Diabetic sequelae


The first ten years of  diabetes  and the quality of  blood glucose level control determine the risk of secondary diseases.

Diabetes mellitus can lead to numerous secondary diseases. The probability of their occurrence is already increased in the early stages of the disease. It is also a fact that the first ten years of diabetes and the quality of blood glucose control determine the risk of secondary diseases. Therefore timely recognition of the metabolic imbalance and best practice treatment is important.

Among the complications of diabetes mellitus, vascular diseases play a central role. According to epidemiological studies, angiopathies are the most common cause of death for diabetic patients, at about 75 percent. Clinical manifestation and severity of vascular changes depend on their localization (retina, kidney, coronary arteries, cerebral vessels, peripheral vessels of the extremities) and the extent of the involved vascular Areas.

What is meant by macroangiopathy and microangiopathy?

 Macroangiopathy as a disease of the major arteries in the brain, the heart (coronary arteries) and in the legs is distinguished from   microangiopathy as a disease of  the small blood vessels, with potantial damage to kidneys (nephropathy), the retina of the eyes (retinopathy), the nerves (neuropathy), the brain and the heart muscle. For both forms of diabetic angiopathy, the duration of manifest diabetes, the quality of metabolic control and certain risk factors play an important role.

High risk of circulatory disorders

In diabetics, arteriosclerotic deposits in the blood vessels develop faster than in healthy people. As a result of these changes in the small or large blood vessels,  these arteriosclerotic sites narrow  over the years and the risk of circulatory disorders increases. Arteriosclerosis occurs at an earlier age in diabetics than in non-diabetics, shows rapid progression and often leads to severe and fatal complications such as heart attack, stroke and foot gangrene (tissue necrosis). Due to its close association with cardiovascular disease, diabetes has been described as a high-risk condition ("high-risk equivalent") for premature death, comparable to the risk of non-diabetics after a heart attack.

The essential clinical pictures of diabetic macroangiopathy are:

• coronary heart disease and heart attack

• disease of the neck and brain arteries and stroke

• peripheral artery occlusive disease

• diabetic foot Syndrome 

Diabetic microangiopathy

The term "diabetic microangiopathy" refers to the largely diabetes-specific vascular changes in the retina, kidneys, nerves and other organs. Measured by the clinical consequences, damage to the fundus of the eye (diabetic retinopathy) and the renal corpuscles (diabetic nephropathy) dominate. Functional diabetic microangiopathy of the feet and heart also plays an important clinical role. It is discussed as an important factor in diabetic cardiomyopathy and diabetic foot syndrome.
Macro- and microangiopathic changes often develop concurrently in diabetics.



Diabetes sequelae – early detection and treatment

In his lecture at the 3rd Patients‘ Day of the Diabetes Information Service at Helmholtz Zentrum München, Dr. Christoph Beck from Nuremberg Medical Center will present clinical pictures that can develop as a late consequence of diabetes mellitus. Many organ systems can be affected – eyes, kidneys, brain, heart, blood vessels in the legs and nerves.

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Diabetes - Was ändert sich im Alter?

PD Dr. Michael Hummel, Forschergruppe Diabetes e.V. am Helmholtz Zentrum München, berichtet auf dem 4. Patiententag im Interview mit dem Diabetesinformationsdienst über Herausforderungen, die das Diabetesmanagement bei sehr alten Patienten mit sich bringt. (Dauer: 2:55 Minuten)

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