What are the symptoms of diabetic vascular disease?

Patients with diabetes will actually develop many diseases in their bodies if they do not receive regular treatment or improper care. It is also possible for diabetic patients to develop vascular lesions. The main sites of vascular lesions are the kidneys, skin, and retina, and the skin is affected throughout the body. For the treatment of diabetes, in addition to regular check-ups, patients also need to adjust their diet, control their sugar intake, and have a good work and rest schedule, so that they can take good care of the disease. Diabetes will cause many changes, so even if vascular disease occurs, patients should not be too nervous and should receive corresponding treatment in a timely manner.

Classification of diabetic vascular disease

1. Diabetes complicated by large vessel disease: Diabetic patients are more likely to develop atherosclerosis than normal people, and it develops rapidly, leading to coronary heart disease, cerebrovascular accident and lower limb gangrene. It is reported that 20% of patients who had peripheral vascular disease in the past were found to have diabetes, and the incidence of intermittent claudication, muscle and skin atrophy, and lower limb gangrene in diabetic patients was also higher than that in normal people. Therefore, patients confirmed to have peripheral vascular disease should be further examined to see if they have diabetes. It is currently believed that the occurrence of macrovascular disease is related to the patient's age, the course of diabetes and the degree of diabetes control.

2. Diabetic microvascular disease: The main sites of microvascular disease in diabetic patients are the microvessels in the retina, kidneys, skin, etc. The main pathological changes are the thickening of the capillary basement membrane. Retinal microvascular disease is common in patients with juvenile-onset diabetes and is the main cause of blindness in the future. Diabetic nephropathy often coexists with diabetic retinopathy and diabetic neuropathy. Diabetic skin microvascular disease can be seen in any part of the body, but it is more common to involve the skin microvessels in the anterior tibia and feet of the lower limbs, resulting in local cyanosis and skin ischemic ulcers. The ulcer is superficial and painful, with good dorsalis pedis artery pulsation.

Symptoms and Signs

(1) Hypertension may cause dizziness and headache, but some patients are asymptomatic and are only discovered during physical examination. However, other causes of high blood pressure should be ruled out, such as pheochromocytoma, primary aldosteronism, hypercortisolism, glomerulonephritis, etc.

(ii) Cardiac symptoms may include chest tightness, shortness of breath after activity, angina pectoris, and in severe cases, heart failure, myocardial infarction, arrhythmia, and even sudden death. The heart border may be enlarged, the heart rate may increase or become fixed, the heart sounds may be low and dull, and symptoms of heart failure may appear: distension of the jugular veins, orthopnea, cyanosis of the lips, hepatosplenomegaly, and lower limb edema.

(3) The brain may have localizing signs such as aphasia, mental changes, limb paralysis, etc., and accompanied by brain atrophy, it may manifest as decreased intelligence, poor memory, slow reaction, etc. Cerebrovascular diseases may present with localizing signs and changes in mental status.

(iv) The lower limbs may experience coldness, weakness, drowsiness, inability to walk for long periods of time, and increased fatigue when walking, which disappears after resting for 2 to 3 minutes. Intermittent claudication may occur later. After walking for a while, there is soreness and cramping pain in the calf gastrocnemius and feet. If you continue walking, the disease will get worse, and you will be forced to stop, or the pain will be relieved after a short rest. As the disease progresses, rest pain and limb pain may occur, which may persist or intermittently worsen when the patient is resting. In severe cases, persistent pain and paresthesia may occur during the night and day. The skin temperature of the affected lower limbs may decrease, the skin color may change, the arterial pulsation may weaken or disappear, and the lower limbs may ulcerate and necrotize.