Diseases and problems associated with impaired microcirculation

Metabolic diseases such as diabetes mellitus

diabetes

About 10 % of the world population suffer from diabetes mellitus. The main cause is an unhealthy lifestyle: improper diet, overweight and lack of exercise.

Diabetes mellitus is a disorder of sugar metabolism. The blood sugar level is regulated mainly by the hormone insulin. If the amount of insulin produced is insufficient (type 1 diabetes), or if the effect of insulin is reduced (type 2 diabetes), blood sugar levels are chronically elevated. After some time, this results in significant damage to blood vessels. The term used for this is therefore diabetic angiopathy. If larger blood vessels are affected, the risk of heart attack and stroke is increased. The microvascular changes caused by diabetes can also cause serious complications.

Impaired microcirculation in patients with diabetes mellitus

Among the most feared long-term consequences of diabetic angiopathy are damage to the eyes (diabetic retinopathy), the kidneys (diabetic nephropathy) and the nerves (diabetic neuropathy).

Diabetic retinopathy is the main cause of blindness in middle age in Germany and other industrialized countries. The retina is supplied with nutrients and oxygen through very fine microvessels. Over time, diabetes can damage the microvessels so that this supply is no longer sufficient. Affected persons at first see everything blurred, as though through a veil. In advanced stages, pronounced vision disorders and even blindness may develop.

According to estimates by the German Diabetes Society, 20 to 40 percent of diabetics suffer kidney damage in the course of their disease. One of the tasks of the kidneys is to filter toxins and waste products out of the blood so they can be excreted in the urine. This work is done via tiny blood vessels in the renal corpuscles. Persistently high blood sugar levels damage these microvessels.

As a result, the filtering capacity of the kidney is reduced and the body is no longer sufficiently detoxified. If left untreated, this can lead to chronic renal failure so that renal functions must be replaced by dialysis or a kidney transplant.

Approximately 30 percent of diabetes patients suffer nerve damage. One cause of this is impaired nerve cell metabolism due to high blood sugar levels. Another factor is reduced oxygen supply to the nerve cells due to the damaged microvessels supplying them. The most evident consequences are abnormal sensations like tingling, burning pain or numbness, especially in the hands and feet. In addition, tactile and temperature sensations, as well as pain perception, may be reduced. This latter factor favours the development of diabetic foot syndrome since wounds are not noticed in early stages and - also due to impaired microcirculation – heal poorly.

Long-term damage resulting from impaired microcirculation in patients with Diabetes mellitus

  • Damage to eyes (diabetic retinopathy) with vision impairments
  • Damage to renal function (diabetic nephropathy), possibly mandatory dialysis
  • Nerve damage (diabetic neuropathy) with abnormal sensations and impaired pain perception
  • Impaired wound healing (diabetic foot syndrome)

Wound healing disorders

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Impaired wound healing often involves several factors. Blood vessel and nerve damage, e.g. caused by diabetes mellitus, are among the most common causes of wound healing disorder.

A healthy body can renew or replace injured tissues and close wounds. A wound that still shows no healing tendency after about four weeks is considered to be a chronic wound.

Impaired microcirculation in wound healing disorders

For the natural healing process to proceed smoothly, the damaged tissue must be amply supplied with nutrients and oxygen. Circulatory disorders, especially in the small blood vessels, delay and hinder the healing process. Chronic wounds are often the result of a lack of blood supply in patients with diabetes mellitus, diseases of the blood vessels or pressure sores (decubitus) in bedridden patients.

 

 

Peripheral arterial occlusive disease (PAOD)

Peripheral arterial occlusive disease affects the larger blood vessels that supply our extremities. In most cases the legs are affected, less frequently the arms. The cause is arteriosclerosis, which leads to narrowing of the vessels (vasoconstriction).

Impaired microcirculation in PAOD

Due to the vasoconstriction, blood supply to the muscles is reduced. The microcirculation in the muscle tissue is no longer able to supply the cells optimally. When the muscles are stressed, e.g. when walking, the oxygen supply is eventually insufficient. The undersupplied leg becomes weak and hurts. In later stages, the pain occurs even on very short walks as well as at rest.

Delayed regeneration, weakened immune system

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In order to stay strong and healthy, energy reserves must be replenished following physical or mental exertion.

After any physical effort, including disease and injuries as well as after physical activity and mental work, our body requires a recovery phase. Both metabolism and reaction processes change under such stress. The supply requirements of the stressed body cells increase – more nutrients and oxygen are needed. At the same time, more metabolic products are produced that need to be removed. The subsequent regeneration period is used to replenish the store of nutrients and recover metabolic balance.

Importance of microcirculation for regeneration

The most important part of supplying the cells and removing waste products takes place via the microvessels. Consequently, microcirculation disorders affect the process of regeneration.

This means that supply to the affected tissue cells is delayed or cannot meet requirements. In the long term, this means a downturn in overall performance capability. The body needs more time to recover after exertions, we recover more slowly, feel exhausted more quickly and are more susceptible to illnesses.

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