OTHER COMPLICATIONS





Alzheimer’s disease: 

ALZHEIMER’S DISEASE IS a chronic, progressive, neurodegenerative disease that causes
memory loss, personality changes, and cognitive problems. It is the most common form of
dementia, and the sixth leading cause of death in the United States.
 Alzheimer’s disease may reflect the inability to use glucose normally, perhaps a type of selective insulin resistance in the brain. The links between Alzheimer’s disease and diabetes have grown so strong that many researchers have suggested Alzheimer’s disease can be called 
diabetes.
 These arguments go far beyond the scope of this book, however.

Cancer
TYPE 2 DIABETES increases the risk of most common cancers, including breast, stomach,
colorectal, kidney, and endometrial cancers. This may be related to some of the
medications used to treat diabetes and will be further discussed in chapter 10. The survival
rate of cancer patients with pre-existing diabetes is far worse than for nondiabetics.

Fatty liver disease
NON-ALCOHOLIC FATTY liver disease (NAFLD) is defined as the storage and accumulation of
excess fat in the form of triglycerides exceeding 5 percent of the total weight of the liver.
This condition can be detected using an ultrasound to examine the abdomen. When this
excess fat causes damage to the liver tissue, which can be revealed through standard
blood tests, it is called non-alcoholic steatohepatitis (NASH). Current estimates suggest that
NAFLD affects 30 percent and NASH 5 percent of the U.S. population; both are important
causes of liver cirrhosis (irreversible scarring of the liver).

NAFLD is virtually non-existent in recent-onset type 1 diabetes. By contrast, the incidence
in type 2 diabetes is estimated at upwards of 75 percent.
Infections
DIABETICS ARE MORE prone to all types of infections, which are caused by foreign organisms
invading and multiplying in the body. Not only are they more susceptible to many types of
bacterial and fungal infections than nondiabetics, the effects also tend to be more serious.
For example, diabetics have a four- to fivefold higher risk of developing a serious kidney

infection.
 All types of fungal infections, including thrush, vaginal yeast infections, fungal
infections of the nails, and athlete’s foot, are more common in diabetic patients.
Among the most serious infections for diabetics are those involving the feet. Despite
adequate blood glucose control, 15 percent of all diabetic patients will develop non-healing
foot wounds during their lifetime. Infections in these wounds often involve multiple
microorganisms, making broad-spectrum antibiotic treatment necessary. However, the decreased blood circulation associated with PVD (see above) contributes to the poor wound
healing. As a result, diabetics have a fifteen-fold increased risk of lower-limb amputation, and account for over 50 percent of the amputations done in the United States, excluding accidents. It is estimated that each of these cases of infected diabetic foot ulcers costs upwards of $25,000 to treat.

There are many contributing factors to the higher rates of infection. High blood glucose may impair the immune system. As well, poor blood circulation decreases the ability of infection-fighting white blood cells to reach all parts of the body.

Skin and nail conditions

NUMEROUS SKIN AND nail conditions are linked to diabetes. Generally, they are more of an
aesthetic concern than a medical one; however, they often indicate the underlying serious
condition of diabetes, which requires medical management.
Acanthosis nigricans is a gray-black, velvety thickening of the skin, particularly around
the neck and in body folds, caused by high insulin levels. Diabetic dermopathy, also called
shin spots, are often found on the lower extremities as dark, finely scaled lesions. Skin tags
are soft protrusions of skin often found on the eyelids, neck, and armpits. Over 25 percent
of patients with skin tags have diabetes.

Nail problems are also common in diabetic patients, particularly fungal infections. The
nails may become yellowy-brown, thicken, and separate from the nail bed (onycholysis).
Erectile dysfunction
COMUNITY-BASED POPULATION studies of males aged 39–70 years found that the prevalence of
impotence ranges between 10 and 50 percent. Diabetes is a key risk factor, increasing the risk of erectile dysfunction more than threefold and afflicting patients at a younger age than usual. Poor blood circulation in diabetics is the likely reason for this increased risk. The risk of erectile dysfunction also increases with age and severity of insulin resistance, with an estimated 50–60 percent of diabetic men above the age of 50 having this problem.

Polycystic ovarian syndrome

AN IMBALANCE OF the hormones can cause some women to develop cysts (benign masses) on
the ovaries. This condition, called polycystic ovarian syndrome (PCOS), is characterized by irregular menstrual cycles, evidence of excessive testosterone, and the presence of cysts (usually detected by ultrasound). PCOS patients share many of the same characteristics as type 2 diabetics, including obesity, high blood pressure, high cholesterol, and insulin resistance. PCOS is caused by elevated insulin resistance  and increases the risk of developing type 2 diabetes three-to fivefold in young women.
OTHER COMPLICATIONS OTHER COMPLICATIONS Reviewed by Leembo on March 02, 2019 Rating: 5

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