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Diabetes & the Vascular System: An Unexpected Risk Factor

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Omar P. Haqqani, MD
Midland Daily News
March 5, 2017

Did you know that, as a health condition, diabetes not only poses serious threats to a general lifestyle, but also can have significant effects on your vascular system?

Diabetes, as a risk factor, can do detrimental damage to the vascular system through a wide array of conditions, including peripheral vascular disease, which affects blood vessels of the lower extremity, stroke, which affects blood vessels of the brain, and renal artery stenosis, which affects blood vessels to the kidneys

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In order to fully understand how diabetes (or diabetes mellitus) can alter the vascular system, however, one must first understand both types of the condition: Type 1 and type 2, and how they can equally affect the body.

Insulin is a natural hormone secreted by the pancreas to help cells in absorbing glucose found within blood circulation.

Type 1 diabetes is the result of a lack of enough insulin being produced by the pancreas, typically caused by a loss of the islets of Langerhans’ beta cells. Type 2 diabetes is classified more by the cells’ inability to respond to insulin, as well as lack of insulin secretion.

Both of these conditions affect the way the body uses blood sugar (glucose) – a vital source of energy for muscle and tissue cells, and the main source of fuel for the brain.

The presence of diabetes, either type 1 or 2, means that the blood has too much glucose in it, and can lead to serious health problems if left untreated. Type 1 is typically developed in childhood or adolescence, while type 2 is a condition more often developed later in life, usually around 40 years old.

Symptoms for either of these conditions vary on the person, and the elevation of blood sugar. Additionally, some symptoms may quickly develop and be more severe for those suffering from type 1, while symptoms may not be experienced initially from those suffering from type 2.

Increased thirst, fatigue, irritability, severe increase in appetite, frequent urination or infection, blurred vision, and uncontrollable weight loss are just some of the many symptoms that can occur in those suffering from either type 1 or 2 diabetes.

Though the cause of type 1 diabetes is largely unknown, it is known, however, that the immune system tends to attack and destroy the pancreas’ insulin-producing cells. Some think that this is caused by genetic defenselessness and environmental elements, but experts are not sure why they develop.

Type 2 diabetes is caused by the cells’ resistance to insulin, resulting in the pancreas not being able to create enough insulin to compensate. Because of this, blood sugar levels rise and build up in the bloodstream.

Again, the reasoning behind this is uncertain, though a strong connection is often made to being overweight and having type 2 diabetes.

In essence, in type 2 diabetics, because of constant exposure to insulin, many cells begin to become resistant to the effects of insulin. Obesity results in constant high levels of insulin exposure, thus resulting in increased resistance.

There are numerous risk factors for the development of both types of diabetes – some shared, and some unique.

In addition to a family history of type 1 diabetes, and exposure to environmental factors, the presence of autoantibodies, which have been shown to damage the immune system, is also prominently found in those who suffer from this sect of the condition.

Type 2 diabetes’ risk factors depend more highly on controllably developed risk factors, such as being overweight or being physically inactive. However, type 1 diabetes also includes risk factors such as family history, race, age, and the development of prior conditions, such as hypertension, gestational diabetes, or polycystic ovarysyndrome.

When either type of diabetes is developed, a wide range of complications can occur as a result, including damage to the eyes, kidneys, feet, nerves, and yes, even the vascular system.

People who suffer from diabetes are inherently at a greater risk of developing atherosclerosis – a condition where the artery’s walls thicken, resulting in a higher chance of PVD’s eventual development.

The mechanism is such that glucose molecules attach to cells that are within the blood vessel, causing an inflammatory process, much like a bee sting.

This inflammatory process causes the immune system to start a vicious loop of activity, resulting in more inflammation and damage to the blood vessel.

The same can be said about stroke and renal artery stenosis. Because diabetes is a risk factor for the development of atherosclerosis, the carotid arteries’ walls can thicken as a result of this condition, making the body more susceptible to stroke.

In the case of renal artery stenosis, however, the renal arteries’ walls can thicken, causing blockage to occur in the blood flow between the aorta and kidneys.

Unfortunately, neither type 1 nor type 2 diabetes ever truly goes away. Though symptoms can come and go, and blood sugar levels can fluctuate in a positive manner with healthy diet and exercise, the condition, in one way or another, is lifelong.

Checking one’s glucose levels, periodic Hemoglobin A1C levels, which determine the long-term glucose control parameters, and regular care by your primary physician can help keep the untoward effects of diabetes at bay.

Remember: Having diabetes doesn’t have to lead to the development of a vascular condition. Through proper supervision, care, and education, a person living with diabetes can still live a fulfilling life.

Dr. Omar P. Haqqani is the chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.

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