Author: McLaren Flint
When most people think of diabetes, blood sugar is usually the first thing that comes to mind. But diabetes is much more than controlling blood sugar levels. It can affect the entire body.
“Diabetes can cause multiple problems as it affects both the body's vascular system and nervous system,” said Dr. Robert Molnar, a board-certified vascular surgeon and chief of surgery at McLaren Flint. “The real issue is the complications that diabetes brings to several of the body's organ systems. Diabetes significantly increases the risk of heart disease, peripheral vascular disease, kidney disease, neuropathy, stroke, and vision loss.
“Diabetes has a progressive injurious effect on both the large arteries and small arteries, on which all the body's organ systems are dependent. Large vessel disease is primarily characterized by the hardening of the arteries, leading to blockages and decreased blood flow to the organs. Small vessel disease leads to a loss of distribution of blood flow at the microscopic level that supplies organs.”
According to the World Health Organization, in 2021, diabetes was the direct cause of 1.6 million deaths, and 47% of all deaths due to diabetes occurred in people younger than 70. Another 530,000 kidney disease deaths were caused by diabetes, and high blood glucose causes around 11% of cardiovascular deaths.
“The heart vessels can become narrowed, leading to heart attacks and heart failure,” said Dr. Molnar. “Peripheral arterial disease most commonly affects the lower extremities and can lead to ulcerations, pain, and limb loss. Carotid artery disease may lead to stroke and significant disability. Small vessel disease may lead to kidney disease with possible renal failure, neuropathy leading to sensory loss and digestive issues, as well as vision loss and bladder dysfunction.”
In addition, a complex combination of complications from diabetes can lead to something called diabetic foot due to nerve damage and poor circulation.
“Nerve damage and poor blood flow to the foot lead to a significant increase in foot ulcerations and non-healing infections that are often far advanced when identified due to the patient’s neuropathy not giving a warning sign of the advanced, non-healing wound,” said Dr. Molnar. “This significantly increases the risk of toe amputation and limb loss.”
While there is no cure for diabetes, lifestyle modifications are the most important factor in managing the disease and limiting its potential complications.
“Controlling blood sugar with frequent daily checks and administering appropriate insulin or medication is extremely important to limit complications from diabetes,” said Dr. Molnar. “Diet and exercise can help to limit the intake of sugar and avoid obesity. Smoking prevention is extremely important given the significant increase in vascular disease. As there are many organ systems affected by diabetes.
“It is also extremely important to be seen and evaluated by your physician multiple times per year. This will assist in the early detection of complications associated with diabetes and allow for interventions to lessen the risk of all the conditions I’ve mentioned.”
If you need a vascular surgeon or diabetes education, resources are available here.