Why Diabetes Affects Circulation

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The Microcirculation In Diabetes.

Abstract Diabetes affects the microcirculation, the large arteries and occasionally the large and small veins, by inducing vessel wall sclerosis. The degree of stiffening produced is linked to its duration. The ability of the diabetic's circulation to distribute blood is affected, especially during increased blood flow. In most tissues this causes no serious burden, but three tissues are unusually susceptible to disturbance--the retina, renal cortex, and peripheral nerve. They develop serious problems in many longstanding diabetics. Damage to the kidney appears to be linked to its unique combination of high blood flow rate and precise control of intraglomerular filtration pressure. As renal arteriolar intima hyalinizes, the glomerular mesangium increases in volume. Diabetic renal changes appear to become irreversible when a critical stage, manifested be albuminuria and hypertension, is reached. The resulting renal failure is associated with clumpy deposits of type IV collagen in the cortex, suggesting that local microvascular autoregulation has been lost. The retinal circulation forms late in fetal life in a process in which local oxygen tension controls new vessel formation. In ad Continue reading >>

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Popular Questions

  1. Shannon Wheeler

    People think of pain as just…pain. Health care professionals must consider the origin of the pain to treat it properly. Muscle pain, visceral (abdominal) pain, bone pain, nerve pain (neuropathy) all have different origins and different characteristics. A medication that works on muscle pain doesn’t necessarily relieve nerve pain.
    Enter gabapentin: If someone has a condition that causes neuropathy, an NSAID such as ibuprofen, while effective for other types of pain, doesn’t help much. Gabapentin is sometimes used to treat the neuropathy instead because it blocks nerve pain. I invite you to look up the medication and review how it works.
    This leads us to ask why are cases of severe neuropathy on the rise, requiring more people to be treated with gabapentin? Circulatory diseases are particularly hard on the nerves of the extremities. A rise in cardiovascular disease and diabetes, which impair circulation, causes the nerves to be damaged but not destroyed. This causes altered sensations such as electrical shock, pins and needle, burning, pinching sensations of the feet. It’s excruciating and can be debilitating. Treating this type of pain with gabapentin or similar drug would be considered a responsible practice.
    While it’s easy to blame doctors for “pushing” gabapentin, it is often the treatment of choice for people who have nerve damage from lifestyle preventable disease. While gabapentin is an appropriate treatment for many painful diseases, I conjecture that the rapid rise in its use correlates to the rapid rise in diseases that affect circulation.

    Edit: I wanted to add that gabapentin is used for reasons other than neuropathy caused from poor circulation.

  2. David Stoney

    Not too sure I’d call it pushing, but in the UK there is no need for a doctor to recommend one drug over another for financial inducements. As most people know there are a lot of pain killers out there, from basic aspirin to morphine and more drugs are added to the space between every year. It has been found out that a large part of the populace don’t get the pain relief they expect as the drug prescribed isn’t suitable for the cause of the pain.
    As a result of some unpleasant injuries gained over the years I have been prescribed everything in the pain relief drug book A-Z, but because the injuries resulted in the removal of discs L1-L5 the back ache was horrendous but it was put in the shade by the sciatica. After thirty years of trying everything under the sun it turned out that the main issue was neuropathic pain for which there are newish drugs like gabapentin and pregabilin. They do the job quite well or they did but now I’m using various opiates (mostly oxycodone based as well as morphine) as life managed to really put a spanner in the works. Being terminal doesn’t half bring clarity - you stop worrying about the stuff you have no control over and the little stuff will take care of itself in due course (sort of!).

    If you’re one of those that sees conspiracies of big pharma and doctors then there’s nothing I can say that will change your mind. If however you’re anything like me, with no medical degree and years of experience as a doctor, then I’d suggest ignore all the inaccuracies on the interweb and go with your doctors advice (they usually know far more than you ever will - as my wife the doctor, likes to cheekily remind me of if I get out of hand!). Forget Dr.Google as you can’t sue them if you make a bad decision.

  3. Ann E Zwicker

    I take it when I've run out of most other options. Some stopped working. Wish I got it decades ago.

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