Prof. Leszek Czupryniak: Poorly managed seniors endure diabetes worse

It is said that diabetes does not hurt. What hurts are its complications. What complications must a senior citizen who neglects the disease face?

With the full set of complications. The crux of diabetes is that a large amount of glucose in the blood damages blood vessels and the peripheral nervous system. Glucose freely enters the cells that lining the inside of the vessels. That is, it enters the nerve cells, which simply "go dumb" and stop functioning properly. Hence we have universality in diabetes, a whole range of symptoms, because we have the nervous system everywhere, and we have the circulatory system everywhere too. The organ that for some mysterious reason is spared in diabetes is the lungs.

The most spectacular problem, because it can end a patient's life, is heart attack, coronary artery disease and stroke, or cerebrovascular disease. It's also lower limb ischemia. In the lower extremities, we see the effects of damage to the nervous system the most. This is the first and even quite early symptom of poorly compensated diabetes. There is a disruption of the peripheral nerves, which is that they cease to function in terms of sensation. The patient moves his leg, but stops feeling what he should. So he experiences micro-injuries, cuts, blisters and calluses are made. This overwhelmingly affects men. Women take much more care of their feet. Men come to us when there is already a festering infection, the leg hurts and pus pours. Sometimes there is a fever. In a way, the pain is a blessing, because it is a signal that something bad is happening. In diabetes, this pain is absent, precisely because the peripheral nervous system is damaged. In addition to the brain, the limbs, heart and eventually the kidneys are damaged. When they stop filtering the blood as they should, then there are changes in the vessels on the fundus of the eye and the organ of sight can be damaged. If someone, having already been diagnosed with diabetes, neglects it and does not treat it well, the appearance of these complications is a matter of a few years.... Moreover, if someone is already struggling with atherosclerosis, for example, diabetes accelerates all these processes. Senior age is special in that the body always functions less well as the years go by, and diabetes accelerates these processes that take place in aging even more. In long-term diabetes, blood vessels are 10-15 years older than in peers without diabetes. So it can be said that a patient with diabetes ages twice as fast, as long as he is treated poorly. If he is well-managed, takes his medications and his sugar levels are not far from normal, there is little or no risk of developing complications.