Caused by high levels of glucose in the blood, due to lack of the hormone insulin, diabetes is one of the diseases that most affects the population in the world. According to data from the National Diabetes Federation, in 2021, the number of people with the disease increased by about 74 million, totaling about 537 million adults. In Brazil, research indicates that 7% of the population lives with the problem and, although the application of insulin is a nuisance for many, Dr. Marcella Garcez, director and professor of the Brazilian Association of Nutrology (ABRAN), explains that it is essential to regulate blood sugar levels.
“The main function of insulin is to promote the entry of glucose into the cells of the body so that it can be used in various cellular activities. A lack of insulin, or a defect in its action, therefore results in a buildup of glucose in the blood, which we call hyperglycemia. The condition, when not controlled, can have negative consequences for vision, kidneys, heart, nerves and lower limbs, in addition to causing dehydration, difficulty healing and respiratory complications”, explains the nutrologist doctor.
Below, doctors explain what are the 7 main complications caused by the disease.
1. Envelhecimento precoce da pele
As dermatologist Dr. Mônica Aribi, effective partner of the Brazilian Society of Dermatology, explains, type 2 diabetes can accelerate skin aging when not treated correctly. “That’s because sugar can bind to proteins like elastin and collagen and destabilize those proteins by a process called glycation. As these proteins are responsible for the support and elasticity of the skin, this process disrupts this tissue and, with it, we have premature aging”.
2. Hair loss
For hair loss, the disease acts differently from the way it interferes with the skin, according to Dr. Monica Aribi. “It unbalances the metabolism and, with it, all the physiological mechanisms of the organism. And an organism that does not work well does not have a perfect vascularization and, consequently, has little nutrition in the tissues, including the scalp, which can cause hair loss”.
3. Slow healing
Excess glucose can react with any protein, lipids and even our DNA, according to plastic surgeon Dr. Beatriz Lassance, a full member of the Brazilian Society of Plastic Surgery. “And that disrupts the functioning of these molecules. When we have a healing process, an orchestra of reactions is necessary for the tissues to reorganize and repair that trauma suffered. This happens in any surgery” ” he says.
In the case of diabetes, the doctor explains that high blood glucose levels interfere with the process of organizing molecules. “In diabetes, if not well controlled, we have chronically excess glucose circulating through the body, many glycated molecules and difficulty in healing. Immunity cells may be compromised, increasing the risk of infection, skin cells work more slowly, altered collagen does not allow proper wound closure.
4. Vascular problems
Diabetes can cause damage directly to the wall of blood vessels. “This damage can arise from increased cholesterol buildup, called atherosclerosis, or from a process called protein glycation, in which the sugar present in the blood will cause inflammatory damage to the vessel wall. These lesions can occur in vessels of different calibers and locations, which can cause damage to various organs,” says vascular surgeon Dr. Aline Lamaita, member of the Brazilian Society of Angiology and Vascular Surgery.
Among the damage caused by the disease to the vessels, the doctor lists: “the first would be the occlusion of very small vessels, called microangiopathy, which can lead to a lack of circulation in the retina, leading to blindness. Macroangiopathy, on the other hand, would be in the wall of the most calibrated vessels, which can cause infarction, stroke and circulatory changes in the legs, which can be an important cause of amputation and difficulty walking. Both macro-and microangiopathy can be regularized with adequate blood glucose control.”
According to Dr. Rodrigo Rosa, a specialist in Human Reproduction, decompensated diabetes can be a cause of infertility, increased risk of abortion and obstetric complications with a higher incidence of preeclampsia. It also states that other risks involve premature birth and dystocias (any disturbance in the proper course of labor), with a higher risk of macrosomia (weight greater than 4 kg at birth) and with a higher risk of hypoglycemia for the baby at birth.
“Diabetes controlled with medication or with insulin, when glycated hemoglobin is at adequate levels, has little relation to infertility. And it also depends on the cause of diabetes, if it is a genetic endocrinopathy, since adolescence, which is Type 1, or a diabetes related to lifestyle habits, lifestyle, when associated with obesity, hypertension, for example, then, yes, there is a greater risk of correlation of diabetes with infertility, but for multiple factors”.
6. Kidney problems
Nephrologist and intensivist Dr. Caroline Reigada, also an expert in Internal Medicine, explains that diabetes is an extremely inflammatory disease, in which the exaggerated amount of glucose in the blood is capable of provoking hyperfiltration of the blood in the kidneys (the so-called glomerular hyperfiltration).
In addition, the expert explains that kidneys, organs of filtration, contain precisely many spider veins, especially within the structures known as glomeruli, which are the true filters of the blood. “The glomeruli can be greatly impaired by diabetes. When this occurs, the patient begins to lose protein in the urine, clinically corresponding to the appearance of foam in the urine, increased blood pressure and edema (swelling).
7. Oral complications
According to Prof. Dr. Mario Sergio Giorgi, homeopathic dental surgeon and member of the Brazilian halitosis Association (ABHA), people who have this disease can have oral repercussions. This is because such individuals are at high risk for developing oral problems such as gingivitis and periodontitis. This, in turn, can evolve, compromising general health, since these diseases can alter the glycemic level (blood sugar level), causing healing problems and other changes that increase the likelihood of infectious processes.
“So, to prevent these oral diseases, the dental surgeon needs to institute an individualized oral health promotion protocol by adopting an effective yet gentle oral hygiene technique. There are differentiated toothbrushes that meet these needs, with Curen bristles […]” ”