TREATED LESIONS

Diabetes mellitus with peripheral damages of blood vessels

Anotaion:
Vascular-degenerative complications of diabetes, known as diabetic angiopathy, determine the bad prognosis of this lesion.

Description:

On principle, they are divided into two types:

 

microangiopathy

macroangiopathy.

 

Diabetic microangiopathy is a specific complication of diabetes and is resulting from disturbed metabolism of carbohydrates and lipids. The resulting changes affect the smallest vessels – capillaries, arterioles and venules with progressive damage – their walls are damaged and blood cells accumulate. The tissue blood flow sharply decreases (tissue hypoxia). Mainly kidneys, retina and extremities (soles and toes) are  affected. Tissue necrosis of skin and hypoderma develops usually.

 

Diabetic macroangiopathy is expressed in early atherosclerosis and deposition of calcium in the walls of middle- and big-caliber arteries of muscular type (of heart, lower extremities). Partial occlusions of blood vessels results, which significantly reduces the blood flow for the relevant artery. This disturbs tissue nutrition, develops Chronic Arterial Artery Deficiency of lower extremities or permanent pain or gangrene. On this background, at minimum trauma (ingrown nail, sore and cut callus, etc.) may have advance infection of sole (diabetic sole), threatening the extremity by amputation.

 

The described changes necessitate consultation of diabetic patients with vascular surgeon, monitoring of risky groups and ultrasonic Doppler exam at least once per year.

 

Treatment is by medicine and surgical – treatment with surgical dressings or by intervention.


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