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How can diabetes mellitus lead to blindness, kidney failure, and nerve damage?
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diabetes mellitus
The islets of Langerhans are responsible for the endocrine function of the pancreas. Each islet contains beta, alpha, delta, and pancreatic polypeptide (PP) cells that are responsible for the secretion of pancreatic hormones. Beta cells secrete insulin, a well-characterized hormone that plays an important role in regulating glucose metabolism.
Diabetes mellitus causes long-term complications primarily through damage to blood vessels and nerves, often driven by chronic hyperglycemia.12
Mechanisms of Damage
- Blindness: High blood glucose damages the small blood vessels in the retina, a condition known as diabetic retinopathy. These vessels may leak fluid or become obstructed, leading to ischemia. In advanced stages, the growth of fragile, abnormal blood vessels can cause hemorrhage, retinal detachment, and glaucoma, all of which can result in vision loss.134
- Kidney Failure: Diabetic nephropathy occurs when high blood sugar and hypertension damage the kidneys' functional units, the nephrons. This damage impairs the kidneys' ability to filter waste from the blood, eventually progressing to end-stage renal disease and kidney failure.52
- Nerve Damage: Diabetic neuropathy can result from the glycosylation of nervous tissue, the accumulation of glucose metabolites, or damage to the small vessels supplying nerves. This leads to symptoms ranging from numbness and tingling to muscle weakness and autonomic dysfunction.1
These complications are often managed by controlling blood glucose levels, blood pressure, and lipid concentrations.15