Diabetic arteoriopathy - Arteriology

Diabetic arteoriopathy

Arteriopathy is a condition manifested by a decrease in blood flow - in the case of diabetics more common in the lower limbs, due to the formation of intravascular thrombi. The main cause of arteritis is the process of atherosclerosis. In other words, this is the slow deposition over a long period, of fats inside the blood vessels throughout the body. In addition to vascular obstruction, there is a process of destruction of the supporting tissues around it by affecting collagen due to enzymatic (but also non-enzymatic) glycosylation.

What are the forms of diabetic arteriopathy

Within the condition, two types have been described, distinguished by the mechanism that determines the vascular changes:

  • Monckenberg medial sclerosis is the name given to the process of calcification of the middle vascular lining with venous stiffening without the occurrence of the narrowing phenomenon, so without ischemia;
  • Atherosclerosis is a disease in which the progressive formation of atheromatous plaques causes narrowing of the vascular calibre with the appearance of ischemia, represented by pain in the lower limbs.

What are the risk factors for diabetic arteriopathy?

It is important to know that in addition to the three main factors that cause atherosclerosis - diabetes, smoking and age> 60 years, involved in the development of diabetic arteriopathy are:

  • An unhealthy lifestyle that includes a diet high in saturated fat, alcohol, and lack of exercise;
  • High blood pressure;
  • Inadequate therapeutic approach to metabolic syndrome.

How we recognize diabetic arteriopathy

The clinical manifestations of this condition secondary to atheromatous vascular obstruction and coagulation disorders are represented by:

  • Paresthesias - numbness of the affected limb;
  • Hot/cold skin sensation;
  • Intermittent pain that accompanies the effort (walking) in the advanced stages of the disease, being present the discomfort when walking for shorter and shorter distances, to pain at rest.

We need to understand that pain is an acute muscle ailment in the absence of oxygen and nutrients (glucose) needed for efficient functioning. The narrower our vessels, the lower the blood circulation followed by the appearance of muscle cramps and trophic skin changes: thin and shiny skin, diminished subcutaneous tissue, decreased hair, altered veneers (thickened, friable nails that may have cracks). cold skin ”, in the late cases of evolution being present the skin ulcerations.

How to treat diabetic arteriopathy

The treatment of the disease is long-lasting and requires a change of lifestyle (quitting smoking, changing diet, regular exercise), controlling vascular risk factors (dyslipidemia, hypertension, metabolic imbalance) along with the administration of medication prescribed by a diabetologist. . Surgical treatment is reserved for cases with severe symptoms (resting or nocturnal pain, disabling claudication) and is represented by percutaneous transluminal angioplasty or vascular bypass.

Infections that appear as a complication in the evolution of the disease require antibiotic treatment, surgical drainage and in severe cases of sepsis amputation of the affected limb.