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#DIABETES PILOT CRACK PDF#
#DIABETES PILOT CRACK SERIES#

Patients often get an early warning when their calf muscles start to ache and become sore when walking. Peripheral vascular disease (PVD) is an atherosclerotic narrowing of blood vessels that results in poor blood flow to the periphery, particularly in the hands and feet it is particularly common and problematic in patients with poorly controlled diabetes. Unfortunately, many patients with type 2 diabetes also have features of metabolic syndrome: they may be overweight or obese and have high blood pressure, both of which can contribute to blood vessel narrowing. It is, therefore, essential that people with diabetes pay particular attention to maintaining their glucose levels within the normal range and avoid other factors that can accelerate blood vessel disease. In people with poorly controlled diabetes, the rate of atherosclerosis is much faster than in those with normal blood glucose control (Pasterkamp, 2013).

A diet high in saturated fat: this raises the level of circulating triglycerides and low-density lipoprotein (LDL) cholesterol, which in turn increases the amount of fat available for the formation of fatty deposits, leading to atherosclerotic occlusion.

Smoking: many of the chemicals in cigarette smoke cross from the lungs into the blood some are highly damaging to endothelial cells.

Hypertension: in patients with high blood pressure, the force exerted on the internal lining of the vessel can mechanically damage the endothelial cells.

George and Johnson (2010) cite the following risk factors:

#DIABETES PILOT CRACK SERIES#

Injury to the endothelium can trigger a series of events that lead to atherosclerosis, a build-up of fatty deposits, reducing the diameter of blood vessels and restricting blood flow this is the most common form of blood vessel disease in diabetes.Īnything that can damage the endothelium or increase blood lipids (fats) can increase the rate of atherosclerosis. In poorly controlled diabetes, hyperglycaemic blood can irritate and damage this delicate layer through a variety of mechanisms (Chait and Bornfeldt, 2009). The innermost layer of a blood vessel (endothelium) is only as thick as a single cell and it is in continuous contact with circulating blood. Most arise from damage to blood vessels (vascular complications), but there are also non-vascular complications. In poorly controlled diabetes, a consistently high blood glucose concentration (hyperglycaemia) can damage all the major organs and organ systems, leading to characteristic complications of diabetes (McCance and Huether, 2014) (Table 1). Glucose is the preferred energy source for most human cell types and, in health, is maintained in the blood at relatively stable concentrations.

In this series, read part 1 here and part 3 here.

#DIABETES PILOT CRACK PDF#

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This article has been double-blind peer reviewed.

Nursing Times 113: 4, 45-48.Īuthors: John Knight is a senior lecturer in biomedical science Yamni Nigam is an associate professor of biomedical science Maria Andrade is a senior lecturer in interprofessional studies all at the College of Human Health and Science, Swansea University. The second article in this three-part series explores the cumulative effects of poorly controlled blood glucose and describes the complications of diabetes, which can be delayed, reduced or even avoided through appropriate monitoring, drug management and lifestyle changes.Ĭitation: Knight J et al (2017) Diabetes management 2: long-term complications due to poor control. Poor glycaemic control can lead to a variety of pathologies, some of which can be life threatening.

Diabetes is a long-term systemic disease that can damage all regions of the body.