Causes of Complications
This is not known for sure. A substance called sorbitol, a metabolite of glucose formed by activation of different chemical reactions, acts as a tissue toxin and is thought to be responsible for all lesions.
A second mechanism is the formation of altered proteins in the body. The lipoproteins are also affected. Altered collagen traps this changed lipoprotein in the vessel walls. Thus blockage of vessels is accelerated. The lipid fractions in the blood are raised. Hyperviscosity, with abnormal aggregation of platelets, occurs.
Patient education is very important. Physicians must spend time to explain that this is a controllable situation and one need not despair. Patients too often do not comply. They abuse their diet and yet expect the blood sugar to remain under control. Firstly, a strict dietary regimen is very important. Secondly, exercise is very valuable.
A diabetic may manage without medication, but he or she cannot manage without exercise and a healthy diet. Exercises like jogging and cycling increase the rate of entry of sugar into the cells and improve insulin sensitivity.
As the cells are metabolically very active during exercise, they consume greater amounts of sugar and the blood levels of sugar reduce. The quantity and type of exercise needed varies from patient to patient and has to be monitored.
The goal of therapy is to maintain blood glucose to as near normal as possible. This is associated with fewer complications in the long run. The danger of low blood sugar during therapy has to be carefully tackled.
Self-monitoring of glucose is convenient though regular hospital check-ups are important. There are a variety of user-friendly gadgets for home monitoring. Periodic laboratory check-ups are essential for counter checks.