{"id":5135,"date":"2025-11-30T23:02:50","date_gmt":"2025-12-01T04:02:50","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&#038;p=5135"},"modified":"2026-01-12T18:36:43","modified_gmt":"2026-01-12T23:36:43","slug":"chronic-complications-of-diabetes-mellitus-atherosclerosis-and-vision-impairments","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/chronic-complications-of-diabetes-mellitus-atherosclerosis-and-vision-impairments\/","title":{"raw":"9p12 Chronic Complications of Diabetes Mellitus: Atherosclerosis, Hypertension, Vision Impairments, Nerve Damage and Renal Failure","rendered":"9p12 Chronic Complications of Diabetes Mellitus: Atherosclerosis, Hypertension, Vision Impairments, Nerve Damage and Renal Failure"},"content":{"raw":"<h1><strong>Overview of Chronic Complications of Diabetes Mellitus:<\/strong><\/h1>\r\n<ul>\r\n \t<li>Chronic high blood glucose causes\u00a0<strong>degenerative damage<\/strong>\u00a0throughout the body over time.<\/li>\r\n \t<li>Significant risk of\u00a0<strong>vascular damage<\/strong>, leading to\u00a0<strong>atherosclerosis<\/strong>, and\u00a0<strong>damage to eyes, kidneys, and nerves<\/strong>.<\/li>\r\n<\/ul>\r\n<h1><strong>Vascular Damage and Atherosclerosis:<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Chronic high blood glucose <\/strong>and\u00a0<strong>hyperlipidemia<\/strong>\u00a0contribute to\u00a0<strong>blood vessel wall deterioration <\/strong>making blood vessels susceptible to the development of\r\n<ul>\r\n \t<li><strong>arteriosclerosis<\/strong> (narrowing and loss of elasticity) and<\/li>\r\n \t<li><strong>atherosclerotic plaque formation <\/strong>(also narrows the lumen of blood vessels).<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li>Damage occurs in\u00a0<strong>small (microvascular)<\/strong>\u00a0and\u00a0<strong>large (macrovascular)<\/strong>\u00a0vessels.<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li>Narrowed blood vessels contribute to <strong style=\"font-size: 1em\">high blood pressure.\u00a0<\/strong><\/li>\r\n \t<li><strong>Blood vessel narrowing<\/strong>\u00a0leads to\u00a0<strong>ischemia<\/strong>\u00a0in tissues and organs.\r\n<ul>\r\n \t<li><strong>Less functional tissue<\/strong>.<\/li>\r\n \t<li>Tissue\u00a0<strong>necrosis<\/strong>\u00a0in severe cases.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li><strong>Hyperglycemia<\/strong> leads to <strong>endothelial cells<\/strong> lining the inside of blood vessels becoming <strong>dysfunctional,<\/strong> specifically because:\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ol>\r\n \t<li>High glucose induces endothelial cell mitochondria to produce high levels of <strong>ROS (Reactive Oxidative Species)<\/strong>, which overwhelm the endogenous neutralizing antioxidants.\r\n<ol>\r\n \t<li>ROS cause damage to cellular proteins, DNA and plasma membranes)<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t<li>High glucose in endothelial cells leads to excessive <strong>glycation<\/strong> of cellular proteins, leading to <strong>toxic waste build-up<\/strong>.<\/li>\r\n \t<li>High glucose <span style=\"text-decoration: underline\">reduces<\/span> the ability of endothelial cells to synthesize the <strong>vasodilator NO (nitric oxide).<\/strong><\/li>\r\n \t<li>High glucose <span style=\"text-decoration: underline\">reduces<\/span> the ability of endothelial cells to phosphorylate <strong>NO synthase<\/strong>.<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t<li>Without the ability to produce NO, blood vessels are <span style=\"text-decoration: underline\">not<\/span> able to conduct normal <strong>autoregulation<\/strong> (e.g., vasodilate regionally in response to increased blood volume and blood pressure).<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li><strong>Lipolysis<\/strong> due to diabetes results in\u00a0<strong>high blood lipids<\/strong>, increasing risk for\u00a0<strong>atheroma formation<\/strong>.<\/li>\r\n<\/ul>\r\n<h1><strong>Vascular Damage - Possible Complications:<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Large blood vessel damage<\/strong>:\r\n<ul>\r\n \t<li>Often worsened by\u00a0<strong>hypertension<\/strong>.<\/li>\r\n \t<li><strong>Coronary arteries<\/strong>\u00a0and\u00a0<strong>brain arteries<\/strong>\u00a0are affected.<\/li>\r\n \t<li>Leads to\u00a0<strong>peripheral vascular disease<\/strong> and\u00a0<strong>risk of cerebrovascular accidents (CVA, strokes)<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li><strong>Peripheral vascular disease<\/strong> can cause risk of <strong>limb ischemia<\/strong>\u00a0and\u00a0<strong>gangrene<\/strong>:\r\n<ul>\r\n \t<li><strong>Claudication<\/strong>\u00a0(pain with exercise) signals insufficient oxygen in muscles.<\/li>\r\n \t<li>Severe cases may require\u00a0<strong>amputation<\/strong>\u00a0to prevent gangrene and further infection.<\/li>\r\n \t<li><strong>Delayed wound healing<\/strong>\u00a0and\u00a0<strong>infection susceptibility<\/strong>\u00a0are common due to poor blood flow.<\/li>\r\n \t<li><strong>Cyanosis<\/strong> may develop due to hypoxia and <strong>ulcers<\/strong>\u00a0may lead to\u00a0<strong>amputation<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li>Affects\u00a0<strong>small vessels<\/strong>\u00a0in the retina, kidneys, nerves, and skin.<\/li>\r\n<\/ul>\r\n<h1><strong>Neurons<\/strong>:<\/h1>\r\n<ul>\r\n \t<li>Rely heavily on steady blood flow.<\/li>\r\n \t<li>Ischemia causes\u00a0<strong>neuronal dysfunction and death<\/strong>.\r\n<ul>\r\n \t<li>Ischemia results in\u00a0<strong>demyelination<\/strong>,\u00a0<strong>loss of function<\/strong>,\u00a0<strong>sensory<\/strong>,\u00a0<strong>motor<\/strong>, and\u00a0<strong>autonomic fibers<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Peripheral neuropathy<\/strong>:\r\n<ul>\r\n \t<li>Loss of\u00a0<strong>sensory<\/strong> gives rise to paresthesia (e.g., <strong>numbness<\/strong>,\u00a0<strong>tingling, loss of sensation).<\/strong><\/li>\r\n \t<li>Loss of<b> motor neurons<\/b> gives rise to\u00a0muscle weakness.<\/li>\r\n \t<li><strong>Autonomic nerve damage<\/strong>\u00a0can cause\u00a0<strong>impotence<\/strong>\u00a0and\u00a0<strong>bladder dysfunction<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Nerve death<\/strong> can accompany <strong>ulcers<\/strong>\u00a0and\u00a0<strong>poor wound healing<\/strong>, especially in the feet.<\/li>\r\n<\/ul>\r\n<h1><strong>Vision Impairments:<\/strong><\/h1>\r\n<ol>\r\n \t<li><strong>Retinal microvascular damage<\/strong>\u00a0leads to:\r\n<ul>\r\n \t<li><strong>Retinopathy:<\/strong> Damage to tiny retinal blood vessels produces:\r\n<ul>\r\n \t<li><strong>Microaneurysms: <\/strong>weakening and bulging of vessel walls.<\/li>\r\n \t<li><strong>Hemorrhages<\/strong>: Bleeding into the retina.<\/li>\r\n \t<li><strong>Neovascularization<\/strong>: formation of new, fragile blood vessels that can rupture and cause scarring.<\/li>\r\n \t<li><strong>Progression<\/strong>:\r\n<ul>\r\n \t<li><strong>Neuron death<\/strong> in the <strong>retina <\/strong>and formation of scarring which distorts the retina.<\/li>\r\n \t<li><strong>Possible Retinal detachment<\/strong>, which is a medical emergency (as retina tears away from vascular tunic (layer of the eyeball), leading to ischemia of the torn portion of the retina.\r\n<ul>\r\n \t<li>Neurons in the retina will die if deprived of oxygen and nutrients for long, making retinal reattachment a pressing necessity.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Blood<\/strong> and <strong>debris<\/strong> can\u00a0float in the<strong> vitreous humor<\/strong>, causing <strong>floaters<\/strong> and impairing vision.<\/li>\r\n \t<li><strong>Retinopathy<\/strong>\u00a0causes\u00a0<strong>visual impairment<\/strong>\u00a0and\u00a0<strong>blindness<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Treatment:<\/strong>\r\n<ul>\r\n \t<li><strong>Photo-coagulation<\/strong>: Laser treatment to seal off leaking vessels.<\/li>\r\n \t<li><strong>Retinal detachment<\/strong>\u00a0is an emergency requiring surgical intervention.<\/li>\r\n \t<li>Replacing the vitreous humor with artificial material is used to fix problems with floaters.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Edema and Macular Damage:<\/strong>\r\n<ul>\r\n \t<li><strong>Macular edema<\/strong>\u00a0causes swelling in the central retina.<\/li>\r\n \t<li>Results in\u00a0<strong>distorted vision<\/strong>.<\/li>\r\n \t<li>Progressive damage can lead to\u00a0<strong>blindness<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong style=\"text-align: initial;font-size: 1em\">Diabetic Cataracts<\/strong>\r\n<ul>\r\n \t<li><strong>Diabetic cataracts<\/strong>\u00a0develop from glucose accumulation in the lens, especially sorbitol.<\/li>\r\n \t<li>Water drawn into the lens causes\u00a0<strong>swelling<\/strong>\u00a0and\u00a0<strong>opacity<\/strong>, impairing vision.<\/li>\r\n \t<li>Cause\u00a0<strong>blurry vision<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ol>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li><strong>Preventative measures:<\/strong>\r\n<ul>\r\n \t<li>Tight blood glucose control.<\/li>\r\n \t<li>Use of sunglasses.<\/li>\r\n \t<li>Cataract surgery if necessary.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Kidney Damage (Nephropathy):<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Diabetes<\/strong>\u00a0accounts for\u00a0<strong>40%<\/strong>\u00a0of end-stage renal failure.<\/li>\r\n \t<li><strong>Damage<\/strong>\u00a0occurs in\u00a0<strong>glomeruli<\/strong>\u00a0and\u00a0<strong>nephrons<\/strong>, leading to:\r\n<ul>\r\n \t<li><strong>Scarring<\/strong>.<\/li>\r\n \t<li>Loss of\u00a0<strong>glomerular filtration rate<\/strong>.<\/li>\r\n \t<li><strong>Renal failure<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Additional factors:\r\n<ul>\r\n \t<li><strong>Hypertension<\/strong>\u00a0worsens renal ischemia.<\/li>\r\n \t<li><strong>Electrolyte imbalances<\/strong>\u00a0from polyuria can affect the heart and muscles.<\/li>\r\n \t<li><strong>Infections<\/strong>\u00a0in urinary tract due to glucose-rich environment.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Summary<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Chronic high blood glucose<\/strong> damages blood vessels, neurons, and organs.<\/li>\r\n \t<li><strong>Retinopathy<\/strong>\u00a0causes vision loss via microvascular damage.<\/li>\r\n \t<li><strong>Diabetic cataracts<\/strong> cause blurry vision<\/li>\r\n \t<li><strong>Macular edema<\/strong> contributes to vision loss and blindness.<\/li>\r\n \t<li><strong>Macrovascular disease<\/strong> increases risk of hypertension and cardiovascular events (e.g., heart attack), stroke, and renal failure.<\/li>\r\n \t<li><strong>Infection susceptibility<\/strong>\u00a0increases due to vascular and immune system impairments.<\/li>\r\n<\/ul>\r\n&nbsp;\r\n<ul>\r\n \t<li>Preventing and managing vascular and neural complications are critical.<\/li>\r\n \t<li>Early detection and management are essential to prevent severe vision loss and tissue necrosis.<\/li>\r\n \t<li><strong>Possible Complications include: Hypoglycemia\u00a0(insulin shock)<\/strong> and <strong>DKA<\/strong>, which\u00a0are <strong>acute, life-threatening events.<\/strong><\/li>\r\n \t<li>Regular screening, tight blood glucose control, and early intervention improve outcomes.<\/li>\r\n<\/ul>","rendered":"<h1><strong>Overview of Chronic Complications of Diabetes Mellitus:<\/strong><\/h1>\n<ul>\n<li>Chronic high blood glucose causes\u00a0<strong>degenerative damage<\/strong>\u00a0throughout the body over time.<\/li>\n<li>Significant risk of\u00a0<strong>vascular damage<\/strong>, leading to\u00a0<strong>atherosclerosis<\/strong>, and\u00a0<strong>damage to eyes, kidneys, and nerves<\/strong>.<\/li>\n<\/ul>\n<h1><strong>Vascular Damage and Atherosclerosis:<\/strong><\/h1>\n<ul>\n<li><strong>Chronic high blood glucose <\/strong>and\u00a0<strong>hyperlipidemia<\/strong>\u00a0contribute to\u00a0<strong>blood vessel wall deterioration <\/strong>making blood vessels susceptible to the development of\n<ul>\n<li><strong>arteriosclerosis<\/strong> (narrowing and loss of elasticity) and<\/li>\n<li><strong>atherosclerotic plaque formation <\/strong>(also narrows the lumen of blood vessels).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Damage occurs in\u00a0<strong>small (microvascular)<\/strong>\u00a0and\u00a0<strong>large (macrovascular)<\/strong>\u00a0vessels.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Narrowed blood vessels contribute to <strong style=\"font-size: 1em\">high blood pressure.\u00a0<\/strong><\/li>\n<li><strong>Blood vessel narrowing<\/strong>\u00a0leads to\u00a0<strong>ischemia<\/strong>\u00a0in tissues and organs.\n<ul>\n<li><strong>Less functional tissue<\/strong>.<\/li>\n<li>Tissue\u00a0<strong>necrosis<\/strong>\u00a0in severe cases.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><strong>Hyperglycemia<\/strong> leads to <strong>endothelial cells<\/strong> lining the inside of blood vessels becoming <strong>dysfunctional,<\/strong> specifically because:\n<ul>\n<li style=\"list-style-type: none\">\n<ol>\n<li>High glucose induces endothelial cell mitochondria to produce high levels of <strong>ROS (Reactive Oxidative Species)<\/strong>, which overwhelm the endogenous neutralizing antioxidants.\n<ol>\n<li>ROS cause damage to cellular proteins, DNA and plasma membranes)<\/li>\n<\/ol>\n<\/li>\n<li>High glucose in endothelial cells leads to excessive <strong>glycation<\/strong> of cellular proteins, leading to <strong>toxic waste build-up<\/strong>.<\/li>\n<li>High glucose <span style=\"text-decoration: underline\">reduces<\/span> the ability of endothelial cells to synthesize the <strong>vasodilator NO (nitric oxide).<\/strong><\/li>\n<li>High glucose <span style=\"text-decoration: underline\">reduces<\/span> the ability of endothelial cells to phosphorylate <strong>NO synthase<\/strong>.<\/li>\n<\/ol>\n<\/li>\n<li>Without the ability to produce NO, blood vessels are <span style=\"text-decoration: underline\">not<\/span> able to conduct normal <strong>autoregulation<\/strong> (e.g., vasodilate regionally in response to increased blood volume and blood pressure).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><strong>Lipolysis<\/strong> due to diabetes results in\u00a0<strong>high blood lipids<\/strong>, increasing risk for\u00a0<strong>atheroma formation<\/strong>.<\/li>\n<\/ul>\n<h1><strong>Vascular Damage &#8211; Possible Complications:<\/strong><\/h1>\n<ul>\n<li><strong>Large blood vessel damage<\/strong>:\n<ul>\n<li>Often worsened by\u00a0<strong>hypertension<\/strong>.<\/li>\n<li><strong>Coronary arteries<\/strong>\u00a0and\u00a0<strong>brain arteries<\/strong>\u00a0are affected.<\/li>\n<li>Leads to\u00a0<strong>peripheral vascular disease<\/strong> and\u00a0<strong>risk of cerebrovascular accidents (CVA, strokes)<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><strong>Peripheral vascular disease<\/strong> can cause risk of <strong>limb ischemia<\/strong>\u00a0and\u00a0<strong>gangrene<\/strong>:\n<ul>\n<li><strong>Claudication<\/strong>\u00a0(pain with exercise) signals insufficient oxygen in muscles.<\/li>\n<li>Severe cases may require\u00a0<strong>amputation<\/strong>\u00a0to prevent gangrene and further infection.<\/li>\n<li><strong>Delayed wound healing<\/strong>\u00a0and\u00a0<strong>infection susceptibility<\/strong>\u00a0are common due to poor blood flow.<\/li>\n<li><strong>Cyanosis<\/strong> may develop due to hypoxia and <strong>ulcers<\/strong>\u00a0may lead to\u00a0<strong>amputation<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Affects\u00a0<strong>small vessels<\/strong>\u00a0in the retina, kidneys, nerves, and skin.<\/li>\n<\/ul>\n<h1><strong>Neurons<\/strong>:<\/h1>\n<ul>\n<li>Rely heavily on steady blood flow.<\/li>\n<li>Ischemia causes\u00a0<strong>neuronal dysfunction and death<\/strong>.\n<ul>\n<li>Ischemia results in\u00a0<strong>demyelination<\/strong>,\u00a0<strong>loss of function<\/strong>,\u00a0<strong>sensory<\/strong>,\u00a0<strong>motor<\/strong>, and\u00a0<strong>autonomic fibers<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Peripheral neuropathy<\/strong>:\n<ul>\n<li>Loss of\u00a0<strong>sensory<\/strong> gives rise to paresthesia (e.g., <strong>numbness<\/strong>,\u00a0<strong>tingling, loss of sensation).<\/strong><\/li>\n<li>Loss of<b> motor neurons<\/b> gives rise to\u00a0muscle weakness.<\/li>\n<li><strong>Autonomic nerve damage<\/strong>\u00a0can cause\u00a0<strong>impotence<\/strong>\u00a0and\u00a0<strong>bladder dysfunction<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Nerve death<\/strong> can accompany <strong>ulcers<\/strong>\u00a0and\u00a0<strong>poor wound healing<\/strong>, especially in the feet.<\/li>\n<\/ul>\n<h1><strong>Vision Impairments:<\/strong><\/h1>\n<ol>\n<li><strong>Retinal microvascular damage<\/strong>\u00a0leads to:\n<ul>\n<li><strong>Retinopathy:<\/strong> Damage to tiny retinal blood vessels produces:\n<ul>\n<li><strong>Microaneurysms: <\/strong>weakening and bulging of vessel walls.<\/li>\n<li><strong>Hemorrhages<\/strong>: Bleeding into the retina.<\/li>\n<li><strong>Neovascularization<\/strong>: formation of new, fragile blood vessels that can rupture and cause scarring.<\/li>\n<li><strong>Progression<\/strong>:\n<ul>\n<li><strong>Neuron death<\/strong> in the <strong>retina <\/strong>and formation of scarring which distorts the retina.<\/li>\n<li><strong>Possible Retinal detachment<\/strong>, which is a medical emergency (as retina tears away from vascular tunic (layer of the eyeball), leading to ischemia of the torn portion of the retina.\n<ul>\n<li>Neurons in the retina will die if deprived of oxygen and nutrients for long, making retinal reattachment a pressing necessity.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Blood<\/strong> and <strong>debris<\/strong> can\u00a0float in the<strong> vitreous humor<\/strong>, causing <strong>floaters<\/strong> and impairing vision.<\/li>\n<li><strong>Retinopathy<\/strong>\u00a0causes\u00a0<strong>visual impairment<\/strong>\u00a0and\u00a0<strong>blindness<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Treatment:<\/strong>\n<ul>\n<li><strong>Photo-coagulation<\/strong>: Laser treatment to seal off leaking vessels.<\/li>\n<li><strong>Retinal detachment<\/strong>\u00a0is an emergency requiring surgical intervention.<\/li>\n<li>Replacing the vitreous humor with artificial material is used to fix problems with floaters.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Edema and Macular Damage:<\/strong>\n<ul>\n<li><strong>Macular edema<\/strong>\u00a0causes swelling in the central retina.<\/li>\n<li>Results in\u00a0<strong>distorted vision<\/strong>.<\/li>\n<li>Progressive damage can lead to\u00a0<strong>blindness<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong style=\"text-align: initial;font-size: 1em\">Diabetic Cataracts<\/strong>\n<ul>\n<li><strong>Diabetic cataracts<\/strong>\u00a0develop from glucose accumulation in the lens, especially sorbitol.<\/li>\n<li>Water drawn into the lens causes\u00a0<strong>swelling<\/strong>\u00a0and\u00a0<strong>opacity<\/strong>, impairing vision.<\/li>\n<li>Cause\u00a0<strong>blurry vision<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><strong>Preventative measures:<\/strong>\n<ul>\n<li>Tight blood glucose control.<\/li>\n<li>Use of sunglasses.<\/li>\n<li>Cataract surgery if necessary.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Kidney Damage (Nephropathy):<\/strong><\/h1>\n<ul>\n<li><strong>Diabetes<\/strong>\u00a0accounts for\u00a0<strong>40%<\/strong>\u00a0of end-stage renal failure.<\/li>\n<li><strong>Damage<\/strong>\u00a0occurs in\u00a0<strong>glomeruli<\/strong>\u00a0and\u00a0<strong>nephrons<\/strong>, leading to:\n<ul>\n<li><strong>Scarring<\/strong>.<\/li>\n<li>Loss of\u00a0<strong>glomerular filtration rate<\/strong>.<\/li>\n<li><strong>Renal failure<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li>Additional factors:\n<ul>\n<li><strong>Hypertension<\/strong>\u00a0worsens renal ischemia.<\/li>\n<li><strong>Electrolyte imbalances<\/strong>\u00a0from polyuria can affect the heart and muscles.<\/li>\n<li><strong>Infections<\/strong>\u00a0in urinary tract due to glucose-rich environment.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Summary<\/strong><\/h1>\n<ul>\n<li><strong>Chronic high blood glucose<\/strong> damages blood vessels, neurons, and organs.<\/li>\n<li><strong>Retinopathy<\/strong>\u00a0causes vision loss via microvascular damage.<\/li>\n<li><strong>Diabetic cataracts<\/strong> cause blurry vision<\/li>\n<li><strong>Macular edema<\/strong> contributes to vision loss and blindness.<\/li>\n<li><strong>Macrovascular disease<\/strong> increases risk of hypertension and cardiovascular events (e.g., heart attack), stroke, and renal failure.<\/li>\n<li><strong>Infection susceptibility<\/strong>\u00a0increases due to vascular and immune system impairments.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Preventing and managing vascular and neural complications are critical.<\/li>\n<li>Early detection and management are essential to prevent severe vision loss and tissue necrosis.<\/li>\n<li><strong>Possible Complications include: Hypoglycemia\u00a0(insulin shock)<\/strong> and <strong>DKA<\/strong>, which\u00a0are <strong>acute, life-threatening events.<\/strong><\/li>\n<li>Regular screening, tight blood glucose control, and early intervention improve outcomes.<\/li>\n<\/ul>\n","protected":false},"author":1370,"menu_order":18,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon-mvv4qnzjlt"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[96],"license":[57],"class_list":["post-5135","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon-mvv4qnzjlt","license-cc-by-nc-sa"],"part":63,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5135","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":19,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5135\/revisions"}],"predecessor-version":[{"id":5257,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5135\/revisions\/5257"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/63"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5135\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=5135"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=5135"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=5135"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=5135"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}