Chapter 17. Chronic Complications of Diabetes

摘要: Publisher Summary Diabetic coma has been more than supplanted by the composite category of cardio-renal disease that now accounts for about 80% total deaths diabetics. As effects long-term diabetes unmask, it becomes evident that, while prolonging life, insulin treatment cannot prevent appearance disabling complications chronic diabetes, such as retinopathy, nephropathy, neuropathy, cataracts, and generalized atherosclerosis. One most striking features is slow progressive development vascular abnormalities, particularly in small blood vessels. retinopathy nephropathy are, thus, rarely found at onset disease. The slow, changes during years incompletely normalized metabolism suggests diabetic angiopathy secondary to metabolic abnormality(ies) characterizing mellitus. Recent investigations suggest disturbances are underlying factor nerve affection. prominent lesion peripheral fibers affected neuropathy segmental demyelination. myelin sheath formed spiral folding Schwann cell membranes, may, fact, result from a defect cell. characteristic decrease conduction-velocities motor sensory nerves may be because Recently, postulated loss abnormalities caused increased aldose reductase activity resulting intracellular accumulation sorbitol. An interesting relationship between impaired motor-nerve conduction-velocity decreased myoinositol concentration streptozotocindiabetic rats. Furthermore, sorbitol levels have cerebrospinal fluid patients with polyneuropathy.