Diabetes The Hows and Whys Please

[athomemom56]

I know there are numerous sources both written and videos on the topic of diabetes available for nurses. I learn best using visuals, but also when Reasons and Rationales are given. If I know the reason, then I understand better. A lot of times I find information that tells me diabetes can cause complications involving the kidneys....but I need to know how and why...If any of you know good sites and especially good videos please let me know. Not only for diabetes, but any condition. This is the best way for me to learn. Following is some info I got from the internet...it tells me the how and why. Here goes:

How does diabetes cause kidney disease?

When our bodies digest the protein we eat, the process creates waste products. In the kidneys, millions of tiny blood vessels (capillaries) with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood.

Diabetes can damage this system. High levels of blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak and useful protein is lost in the urine. Having small amounts of protein in the urine is called microalbuminuria.

The kidneys work hard to make up for the failing capillaries so kidney disease produces no symptoms until almost all function is gone. Also, the symptoms of kidney disease are not specific......

Here's another complication of diabetes....with the how's and whys....

Gastroparesis

• Gastroparesis is a type of neuropathy (nerve damage) in which food is delayed from leaving the stomach.
  
• This nerve damage can be caused by long periods of high blood sugar.
  
• Delayed digestion makes the management of diabetes more difficult.
  
• It can be treated with insulin management, drugs, diet, or in severe cases, a feeding tube.
  

Gastroparesis is a disorder affecting people with both type 1 and type 2 diabetes in which the stomach takes too long to empty its contents (delayed gastric emptying). The vagus nerve controls the movement of food through the digestive tract. If the vagus nerve is damaged or stops working, the muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped.

Just as with other types of neuropathy, diabetes can damage the vagus nerve if blood glucose levels remain high over a long period of time. High blood glucose causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves.

Sorry to be so long, and hope you get what I mean...

Barbra Ann

[Nurse Paolo]

Diabetes is an elevation of the blood sugar above the normal value. Lets simplify it in the most easiest way so that we can fully grasp the rationale why complications exist.

Let me start by discussing oxygenation. Our blood vessels carries oxygenated blood and travels all over the body tissue (that includes the kidneys, brain, heart, nerves, eyes, etc.) to deliver oxygen for proper tissue perfusion.

Now, in diabetes the blood sugar is so high that causes blood to become thick or viscous. And that makes the blood flow slower, consequently causing slow tissue perfusion, meaning blood cannot bring enough oxygen that can gradually kill the nerves (causing neuropathy), kidney (nephropathy), eyes (retinopathy).

[classicdame, MSN, EdD]

Nurse Paolo is right. All complications relate to poor circulation. In nerves, the synapses are not "circulating" because they are literally short-circuited by glucose interference. In organs the vessels tend to leak and oxygen and other nutrients cannot reach the organs. Blood with sugar is thicker than blood alone, which means the heart and everything else has to work harder to get the thick blood around and around. It is a wasting disease.

[pfeliks]

Just an FYI. Diabetes is the cause of gastroparesis in about 30% of cases. 70% of gastroparesis cases are idiopathic and unrelated to diabetes. I happen to be one of the 70%. For the record, GP really sucks and is a daily struggle for those who have it. I used to weigh 190 but am now stable at around 155.

[classicdame, MSN, EdD]

sorry you have this condition. I know it must be a challenge.