Mechanisms of Diabetes
Diabetes can lead to major health complications such as nerve damage, kidney damage, and cardiovascular disease. The three mechanisms which influence these diabetic complications are: blood pressure, glucose control, and lipid control.
Nephropathy, a disease/damage to the kidneys, is characterized by the development of proteinuria and a decline in glomerular filtration rate. High glucose levels and high blood pressure are the main causes of nephropathy. The high levels of glucose in the blood cause an increase in glucose reabsorption which then leads to both hyperfiltration and increased intraglomerular. This extra pressure on nephrons over time weakens their ability to filter, ultimately leading to kidney damage and leakage of proteins into the urine.
Retinopathy, described as lesions within the retina, is also caused by high blood pressure and poor glycemic control. Hyperglycemia causes changes to the blood vessels in the retina by damaging or killing pericyte cells (The cells that line blood vessels and help regulate blood flow) which then alters the blood-retinal barrier and vascular permeability. Damage to the retinal blood vessels eventually results in ischemia. In response to ischemia, neovascularization takes place which is the formation of new blood vessels. The new fragile blood vessels that grow in the retina are prone to leaking blood into the back of the eye. The leaking of the fluid into the macula (Area responsible for clear central vision) causes the macula to swell, thus leading to vision loss.
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