I’m sure it was. He developed calluses on his feet. One night, while he was watching television, he picked at the callus on one of his feet. Because he wasn’t paying attention and because he had very little feeling in his feet, he picked too far. The wound became infected. He should have gone to the doctor or the hospital to get an antibiotic, but he thought he could take care of it himself. To make a long story short, he developed gangrene in that foot and ultimately had to have his leg amputated above the knee.
Cardiovascular disease includes arteriosclerosis and atherosclerosis (hardening of the arteries and clogging of the arteries, respectively), coronary artery disease (blockage to the arteries that feed the heart), congestive heart failure, and hypertension. Cerebrovascular disease involves blockage of arteries that feed the brain resulting in stroke.
Musculoskeletal complications
There are three musculoskeletal complications of diabetes. These are frozen shoulder, a disorder of connective tissue (collagen) limiting the normal range of motion of the shoulder; Dupuytren’s contracture or trigger finger, a locking of the index finger; and carpal tunnel syndrome, a painful disorder of the wrist and hand.
Impaired Mental Function, Dementia, and Alzheimer’s Disease
Three studies that have come out linking diabetes to impaired mental function, dementia, and Alzheimer’s disease. A study published in the October 2004 issue of Diabetes Care found that people with type 2 diabetes experience a decline in mental function and mood during episodes of hyperglycemia – an excessive rise in blood glucose. During acute hyperglycemia, speed of information processing, working memory, and some areas of attention were impaired. Acute hyperglycemia also adversely affected mood, with reduced feelings of happiness and increased agitation, anxiety, lethargy, and tiredness.
A study in the Nov. 23, 2004, issue of Neurology found that middle-age people with diabetes are nearly three times more likely to develop dementia in old age than people without diabetes. Finally, a study published in the Dec. 8, 2004, issue of the Journal of Neuroscience found that risk of Alzheimer’s disease is increased in people with diabetes.
The complications of diabetes are not inevitable
These complications are horrendous. But keep in mind – they are not inevitable. They can be avoided or reversed if sugar is maintained in the normal range. How do you do this? By finding out what causes sugar to rise above the normal range and eliminating that cause. Next month’s article will address the causes of diabetes and what can be done to avoid them and reverse them.
Mary Lou Williams, M. Ed., is a writer and lecturer in the field of nutrition. She welcomes inquiries. She can be reached at 267-6480.