Diabetic Vascular Disease
What is diabetic vascular disease?
Diabetic vascular disease refers to the development of blockages in the arteries throughout the body due to diabetes. If you have diabetes, it means that too much glucose is in your bloodstream because of your body's inability to either produce insulin or to use insulin efficiently.
There are several vascular diseases that have been linked to diabetes:
- Retinopathy: the abnormal growth of blood vessels in your retina, which is part of your eye
- Nephropathy: a kidney disease
- Neuropathy: a condition of the nerves themselves that causes a loss of protective sensation in the toes or feet
- High cholesterol
- High blood pressure
- Coronary heart disease
Controlling your blood sugar is the best way to slow or prevent these vascular problems from occurring. If you do not manage your diabetes or maintain healthy habits, you could develop serious health conditions, including blindness, kidney failure, stroke, heart attack, or ulcers in your feet. Eventually, if you develop dead tissue, which is known as gangrene, it could lead to infection and ultimately to amputation.
What are the symptoms?
If you have diabetes-related vascular problems, you may have the following symptoms:
- Blurred vision
- Floating spots in your vision called floaters
- Swelling of your face or limbs or unexpected weight gain
- Foamy looking urine
- Foot sores
- Loss of feeling or a burning feeling in your hands or feet
- Pain in your legs when walking
- High blood pressure
- Chest pain
How is it diabetic vascular disease diagnosed?
Your doctor will begin by asking you questions about your general health, medical history, and symptoms. In addition, a physical examination will be carried out. To confirm a diagnosis of diabetes, your doctor will also perform a blood test to measure your glucose level.
As diabetic vascular disease can affect many different locations in your body, its diagnosis and treatment will often involve the collaborative approach of a variety of doctors.
Tests that are often used to diagnose diabetic vascular disease include:
- Urine test: to check for diabetic kidney disease.
- Kidney biopsy: to check for diabetic kidney disease.
- Exercise treadmill testing or ECG stress test.
- Ankle brachial index (ABI): which compares the blood pressure in your arms and legs.
- Duplex ultrasound: to measure the speed of blood flow and see the structure of your leg vessels.
- Blood tests: to measure your cholesterol level and the levels of other blood fats.
How is diabetic vascular disease treated?
Diet and medication
Maintaining healthy blood sugar levels, controlling high blood pressure, and controlling lipid levels through diet and medications all play an important part in diabetic vascular disease treatment. Your doctor can provide advice regarding the optimum diet for your particular needs.
Insulin or glucose-lowering medications help control blood sugar levels. Medications to lower blood pressure include angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, calcium channel blockers, and diuretics. Cholesterol lowering medications include statins, which reduce the amount of cholesterol in your blood.
To help keep your blood from clotting, your doctor may prescribe antiplatelet medications, such as aspirin and clopidogrel (plavix).
If you have retinopathy, your doctor may recommend laser surgery, in which a surgeon removes the abnormal blood vessel growth that is affecting your vision.
To restore circulation to your leg and avoid amputation, your surgeon may need to perform a procedure such as angioplasty or bypass surgery. Bypass surgery creates a detour around any narrowed or blocked sections of your artery.
To perform a bypass, your surgeon connects an artificial or transplanted blood vessel to the blocked artery to help blood flow around the blockage in your affected leg. The blood then flows through the new vessel, bypassing the blocked part of the artery. Sometimes the blockage itself can be removed with a procedure called an endarterectomy.
Angioplasty and stenting
In an angioplasty, a long, thin, flexible tube called a catheter is inserted through a puncture, or sometimes through a tiny incision, into an artery in your leg above the narrowed section and is guided through your arteries to the blocked area. Once there, a special balloon pushes the plaque in your artery against your artery walls, widening the vessel. If needed, a tiny mesh-metal tube called a stent may then be placed into the narrowed area of your artery to keep it open. The stent remains permanently in your artery. After successful angioplasty, blood flows more freely through your artery. Your general health, as well as the location and extent of the blockage, determine what procedure is likely to work best in your particular situation.
Lifestyle changes that help you manage diabetic vascular disease include:
- Quit smoking
- Eat a low-fat diet
- Maintain a healthy weight
- Exercise regularly
- Monitor your blood glucose level
- Examine feet daily
- Use moisturising foot cream to prevent dry skin on the feet
- Protect feet from injury and keep them dry