STM Article Repository

In the present world scenario, there is a continuous increase in the number of cases of diabetes. In this chapter we will discuss the complications which are generally seen in a diabetic patient. Hyperglycemia, a partial or complete lack of insulin action, and the emergence of diabetes-specific pathology in the retina, renal glomerulus, and peripheral nerves are all characteristics of diabetes. Diabetes and decreased glucose tolerance more than triple or even eight-fold the risk of cardiovascular disease (CVD). Therefore, diabetes affects more than 40% of individuals with acute myocardial infarction (MI) who are hospitalized and 35% of people have poor glucose tolerance. Diabetes mellitus is now the primary cause of new blindness in adults 20 to 74 years old as well as the major cause of end-stage renal disease (ESRD) in the developed world as a result of its disease-specific pathology. Dialysis patients with diabetic ESRD had a 50% worse survival rate than individuals without diabetes. Neuropathy, which includes distal symmetrical polyneuropathy, mononeuropathies, and a range of autonomic neuropathies that result in erectile dysfunction, urine incontinence, gastroparesis, and nocturnal diarrhoea, affects more than 60% of diabetic patients. Increased vascular permeability, which permits extravasation of plasma proteins that build up as periodic acid- Schiff-positive deposits in the vessel walls, is one of the earliest. Changes in the synthesis and turnover of the extracellular matrix's constituent proteins and glycosaminoglycans also result in an increase in the extracellular matrix produced by perivascular cells like pericytes (retina) and mesangial cells (glomerulus). As a result, the renal glomerulus' mesangial matrix expands and the basement membrane thickens in several tissues, including the vasa nervosa and retinal capillaries. Patients with type 1 diabetes mellitus (T1DM) (Nathan DM et al) and type 2 diabetes mellitus (T2DM) (Turner R et al) experience macrovascular problems. [1, 2] This is especially concerning because diabetes is becoming more common among teenagers and younger adults as well, which encourages the earlier onset of long-term cardiovascular issues. HbA 1c may operate as a continuous and independent risk factor for macrovascular disease, according to several studies, but this association is not as substantial as that for microvascular complications. There is a 10-fold increase in the risk of microvascular disease endpoints for an increase in HbA 1c from 5.5% (37 mmol/mol) to 9.5% (80 mmol/mol), but only a 2-fold increase in the risk of macrovascular disease endpoints. The Lancet published nearly a entire issue on the diabetic foot to coincide with World Diabetes Day in 2005. This was the first time a major non-specialist journal had focused on this widespread issue, but there are still significant obstacles to delivering crucial messages about the diabetic foot. Such findings amply demonstrate the necessity of a regular screening programme for high-risk persons in all diabetes programmes.