From the Guidelines
Diabetes quickly affects the eyes, kidneys, and nerves because these tissues are particularly vulnerable to high blood sugar levels, leading to microangiopathy and damaging processes such as advanced glycation end products, oxidative stress, and chronic inflammation, as supported by the most recent evidence from 1.
Key Factors Contributing to Damage
- High blood sugar levels damage small blood vessels and specialized cells in the eyes, kidneys, and nerves
- Limited regenerative capacity of these tissues allows damage to accumulate over time
- The kidneys' high blood flow, the retina's high metabolic rate, and the peripheral nerves' long, vulnerable axons make them susceptible to glucose-related damage
Recommendations for Management
- Implement strategies to help people with diabetes reach glycemic goals to reduce the risk or slow the progression of diabetic retinopathy, as recommended by 1
- Annual comprehensive eye examinations and regular screening for kidney disease and neuropathy are crucial for early detection and management of complications
- Optimizing blood pressure and serum lipid control can also help reduce the risk of diabetic retinopathy, as stated in 1
Importance of Early Detection and Management
- Diabetic retinopathy, nephropathy, and neuropathy can appear as early complications of poorly controlled diabetes, sometimes even before diagnosis
- Early detection and management can help prevent or delay the onset of these complications, improving quality of life and reducing morbidity and mortality, as emphasized by 1
From the Research
Diabetes Complications
Diabetes quickly affects the eyes, kidneys, and nerves due to several factors. The main reason is the damage caused by high blood sugar levels to the microvascular system, which includes small blood vessels that supply these organs 2, 3, 4.
Microvascular Complications
- Retinopathy: High blood sugar levels damage the blood vessels in the retina, leading to diabetic retinopathy, which can cause blindness if left untreated 2, 5.
- Nephropathy: Diabetes damages the blood vessels in the kidneys, leading to kidney failure and requiring dialysis or a kidney transplant 2, 3, 4.
- Neuropathy: High blood sugar levels damage the nerves, causing numbness, tingling, and pain in the hands and feet, and can lead to serious foot complications such as ulcerations and amputations 3, 6, 4.
Pathophysiology
The precise pathophysiology of these vascular complications is becoming better understood, but specific treatment and prevention remain complex 4. Microvascular abnormalities, such as endothelial thickening and luminal occlusion, occur in diabetic neuropathy and are probably involved in resulting nerve damage 3.
Prevention and Treatment
Early detection and timely treatment can prevent or delay the onset of these complications 2, 6. Therapeutic intervention should be directed at the gross abnormalities in the microvasculature, such as endothelial cell proliferation and arteriovenous shunting 3. Infrared thermography-based computer-aided diagnosis methods can be used for early detection of diabetic foot complications 6.