Diabetes is more than just a metabolic disorder related to the body’s ability to use carbohydrates. It is also a cause of vascular disease affecting nearly all blood vessel types and sizes. Vascular complications are responsible for most of the morbidity, hospitalizations, and death that occur in diabetic patients.
Vascular surgeons like Dr Anupa Ramnarain, a certified vascular and endovascular surgeon treats and teach others about how to deal with complications such as these.
She has also been involved in undergraduate and post graduate vascular teaching and training and is proficient in both open and minimally invasive (endovascular) procedures.
Heart attacks, stroke and DVT
Diabetics are at heightened risk of both adverse microvascular and cardiovascular events. Once cardiovascular disease develops, diabetes seems to make it worse and more difficult to treat. Another looming risk in diabetics is higher incidence of stroke. A longitudinal study of women over more than two decades found that type 1 diabetes mellitus was associated with increased risk of both ischemic and hemorrhagic strokes, while type 2 diabetes mellitus seemed to increase the risk of ischemic stroke but not hemorrhagic stroke.
Blood sugar levels seem to be very important. A recent study suggested that the risk of stroke is increased in diabetic patients with hyperglycemia, but not in those without hyperglycemia. Large randomized-controlled trials have also provided evidence that good metabolic control in both type 1 and 2 diabetes can delay the onset and progression of many complications.
Hyperglycemia or high blood sugar, damages blood vessels through a process called “atherosclerosis”, or clogging of arteries. This narrowing of arteries can lead to decreased blood flow to heart muscle and cause a heart attack. If it leads to decreased blood flow to the brain it can cause a stroke, and if it leads to decreased blood flow to the arms and legs, the extremities, it can lead to pain and decreased healing of infections, which can also end up leading to amputations in some cases.
Risk of amputation
Statistically, the risk of foot ulceration and limb amputation increases with a patient’s age and how long they have been a diabetic. Diabetes is the leading cause of non-traumatic lower extremity amputations, often as a result of the culmination of many years of incidents of high blood sugar.
The damage caused by hyperglycemia is cumulative and can lead to an open sore or wound on the foot of a person with diabetes known as a diabetic foot ulcer. Most commonly located on the bottom of the foot, they occur in approximately 15 percent of all people with diabetes with many needing to be hospitalised due to infection or other complications. Up to a quarter of all diabetic patients developing a foot ulcer will require an amputation.
Dr Anupa Ramnarain, a certified vascular and endovascular surgeon, as well as a member of the VASSA (Vascular Society of South Africa) executive committee has been in the vascular field for 10 years.
As a member of the Durban Vascular Institute, a comprehensive vascular practice located in the heart of Umhlanga at the Busamed Gateway Private Hospital, she performs a wide range of procedures and assists her patients in the evaluation, diagnosis, treatment and management of vascular disease.
Vascular diseases are very common and among the most prevalent medical disorders worldwide. Unfortunately they are a major cause of disability and death as well.
Contact the Dr Ramnarain on 031 4922106 or email [email protected] for more information.