Microvascular Complications in Diabetes

Contributed by: Laura Smith, Pharm.D. Candidate

UMKC School of Pharmacy

Text Box: What are microvascular complications? Microvascular is a fancy word for “little vessels”. These little blood vessels in your body are like the branches of a tree. The smallest twigs of the tree are similar to the little vessels found in places like your eyes and toes. Diabetes causes a decrease in blood flow and the first places affected by decreased blood flow are the smallest vessels. Location of little vessels and the complications Eyes Mouth Feet Hands Kidneys Eyes Diabetics develop cataracts at an earlier age than the general population The longer you have had high blood glucose levels, the more at risk you are for eye problems Retinopathy can occur in people with diabetes. Retinopathy is when the retina in the eye breaks down and this causes loss of vision. People with diabetes and have high blood glucose levels, high blood pressure, or smoke are at an increased risk Retinopathy is the leading cause of blindness in the U.S. in adults ages 20-74 Up to 20% of patients with Type 2 Diabetes (DM 2) have retinopathy at the time of diagnosis. Over 60% of patients who have had DM 2 for 15 years will have retinopathy What to do Monitoring Yearly eye exams for patients who have had diabetes type 1 for more than 3-5 years Yearly for all patients with DM 2

Text Box: Prevention Good control of blood glucose!!! Avoid tobacco Keep good control of blood pressure Teeth Patients with diabetes are at risk for gingivitis and cavities What to do Monitoring A trip to the dentist every 6 months Prevention Brush and floss two times a day Massaging gums daily can help increase blood flow and prevent problems Feet and Hands Neuropathy is nerve damage that causes problems with sensation, loss of feeling, pain, and an increased risk for infection Neuropathy can be caused by poor blood glucose control over an extended period of time It generally affects the lower portions of your arms and legs (aka hands and feet) What to do Monitoring for foot problems Daily foot inspection, yearly inspection by a physician Prevention of foot problems Good control of blood glucose!!! Stop smoking Exercise: it can help increase blood flow Daily foot inspection Inspect skin, hair, and nails for breaks in the skin Feel the feet for excessive warmth and dryness Inspect shoes and socks for inappropriate wear patterns or improper fit Avoid going barefoot, wearing sandals, or open-toed shoes EVEN INSIDE THE

Text Box: HOUSE!!! Make sure bath water is not too hot Moisturize feet daily to avoid excessive dryness and cracking Treatment There are several types of drugs that can be used for neuropathy Drugs treat the pain, not the problem The nerve damage that causes the pain of neuropathy is permanent Kidney Nephropathy (kidney damage) is defined as changes in the small blood vessels in the kidneys Diabetic nephropathy occurs in 20-40% of patients with diabetes Diabetes is the leading cause of end-stage renal disease, needing dialysis What to do Monitoring A test every year at the physician’s office for the presence of protein in the urine is warranted in all DM 2 patients Prevention Good control of blood glucose!!! Some drugs can decrease the chances of getting kidney damage With these risks, it is very important to keep a close watch on your health and risk for diabetes. For more information, visit www.diabetes.com.