Vascular disease

By age 55, about 35% of men and women with type 1 diabetes have died from a heart attack compared to 8% of nondiabetic men and 4% of nondiabetic women.

People with type 1 diabetes are also at higher risk to develop blockages in the major arteries of the legs than nondiabetics. Lower the risk of vascular disease by aggressively treating cholesterol and blood pressure, exercising regularly, and avoiding or quitting tobacco products.

Microvascular disease

Microvascular (small vessel) changes occur in capillaries of every organ of the body. There is a thickening of the wall of the small blood vessels. These changes are responsible for many of the diabetes complications.

Eye complications

Changes in the small blood vessels of the retina (also known as diabetic retinopathy) predispose the diabetic to several eye disorders. After 15 years of diabetes, 80% of diabetics will have some diabetic retinopathy.

If bleeding and scarring has developed, a retinal detachment may occur, causing blindness. Vascular changes in the iris may cause obstruction of the flow of ocular fluid and cause glaucoma. Diabetics are also more likely than nondiabetics to develop cataracts.

Diabetic nephropathy (kidney disease)

Kidney abnormalities may be noted early in the disease. Poorly controlled diabetes may accelerate the development of kidney failure. Urinary tract infections in diabetics tend to be more severe and may result in kidney damage.

Diabetics are more vulnerable to kidney damage from high blood pressure than nondiabetics.

Diabetic neuropathy(nerve damage)

People with diabetes may develop temporary or permanent damage to nerve tissue. Diabetic neuropathy is more likely to develop if blood glucose is poorly controlled. Some diabetics will not develop neuropathy, while others may develop this condition relatively early.

On average, symptoms such as numbness and tingling occur 10 to 20 years after diabetes has been diagnosed.

Diabetic foot problems

The feet of people with diabetes are very susceptible to infection and injury. Many diabetes-related hospital admissions are for foot problems, and a significant number of non-accident-related leg amputations are performed on diabetics.

Several foot problems are common in people with diabetes, including skin changes (loss of hair; loss of ability to sweat; and dry, cracked skin), arterial insufficiency (impaired blood supply to feet), neuropathy, and specific foot deformities (hallux valgus, bunion, hammertoe, and calluses).

ONCOLOGY

I. What is cancer?

Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these cells to invade other tissues, either by direct growth into adjacent tissue through invasion or by implantation into distant sites by metastasis. Metastasis is defined as the stage in which cancer cells are transported through the bloodstream or lymphatic system. Cancer may affect people at all ages, but risk tends to increase with age, due to the fact that DNA damage becomes more apparent in aging DNA. It is one of the principal causes of death in developed countries.

There are many types of cancer. Severity of symptoms depends on the site and character of the malignancy and whether there is metastasis. A definitive diagnosis usually requires the histologic examination of tissue by a pathologist. This tissue is obtained by biopsy or surgery. Most cancers can be treated and some cured, depending on the specific type, location, and stage. Once diagnosed, cancer is usually treated with a combination of surgery, chemotherapy and radiotherapy. As research develops, treatments are becoming more specific for the type of cancer pathology. Drugs that target specific cancers already exist for several cancers. If untreated, cancers may eventually cause illness and death, though this is not always the case.

The unregulated growth that characterizes cancer is caused by damage to DNA, resulting in mutations to genes that encode for proteins controlling cell division. Many mutation events may be required to transform a normal cell into a malignant cell. These mutations can be caused by chemicals or physical agents called carcinogens, by close exposure to radioactive materials, or by certain viruses that can insert their DNA into the human genome. Mutations occur spontaneously, and may be passed down from one generation to the next as a result of mutations within germ lines.

Many forms of cancer are associated with exposure to environmental factors such as tobacco smoke, radiation, alcohol, and certain viruses. While some of these risk factors can be avoided or reduced, there is no known way to entirely avoid the disease.