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1) Complications of diabetes mellitus

Chronic hyperglycaemia causes irreversible damage over time to a number of tissues: particularly the small blood vessels of the retina (retinopathy), the glomerulus (nephropathy) and peripheral nerves (peripheral neuropathy). These are the microvascular complications. They are strongly linked to long term elevated blood glucose. Macro vascular complications are further divided into coronary circulation ( angina, acute coronary syndrome or myocardial infarction), cerebral circulation (transient ischaemic attack, stroke), peripheral circulation ( foot diseases). 

other complications are - infections, rheumatological complications, skin complications. 


2. Diabetic neuropathy 

symptoms include paraesthesia in the feet, sharp pain in lower limbs ( worse at night and felt mainly on the anterior aspect of the leg), burning sensation in the soles of feet and cutaneous hyperaesthesia. As the condition advances, structural changes appear in the foot leading to loss of lateral and transverse arches and clawing of toes. 

Loss of sensation to a 10 g monofilament provides evidence of increased risk and requirement of foot care. The earliest signs of neuropathy may be decreased distal vibration, touch, and pin sensation and ankle reflex loss on examination. The first symptoms are usually decreased feeling or tingling in the toes.


sources- 1. Davidson’s principles and practice of medicine textbook 

2.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4090918/





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