DIABETIC ANGIOPATHY: ALSO KNOWN AS DIABETIC PERIPHERAL ANGIOPATHY (DPA)

Diabetes is a serious condition where the body loses the ability to regulate blood sugar level. Patients suffering from diabetes tend to have elevated blood glucose.

Long term neglect or prolonged periods of elevated sugar levels can lead to a range of associated secondary conditions.

Diabetic angiopathy is one of the most common complications that arise from chronic diabetes. Patients suffering from diabetic angiopathy experience a narrowing in the arteries.

As a result, there is an under-supply of blood and oxygen to different organs and can lead to damage in the long term. Angiopathy is a very serious condition and has debilitating effects on quality of life. It is in the patient’s best interest to seek immediate medical attention.

 

CAUSES & TYPES OF DIABETIC ANGIOPATHY

The main cause of diabetic angiopathy is high blood sugar. If sugar is present in excessive amounts in the blood it can damage cells and tissues. The cells that line the arteries are damaged and the smooth layer of the cell wall called endothelium is compromised.

Rough spots arise along the endothelium and can encourage the build-up of deposits we refer to as plaque. As time progresses, these deposits calcify and become more pronounced, effectively narrowing (stenosis) the artery and hampering natural blood flow.

The bottleneck created results in under-supply of oxygen-rich blood to different organs. Patients can develop various disorders depending on the location of the stenosis and generally have an increased risk of stroke and a heart attack.

Broadly there are two forms of diabetic angiopathy, they are:

• Micro-Angiopathy: Primarily affects the small blood vessels in the kidneys, eyes or nerves. 

• Macro-Angiopathy: Primarily affects the large blood vessels in the brain or the neck as well as the coronary arteries or the large arteries of the legs.

 

DIABETIC PERIPHERAL ANGIOPATHY (DPA) SYMPTOMS

Typical angiopathy symptoms are hard to diagnose since the stenosis can occur almost anywhere in the body and often go unnoticed for a long time. Depending on the location of the narrowing (stenosis) some of the most commonly known symptoms include:

• Micro-angiopathies of the kidney. This involves excreting an unusually high concentration of a certain protein (albumin). Albumin plays an important role in keeping fluids in the bloodstream, so it doesn’t seep into other tissues. Changes in the natural level of albumin secretion can have serious consequences for the circulatory system.

• If the eye is affected, there are no immediate symptoms. In time, there are visual disturbances such as blurred vision and dark spots or veils in the visual field. These are the first signs of retinopathy, which can lead to blindness if the course is severe.

• If vessels in the brain are affected, this can be manifested by problems with concentration or thinking, memory problems, mood swings or depressive moods.

• Angiopathy in larger vessels (macro-angiopathy) can cause a weakened pulse in the early stages as well as cold feet and hands or pain when walking longer distances.

 

DIAGNOSIS OF DIABETIC PERIPHERAL ANGIOPATHY

• A complete patient’s history is crucial to determine pre-existing risk factors of developing diabetic angiopathy.

• Doctors typically run a blood sugar test using a drop of blood to confirm elevated levels of blood sugar as well as the low levels (or absence) of insulin in cases of Type-1 Diabetes and insulin resistance in Type-2 diabetes.

• Doctors can also request a urine sample to test for glucose or chemicals produced in the body as by-products due to the lack of insulin.

• Sophisticated imaging technology like Ultrasound can help detect blockages in the arteries caused by the calcification of plaque and can allow doctors to pinpoint the location of stenoses.

DIABETIC ANGIOPATHY PREVENTION

Optimal blood sugar control is the most important preventive option. Daily blood sugar checks, an adapted diet and a graduated drug therapy to the correct insulin administration helps to keep the blood sugar level below the critical value.

Diabetic training allows patients to deal with their illness competently and in a well-informed manner. A healthy, active lifestyle with regular physical activity is beneficial to improve blood flow, reduce blood pressure and improve the performance of the heart.

 

TREATMENT FOR DIABETIC PERIPHERAL ANGIOPATHY (DPA)

Treatment of angiopathy primarily aims at minimizing the risk factors and a long term goal to regulate blood sugar levels. Regulating the sugar levels can itself act as a major step towards shielding the body from further damage and disease progression. A good treatment path for Diabetic angiopathy include:

• REGULAR INSULIN INJECTIONS

In general, external intake of insulin is required to regulate and maintain healthy levels of blood sugar in the body. Patients suffering from type 1 (little to no insulin production) and type 2 (insulin resistance in the short run, leading to a decrease in the overall production of insulin in the liver) require localized injections to stay healthy.

• LIFESTYLE CHANGES

It is important to make certain lifestyle changes, especially in the case of micro-angiopathy. The blood vessels are too small to seek surgical treatment and thus, alternate methods should be explored. Typically, a healthy diet, avoiding smoking and drinking, regular exercise can help boost blood circulation and improve the supply of oxygen in the affected areas.

• SURGICAL INTERVENTION

In case of macro-angiopathy, there are a few surgical procedures that can be used to alleviate symptoms and provide relief. Some of them include:

• The removal of calcified plaques (lime peeling)

• The dilation of the narrowed vessel using a balloon catheter (balloon catheter dilatation)

• Bypass surgery

• The implantation of a tube (stent) that keeps the narrowed vessel open and thus improves blood flow.

Surgery has significant risks. However, it might be necessary to avoid life-threatening incidents like a stroke or heart attack.

 

SOFT PAD INSOLES: COMFORTABLE FOOTWEAR

In diabetic angiopathy, reduced blood flow to the legs and feet affects wound healing (healing takes longer). Even minor injuries to the feet can lead to chronic wounds and ulcers that do not heal – referred to as the diabetic foot syndrome. Those affected usually do not notice when sores form due to the impaired sensitivity. 

Comfortable footwear with soft inner padding and no pressing seams along with a soft pad inserts, such as that of ErgoPad soft Diabetes, prevents the formation of pressure points and wounds.

The ErgoPad soft diabetes shoe inserts particularly relieve the critical areas on the heel and the big toe joint, which are particularly stressed during movement. The insole helps prevent the development of diabetic foot syndrome.

Regular use of a soft insole can greatly improve the quality of life of a patient and can effectively shield them from further damage and risk of infection (sepsis) and is highly recommended for a healthy prognosis.

Additionally, we recommend wearing the ViscoPed Foot Orthosis. This shoe insole is able to fit in most shoes without modification,

The ViscoPed has long soles, meaning they cushion the entire sole of the foot. The forefront and heel also have pressure relief zones which redistribute typical pressure peaks across the wider surface of the foot for relief.

The viscoelastic material is shock-absorbing, allowing your knee, hip and spine joints to be protected.