One in three people with diabetes is unaware of their condition, according to the Association du diabète (AD), (DL), which is launching an awareness campaign called “Protégeons nos artères” ‘Protect your arteries’ ahead of World Diabetes Day on Nov. 14.
“The maintenance of high blood glucose levels slowly damages the walls of these vessels. Both the duration of diabetes and its possible imbalance increases the risk of complications. There is no distinction: small and large vessels, as well as nerve fibers, are the target of a prolonged excess of blood sugar.
Damage to the blood vessels can affect different organs,” explains Prof. Régis Radermecker. Even if there are common mechanisms, there are still many uncertainties about the different processes that lead to the sometimes irreversible change. However, all these mechanisms have one thing in common: they attack the endothelium. Smoking, high blood pressure, high cholesterol, and a sedentary lifestyle also increase the risk.
A CHECK-UP THAT CHANGES EVERYTHING…
“An annual checkup is recommended for all diabetics, precisely to detect the appearance and presence of complications: it is essential to check everything and to do this regularly,” assures Prof. Radermecker. What’s the point of this? To address the problems (if any…), to ensure the best possible quality of life for the person.
“The analysis of the results of blood, urine, ophthalmic and cardiological examinations aims to prevent or delay complications. The information collected allows treatments to be adapted: the diabetes treatments can be revised to manage diabetes better balance to make, and therapies can be initiated to the effect of restricting the set of complications. If they are present, there is no going back, but Prof. Radermecker adds the following event may be weakened in many cases and its progress is slowed, if not avoided.
TO AVOID THE DISASTER…
Depending on which blood vessels are affected, complications can have different consequences depending on the organs. For example, in the case of the heart, shortness of breath or pain may occur. These symptoms sometimes precede a heart attack or potentially fatal cardiac decompensation. But “one of the specifics of diabetes is that it can also cause an infarction that is not felt by the person (but is detected during the checkup),” explains the diabetologist. In general, 30% of diabetics – ie almost 1 in 3 – have cardiovascular problems in the broad sense. They are two to four times more likely to have a heart attack than the rest of the population, and these heart attacks are twice as fatal for them.
Complications affecting the arteries of the brain, in turn, lead to strokes. “Their symptoms are a sign of absolute medical urgency to try, with prompt treatment, to avoid its after-effects: paralysis and death,” he says.
The narrowing of the great vessels in the legs can cause pain but also block these arteries, with an eventual risk of amputation (treatments and/or operations are aimed at preventing this). When diabetes progressively damages the nerves in the legs and feet, tingling, pain (sometimes severe), and a loss of sensitivity are to be expected. When pain is no longer a warning sign, the risk of undetected and untreated wounds or ulcers increases. Infection, gangrene and amputation can occur.
In addition, nerve fiber damage is also the cause of neuropathies affecting the lower extremities, blood pressure and heart (exertion becomes more difficult), and the digestive system (for example, delaying gastric emptying, which can lead to vomiting after meals ). The genitals or bladder are also affected. Worldwide, 26% of people with diabetes experience painful diabetic neuropathy.
The wear and tear on the small vessels also cause significant damage to the kidneys, which then function less efficiently, with the risk of chronic renal failure. Treatment consists of dialysis or, less commonly, a kidney transplant. According to the European Center for the Study of Diabetes, people with diabetes are nine times more likely to be on dialysis than the general population. In the US, 35% of people with diabetes suffer from chronic kidney disease…
Finally, one of the most common complications of poorly controlled diabetes is an eye disease. The damage to the small blood vessels of the retina can lead to progressive loss of vision and/or the development of macular edema. In addition, the development of diabetic retinopathy (damage to the retina), if not controlled and treated, can eventually lead to blindness. This condition is the leading cause of blindness before the age of 65… In France, it is estimated that 50% of diabetics are affected by this complication.
THE WAY TO REASONABILITY…
The listing of the complications associated with blood vessel damage due to unbalanced diabetes is not intended to scare people. Initially, you have to fight to prevent them from happening,” says Professor Régis Radermecker. Then when complications are identified, everything must be done to slow down development. Everyone has health capital. The goal is everything makes every effort to preserve it, like the preservation of any other capital, also the capital of love. Today we have instruments to detect complications, but also, in many cases, therapeutic instruments to respond to them and slow their progression Thanks to advances in the treatment of nephropathy (kidney disease), heart disease, and retinal disease, for example, its effects can be limited. For neuropathies, pain management can be more complicated…but the treatments will undoubtedly evolve in turn.
Meanwhile, during the dialectologists are annual checkup, guided by an examination of the back of the eye, a blood and urine check, and a cardiological checkup, followed by an examination of the patient and listening to his or her complaints. Based on all the information gathered, positive action can be taken as quickly as necessary, without the disease gaining ground. “The earlier we find out, the more proactive we can be,” says the diabetologist. The slogan of this Diabetes Day is certainly not wrong. Like Prof. Radermecker says: “By taking care of your arteries, by having an annual check-up, you can walk next to the cliff…and still enjoy the scenery.