Type Of Diabetes

It is not clear yet if people with type 1.5 have the same high risk for cardiovascular problems as individuals with type 2.

According to the "Rotterdam Study" reported in the journal Neurology, diabetes mellitus may not only damage the function of the eyes, limbs, kidneys, and heart – it may also impair the function of the brain and hasten the process of senile dementia.

The Rotterdam Study is a large, ongoing prospective analysis which tracked dysglycemia and dementia in over 6,000 individuals over age 55.  The researchers found that diabetes mellitus nearly doubles the risk of developing both vascular dementia and Alzheimer's disease.  Diagnosis of diabetes was based on World Health Organization criteria using a glucose tolerance test.

A related editorial called Alzheimer's a possible "brain-type diabetes".  Besides damaging important blood vessel networks and increasing the risk of small "silent" strokes deep inside the brain, dysglycemia may be directly involved in the development of the neurofibrillary tangles, the clumping of nerves and fiber tissue inside the brain characteristic of Alzheimer's.

The researchers noted that advanced glycation end products (AGE), proteins damaged by chronically high blood sugar levels, are commonly found inside these tangles.  "In brains of AD patients the receptor for AGE appears overexpressed," they noted.  "Activation of this receptor leads to increased oxidative stress that may result in cellular damage."

Diabetes also disrupts insulin signaling to other cells in the body.  This altered signaling may increase the activity of a neuronal enzyme that stimulates phosphorylated tau proteins to build up, a key trigger mechanism cited as one of the earliest signs of Alzheimer's.

NOTE: This study strongly suggests the important potential role of glycation products and insulin response, not just glucose levels, in causing degenerative disease.

Relatives of people with Type 1 Diabetes, as well as the sufferers themselves, run a risk of developing celiac disease.  The resulting inflammation and tissue damage reduces vitamin B12 absorption and may lead to Pernicious anemia, which occurs in approximately 1 in 50 adults with Type 1 Diabetes.

Diabetic retinopathy will occur in 90% of persons with type 1 diabetes.

People with diabetes have been reported to be at increased risk of being diagnosed with DCM.

Type II diabetes mellitus is the leading cause of chronic kidney disease, accounting for 35% of the new cases each year and 25% of all cases in the U.S.

Hypomagnesemia has been demonstrated in both insulin-dependent and non-insulin-dependent diabetic patients.  A low intake of magnesium, which is a common deficiency, has been associated with insulin resistance and diabetes in several studies.  Magnesium deficiency in diabetes is most likely the result of increased urinary magnesium losses secondary to chronic glycosuria.  However, short-term improvement in glycemic control has not been shown to restore the serum magnesium level.  Long-term studies may be needed to resolve this discrepancy.

Diabetes is a risk factor for the development of pneumonia.

Up to 50% of all people with leg artery disease have diabetes; for them, controlling both conditions is crucial.  Diabetes increases your risk for leg artery disease fourfold, and accounts for nearly half of all amputations in the U.S. that aren't related to accidents.

Diabetes makes hardening of the arteries much more dangerous (especially in the feet and toes) through several different mechanisms, and it's still not fully understood which ones matter most.  People with diabetes are prone to nerve damage in the legs and feet, which means they often may overlook minor injuries.  This, combined with poor circulation that slows wound healing, can cause small wounds to develop into more serious infections.  Diabetes also makes people more likely to develop blockages in smaller vessels far from the heart, and those blockages tend to be more widespread and harder to treat.

Cardiovascular disease is the leading cause of diabetes-related death.  People with diabetes are two to four times more likely to develop cardiovascular disease.  At least 65% of people with diabetes die from heart disease or stroke.

If you are diabetic, you are at higher risk of developing infections, including periodontal diseases.  These infections can in turn impair the body's ability to process and/or utilize insulin, creating a vicious circle in which your diabetes may be more difficult to control and your infection more severe than in a non-diabetic. [Journal of Periodontology November 1999]