These substances are no longer excreted by the kidneys and accumulate in the body. The accumulation of urea in the body gives patients with diabetic nephropathy a specific smell. However, the most dangerous is the accumulation of toxic ammonia in the body. It easily penetrates the central nervous system and damages it. Symptoms of diabetic angiopathy with damage to the capillaries and coronary arteries of the heart.
The structure of the heart The heart is a muscular organ, each cell of which must constantly receive oxygen and nutrients. This is provided by an extensive capillary network and coronary arteries of the heart. The heart has two coronary arteries - the right and left, which are affected by atherosclerosis in diabetes mellitus. This process is called diabetic macroangiopathy. Damage to the capillary network of the heart is called diabetic microangiopathy. Between the capillaries and muscle tissue there is an exchange of blood, and with it oxygen. Therefore, when they are damaged, the muscle tissue of the heart suffers.
In diabetes mellitus, both small capillaries (with the development of microangiopathy) and coronary arteries (with the development of macroangiopathy) can be affected in the heart. In both cases, symptoms of angina pectoris develop. The mechanism of pain is hypoxia of the heart. In diabetes mellitus, atherosclerotic phenomena are noted in the coronary vessels of the heart. At the same time, plaques and stripes are deposited on the vessels, which narrow their lumen. As a result, a much smaller volume of blood supplies the heart muscle. The heart begins to lack oxygen. Under conditions of oxygen starvation, anaerobic (oxygen-free) breakdown of glucose is activated with the formation of lactic acid. Lactic acid, being a strong irritant, irritates the nerve endings of the heart, which is clinically expressed in pain.
Violation of the heart rhythm With the defeat of the small vessels of the heart and their sclerosis in the myocardium, changes specific to diabetes mellitus develop, which are called diabetic myocardial dystrophy. At the same time, not only damage to the capillary network is detected in the heart, but also changes in muscle fibers, proliferation of connective tissue, and microaneurysms. Due to dystrophic changes in the myocardium itself, various cardiac arrhythmias occur.
Signs of heart failure Heart failure develops due to damage to both the heart muscle itself (microangiopathy) and due to damage to the coronary arteries (macroangiopathy). The main signs of heart failure are shortness of breath, coughing, and a drop in stroke volume. As a result of damage to the heart muscle and its vessels, the heart loses its ability to fully contract and provide the body with blood. Falls stroke and minute volume of the heart. At the same time, stagnation of venous blood is noted in the lungs, which is the cause of shortness of breath. In the future, fluid accumulates in them, which causes coughing.
Damage to the heart vessels in diabetes mellitus can be isolated, but most often it is combined with damage to the kidneys, retina, and vessels of the lower extremities. Diabetic angiopathy of the lower extremities. Symptoms of diabetic angiopathy of the lower extremities are due to both diabetes-specific changes and the atherosclerotic process in them. The mechanism of development of these symptoms is primarily due to insufficient blood supply to the tissues, as well as nerve damage. Cold, chilliness in the legs are due to poor blood circulation, especially during prolonged physical exertion. Goosebumps, burning sensation, numbness are caused by damage to the peripheral nerves (diabetic neuropathy), as well as vasospasm.
Pain, leg cramps and intermittent claudication Pain develops when the leg muscles begin to experience a lack of oxygen for a long time.
This is due to a significant narrowing of the lumen of the blood vessel and a decrease in blood flow in them. Initially, the pain occurs when walking, which forces the person to stop. These transient pains are called intermittent lameness. It is accompanied by a feeling of tension, heaviness in the legs. After a forced stop, the pain goes away.
They are caused by a low concentration of potassium in the body. Hypokalemia develops in diabetes mellitus due to frequent urination, as potassium is rapidly excreted in the urine.
Sometimes the skin becomes bluish. Nails slow down their growth, deform, become thick and brittle. Changes develop due to prolonged malnutrition of tissues, since blood supplies tissues not onlyonly oxygen, but also various nutrients. The tissue, not receiving the necessary substances, begins to atrophy. So, in people with diabetic angiopathy, subcutaneous fatty tissue most often atrophies.
Their development is associated with reduced tissue resistance, general and local decrease in immunity. Most often they develop against the background of partial obliteration of the vessel.