Kidney and Eye are inextricably linked in many diseases, both common and esoteric. Renal disease microvasculature is not readily in vivo while retinal microvasculature is easily accessible to direct non-invasive micro vasculation. Hence, patients with renal disease may require specific ophthalmologic treatment. The best example in the developed world of the frequent need for clinical input from both specialties is in the care of diabetic patients, who may develop Micro vascular complications.
Diabetes Mellitus (DM) is a global health issue affecting children, adolescents and adults. Diabetes complications are divided into Micro vascular and Macro vascular complications. Micro vascular complications include damage to eyes (leading to blindness), kidneys (leading to renal failure) and nerves (leading to impotence and diabetic foot disorders). Macro vascular complications include cardiovascular diseases such as heart attacks, strokes and insufficiency in blood flow to legs.
Diabetic Nephropathy (DN) is a serious and progressive complication of both type 1 DM (Results from the body’s failure to produce insulin) and type 2 DM (Results when the pancreas does not produce enough insulin to control glucose level or
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There are two types of DR: Non-Proliferative diabetic retinopathy (NPDR) and Proliferative diabetic retinopathy (PDR). In NPDR, the damaged blood vessels leak extra fluid and small amount of blood into the eye. This condition leads to the formation of exudates in the retina. As the disease progresses the amount of exudates also increases. In PDR, the blood vessels in the retina close which prevent the blood flow in the eye. At this condition the new blood vessels are formed in order to supply blood to the blocked area and are called as
Patients with type 2 diabetes are at risk of macrovascular and microvascular complications. Evidence has shown that an improvement in blood glucose control, as shown by a reduction in HbA1c levels, is associated with a reduction in microvascular complications (2,3,4).
Uncontrolled diabetes can affect nearly every organ of the body; of which, heart disease and kidney failure are most commonly impacted. Known as diabetes mellitus, a collective term for various blood abnormalities, the term diabetes refers to either a scarcity of insulin in the body or the body’s inability to accept insulin. Though the symptoms of diabetes are manageable, many are unaware as to having it. According to the CDC report “2011 Diabetes Fact Sheet,” approximately 6 million people in the United States have undiagnosed diabetes. Undetected, diabetes can become deadly. In a recent World Health Organization report “Diabetes Action Now: An Initiative of the World Health Organization and the International Diabetes Federation,” it
Diabetes mellitus (DM) is a condition in the body that is related to a faulty metabolism. It means that the body’s metabolism is not functioning properly, which leads to adverse effects in the health. The food we ingest, gets broken down into blood sugar (glucose), which is what fuels our body in the form of energy. This converted glucose needs to enter our cells so that it can be used for energy and growth. And in order for the glucose to enter our cells, there needs to be insulin present, which the beta cells of the pancreas is responsible for producing. This hormone is responsible for maintaining glucose level in the blood. It allows the body cells to use glucose as a main
This article goes in detail about the complications of Type 2 Diabetes, on how hyperglycemia damages the vascular system leading to microvascular disease and macrovascular disease. The complications of microvascular disease are diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. On the other hand, with macrovascular disease includes Cardio Vascular Disease (CVD), such as Atherosclerosis. Furthermore, the article gives recommendations of treating Type 2 Diabetes and the prevention of its health related complications with medication, screening, diet, and exercise.
Type II is similar to Type I but this particular branch is known as a Non-Insulin Dependent Diabetes Mellitus (NIDDM), meaning that the production of insulin is not the problem. Patients with type II have an insulin resistance condition, which means that their body has become resistant to the insulin hormone and therefore, the cells in the body do not react to it. When resistance to insulin takes place, the pancreas makes an effort to produce as much insulin as it can, in order to attempt to stimulate the body’s cells, until it can no longer produce sufficient amounts. Once the insulin production has worn out, blood sugar levels in the bloodstream rise and diabetes type II manifests. Insulin levels in the body may be normal but because of the resistance, there is a decrease in sensitivity to liver and muscle cells, and because the insulin cannot penetrate such muscles, it becomes ineffective. Unlike type I, type II can be
The most well known T2DM microvascular complications are diabetic retinopathy and nephropathy. Diabetic retinopathy (DR), the most common microvascular complication, is responsible for over 10,000 new cases of blindness in the United States each year [102] and is projected to affect >60% of T2DM patients by the first decade of disease [103]. DR is classified into 2 main stages: nonproliferative DR (NPDR) and proliferative DR (PDR). NPDR is further classified into mild, moderate, or severe stages with the earliest signs of NPDR including decreased pericyte coverage of the retinal capillaries [104] due to pericyte loss and microaneurysms (swelling of the retinal blood vessels) [105]. Pericytes
Why do we treat diabetes? There are a number of downstream events associated with abnormal blood glucose levels. If glucose levels are managed properly, the complications associated diabetes can be controlled, and sometimes completely prevented. The main problem with having more than the normal amount of glucose circulating in the blood stream is the effect that excess glucose can have on both large and small blood vessels (DTC, 2004). Micro-vascular and macro-vascular problems associated with diabetes can be seen in the heart, eyes, kidney, legs and feet. Diabetic patients are twice as likely to suffer from a mycocardial infaraction, twenty-five times more likely to suffer blindness, and seventeen times more likely to suffer kidney failure compared to a non-diabetic (DTC, 2004). Because of great number of risks associated with abnormal blood glucose levels, diabetes is aggressively treated to improve the quality of life and prevent complications in patients.
Hyperglycemia results in damage to retinal capillaries. This weakens the capillary walls and results in small outpouchings of the vessel lumens, known as microaneurysms.
Diabetes is very prevalent in the today’s society. It is estimated that about 10% of the population currently suffers from this disease. There are two types of diabetes. Type 1 is commonly referred to as insulin-dependent diabetes. Type 2 is commonly known as non-insulin dependent diabetes. The main difference between both types is that there is an insulin deficiency for Type 1 and an insulin resistance and failing insulin secretion for Type 2.I have been suffering from diabetes for the last two years. I was actually diagnosed with TYPE 2 DIABETES.
Type 2 diabetes self-management education is necessary to prevent the development of long- term health complications associated with poor metabolic control in individuals with diabetes (Kennedy, 2012). The national average of adults who attended diabetes self-management education changed little from 51.4% in the year 2000 to 57.4% in 2010 (Centers for Disease Control [CDC], 2014). A Healthy People 2020 goal is to increase the number of adults who receive diabetes education by 10% (HealthyPeople.gov, 2014). Type 2 diabetes has reached epidemic proportions, accounting for 90-95% of diabetes cases. Complications related to uncontrolled diabetes include kidney disease, blindness, lower-extremity amputations, stroke and heart disease. Poorly controlled diabetes is one of the primary causes of kidney failure, with 10-20% of people with diabetes dying from kidney failure. Cardiovascular disease accounts for 50% of deaths in people with diabetes (Kennedy, 2012).
By 2025, it is estimated that 380 million individuals will be diagnosed with diabetes. With that being said, 4 million of them will lose their sight. Diabetic Retinopathy (DR) is the leading cause of blindness in patients ranging from age 20 to age 74. Development and progression of this disease is closely associated with blood pressure, blood glucose, the type and duration of diabetes, and possibly lipids. Although it has been found true that chronic hyperglycemia causes the development and progression of diabetic retinopathy, the mechanism of how the damage is caused is unclear. To further look into the complexity of DR, the disease can be classified as non-proliferative diabetic retinopathy (NPDR), which is
People with diabetes mellitus who have atherosclerosis are at a higher risk for developing macro- and micros-vascular complications. One reason for this is an increase incident of plaque instability and blood clotting. This is a consequence of the decreased size of the lumen of the blood vessel and the raised capillary pressure. Diabetes mellitus long-term complications alters the normal cell function of endothelium (smooth muscle) and platelets cells of the vascular system. These changes lead to widespread lesions of the arterial walls that are associated with atherosclerosis.
"Diabetes mellitus is not a single disease but a group of disorders with glucose intolerance in common" (McCance 674). Diabetes mellitus is a metabolic disorder characterized by hyperglycemia (increased blood sugar) and results from defective insulin production, secretion, and utilization. There are many forms of diabetes. "Diabetes increases the risk of heart and blood vessel disease, amputation, infections, kidney damage, eye problems (including blindness), and nerve malfunction" (Husain). I will
Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.
Diabetes is associated with an increased risk of developing primarily vascular complications that contribute to morbidity and mortality of diabetic patients. Poor glycaemic control leads to vascular complications that affect large (macrovascular), small (microvascular) vessels or both. Macrovascular complications include coronary heart disease, peripheral vascular disease and stroke. Microvascular complications contribute to diabetic neuropathy (nerve damage), nephropathy (kidney disease) and retinopathy (eye disease).