3 Macrovascular Risks of Uncontrolled Diabetes Mellitus

Uncontrolled diabetes mellitus (either type 1 or type 2) is associated with several complications caused by the chronic damage that excess glucose causes to the tissues of the body. The vascular tissue, is particularly sensitive and leads to the damage of organs as we are going to see.

Coronary Artery Disease (CAD). Diabetics have a higher rate of heart attacks than the general population. Excess glucose over many years contribute to the generation of atherosclerosis and the formation of plaques in the coronary arteries that will eventually be the cause of the heart attacks. Heart attacks, are also the main cause for heart failure and sudden death.

Cerebrovascular Disease (CVD). A similar problem in the vascular system of the brain is responsible for the appearance of more strokes in diabetics than in the general public. In this case, the atherosclerosis and the plaques are formed in the carotid arteries and the arteries of the brain. Debilitating strokes, and dementia are the main consequences.

Peripheral Artery Disease (PAD). If the atherosclerosis and plaque formation happens in the arteries of the lower extremities, the consequence may be the amputation of different parts of the leg. These can range from losing toes to the loss of an entire limb. It is well known that diabetics have a higher incidence of amputations than non-diabetics

Strict control of the blood sugar is the mainstay of the prevention of these complications. To get to the point of a heart attack, a stroke or an amputation, decades of elevated blood sugar have to be present. In addition, other factors such as smoking, high blood pressure, or genetic predisposition can speed up the process of atherosclerosis. There are many options to control the blood sugar, including many pharmacologic measures such as oral medications and injectables such as insulin and non-pharmacological measures such as diet and exercise.

Marco A. Ramos MD

5 Possible Consequences of Uncontrolled High Blood Pressure

Uncontrolled high blood pressure (hypertension) is associated with several health conditions. Hypertension is treatable, so this means that the following diseases can be prevented or delayed. 

1. Heart attacks. Elevated blood pressure is related to atherosclerosis, which, by narrowing the coronary arteries, can lead to heart attacks. Heart attacks can cause congestive heart failure and sudden death. 

2. Impaired vision. Hypertension can cause something called hypertensive retinopathy. This means that the retina (where the images are formed in the eye) can get damaged by chronic high blood pressure and can lead to impaired vision and blindness.

3. Amputation of limbs. High blood pressure can lead to the amputations of limbs, specially feet and legs. The problem starts with the atherosclerosis in the arteries of the limbs which eventually leads to obstruction and lack of blood supply to the feet and legs, especially. Hypertension is related to the atherosclerosis of the limb arteries, just as with the heart.

4. Stroke. The brain can also be the victim of atherosclerosis, which is related with hypertension (as we have just seen). In addition to this, if the blood pressure becomes too high, it can lead to bleeding inside the brain, by rupture of the arteries.

5. Kidney disease. The kidneys are very sensitive. Elevated blood pressure for a long time can cause scarring of the kidney tissue to the point that it cannot perform its functions anymore. The kidneys are important for sodium and potassium control, blood pressure control, generation of red blood cells, vitamin D and calcium metabolism and acid-base balance.

Marco A. Ramos MD