Picture of Nirain A. D’Souza, M.D.

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The eyeball itself consists of an outer shell (cornea and sclera), a middle one - vascular and an inner one - the retina.

The retina or "retina" has its own capillary network, which is the target in diabetes. It is represented by arteries, arterioles, veins and capillaries. Symptoms of diabetic angiopathy are divided into clinical (those that the patient presents) and ophthalmoscopic (those that are detected during an ophthalmoscopic examination).

Clinical symptoms Damage to the retinal vessels in diabetes mellitus is painless and almost asymptomatic in the initial stages. Symptoms appear only in the later stages, which is also explained by the late visit to the doctor. If retinopathy is complicated by hemorrhages in the vitreous body, then it is manifested by the presence of dark floating spots in front of the eyes. These spots may then disappear, but vision may be lost forever. Since the vitreous body is normally transparent, the presence of accumulations of blood in it (due to rupture of blood vessels) provokes the appearance of dark spots in the field of view.

If a person did not go to the doctor in time, then strands form between the vitreous body and the retina, whichwhich pull the retina, which leads to buy duphaston online. Retinal detachment is manifested by a sharp decrease in vision (up to blindness), the appearance of flashes and sparks before the eyes. Also, diabetic retinopathy can occur with the development of duphaston edema. In this case, the patient has a feeling of a veil before his eyes, loss of image clarity. A continuous veil before the eyes or a local cloud is the projection site of edema or exudates on the retina.

Ophthalmoscopic symptoms These symptoms are detected during an ophthalmoscopic examination, which consists in visualizing the fundus with an ophthalmoscope and a lens. During this study, the doctor examines the vessels of the retina, the nerve. Symptoms of damage to the retinal vessels appear much earlier than complaints from the patient. At the same time, narrowed arteries are visualized in the fundus, microaneurysms are detected in places. In the central zone or along the large veins, there are a few hemorrhages in the form of dots. Edema is localized along the course of dydrogesterone pills or in the center of the macula. Also, multiple soft exudates (fluid accumulations) are noted on the retina. At the same time, the veins are dilated, filled with a large volume of blood, tortuous, and their contour is clearly defined.

Sometimes in a vitreous body numerous hemorrhages are visible. Subsequently, fibrous strands form between it and the retina. The optic nerve head is pierced by blood vessels (optic neovascularization). As a rule, these symptoms are accompanied by a sharp decrease in vision. Very often, only at this stage, patients who neglect planned medical examinations go to the doctor.

Symptoms of diabetic nephropathy. Diabetic nephropathy is a lesion of the kidney vessels in diabetes mellitus with the further development of renal failure.

The structure of the kidney The functional unit of the kidney is the nephron, which consists of duphaston pills, capsule and tubules. The glomerulus is a collection of many capillaries through which the body's blood flows. From the capillary blood, all waste products of the body are filtered into the tubules, and urine is also formed. If the capillary wall is damaged, this function is impaired.

Symptoms of diabetic nephropathy include complaints from the patient as well as early diagnostic signs. For a very long time, diabetic nephropathy is asymptomatic. The general symptoms of diabetes come to the fore. Vivid clinical manifestations of diabetic nephropathy appear 10-15 years after the diagnosis of diabetes mellitus.

Prior to this, there are only laboratory signs of nephropathy. The main such sign is protein in the urine (or proteinuria), which can be detected during a routine medical examination. Normally, the amount of protein in daily urine should not exceed more than 30 mg. In the initial stages of nephropathy, the amount of protein in the urine per day ranges from 30 to 300 mg. In the later stages, when clinical symptoms appear, the protein concentration exceeds 300 mg per day.

  • The mechanism of formation of this symptom is damage to the renal filter (its permeability increases), as a result of which it first passes small, and then large protein molecules.
  • As the disease progresses, symptoms of renal failure begin to order dydrogesterone pills the general and diagnostic symptoms.
  • The mechanism of edema formation is associated with the loss of proteins in the blood, which are excreted along with the urine.
  • Normally, blood proteins create oncotic pressure, that is, they retain water within the vascular bed. However, with the loss of proteins, the fluid is no longer retained in the vessels and penetrates into the tissues.
Despite the fact that patients with diabetic nephropathy lose weight, they look edematous outwardly, which is due to massive edema.

The mechanism of increasing blood pressure consists of several pathogenetic links.


High blood pressure In advanced stages, patients with diabetic nephropathy have high blood pressure. High blood pressure is considered when the systolic pressure is greater than 140 mmHg and the diastolic pressure is greater than 90 mmHg.

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First of all, it is the retention of water and salts in the body. Secondly, activation of the renin-angiotensin system. Renin is a biologically active substance produced by the kidneys that regulates blood pressure through a complex mechanism. Renin begins to be actively produced when the kidney tissue experiences oxygen starvation. As you know, the capillaries of the kidney in diabetes mellitus are sclerosed, as a result of which the kidney ceases to receive the necessary amount of blood, and with it oxygen.

In response to hypoxia, an excess amount of renin begins to be produced.

It, in turn, activates angiotensin II, which constricts blood vessels and stimulates the secretion of aldosterone. The last two points are key in the development of arterial hypertension.

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