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- UlcerThe answer perhaps, to why we treat Type 2 Diabetes can be better explained by the rationale that treatment prevents the microvascular complications of diabetes. The microvascular complications are a collective term referring to the areas of injury that are caused specifically by abnormally high levels of glucose. These complications are unique to Diabetes and include retinopathy, neuropathy and nephropathy. The reason why some tissues are more vulnerable to injury from hyperglycemia than others, is because these tissues can take up glucose independent of insulin. Most tissues like muscle or adipose tissue require the presence of insulin to allow glucose to enter the cells. Other tissues however do not require this action of insulin and the entry of glucose into these tissues is determined by the concentration of glucose in the blood. The higher the glucose concentration, the more glucose is taken into these cells. These vulnerable tissues include the lens of the eye, the myelin cells that cover nerves, parts of the kidney, red blood cells, and the lining cells of blood vessels (endothelium). Retinopathy involves the development of abnormal blood vessels on the retina that can leak or bleed and if untreated can lead to blindness. Neuropathy can involve damage to nerves, which could be part of the autonomic or peripheral nervous system. Injury to the autonomic system could result in dysfunction of the bowel (delayed gastric emptying), pelvic structures (delayed bladder emptying, impotence), heart (arrhythmias). Peripheral neuropathy can cause numbness or pain in the extremities. Loss of sensation to the feet can lead to disturbance in muscle function which alters the shape of the foot leading to disturbed weight bearing. This in turn predisposes an individual to foot ulcer formation, infection and amputation. Nephropathy refers to injury to the kidneys. The earliest abnormality is recognized by the presence of increased amounts of protein in the urine (microalbuminuria). Over time this can progress to impaired kidney function and still later, kidney failure.
- Skin CareThe downside: Multiple treatments can get expensive. Sometimes there is a temporary reddening of the skin or localized swelling. Patients might have to use special skin-care products and/or a prescribed skin-care regimen.