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Diabetes – Part Two

By September 30, 2022Physiotherapy

In our last blog we discussed the different types of Diabetes that commonly affect Australians. In this blog we are going to explore some of the common complications that can arise from a diagnosis of Diabetes. Not everyone with a diagnosis of Diabetes will develop complications, it depends on the time since diagnosis and how well managed the condition is, however these complications can be delayed and avoided with lifestyle and exercise choices.

One of the main complications of Diabetes is neuropathy. Neuropathy is known as a microvascular complication of the disease as it affects the small vessels and nerves of the peripheries and autonomic nervous systems. The high levels of blood sugar that are associated with Diabetes are toxic to the Schwann cells which make up the nerve and cause them to swell up. As a result of this there is reduced sensitivity to stimuli as the nerves are no longer as sensitive as they once were. For a peripheral neuropathy the condition starts in the feet and hands and progresses up to the more proximal muscles as the condition worsens, it is sometimes also associated with pain. It starts as just a loss of sensation in these areas, but in more severe cases can progress to loss of muscle function. People with neuropathy can also experience symptoms related to autonomic neuropathy, this is where the Schwann cells in the autonomic nerves are affected by excessive sugar in the blood.  The autonomic nerves are responsible for maintaining elements of the bowel, digestion and heart rate. This reduced sensitivity of the nerves can have significant effects on stomach emptying, feeling nauseous and cause excessive sweating after eating. These microvascular effects tend to effect type 1 diabetics more often.

Another complication of Diabetes is the development of heart disease. This occurs secondary to the toxic effect that the excess glucose causes on blood vessels. With continued exposure to the high levels of sugar in the blood there is ongoing trauma and leads to the build-up of atherosclerotic plaques in the walls of blood vessels. This reduces the blood flow to the tissue of the heart which can cause symptoms related to angina and when this blood flow restriction becomes severe, or pieces of the plaque break off it can cause a heart attack. This same process which effects the blood vessels of the heart can affect other areas of the body including the blood vessels in the legs leading to peripheral vascular disease and the blood vessels of the brain leading to stroke. These are known as macrovascular effects and are thought to effect people with type 2 diabetes more than those with type 1.

At this current time there is no cure for diabetes, however with good lifestyle management and exercise the risk of developing complications is lowered. Exercise helps keep glucose levels in the blood low and in type 2 diabetics improves the insulin sensitivity of the normal body cells. Exercise and good diet management is also essential in reducing weight gain and minimalizing the effects of cholesterol in independently developing heart disease, peripheral vascular disease and stroke.

If you need help with managing your exercise and don’t know where to start, contact one of our CBD Physio’s to get you started.

Emillie Kinkella

Emillie joined the Bend + Mend team after a move east to Sydney from Bunbury, Western Australia. Emillie graduated from Curtin University with a Bachelor of Science (Physiotherapy) in 2017 and since graduation has had experience in both the public and private settings working in musculoskeletal physiotherapy. She has undergone post graduate training in dry needling, tendinopathy management, lower back pain disorders and Clinical Pilates. Emillie grew up in a soccer orientated family and enjoys treating soccer related injuries sustained both on and off the field, along with lower back pain disorders and tendinopathies. Outside of work Emillie enjoys cooking up a storm and exploring the sights of beautiful Sydney.

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