Medical Director, Katahdin Valley Health Center
Everyone would probably love to find a “fountain of youth” sometime in their lives, but for those who have diabetes, or have the potential for this disorder (being overweight, especially around the middle or have a strong family history of diabetes in one or more first degree relatives), the exact opposite is what is probably going on in your insides.
Those with diabetes have the potential to age much more quickly than a non-diabetic would. Rather than write on this topic with particulars, I’d like anyone with this metabolic disorder to know that by keeping a broad perspective on the “do’s and don’ts”, you can achieve the equivalent of finding the “fountain of youth”.
The reason that diabetes is such a malady is that higher concentrations of blood sugar damage the inside lining of our blood vessels. The smaller vessels would go first, then the larger.
The reason to have your eyes checked, the sensation in your feet questioned, or examined for ulcers, as well as having your kidney function tested periodically, is to assess the actual damage TO BLOOD VESSELS that may have already occurred. The eye affords a direct view to the blood vessels of the retina; the foot exam checks for the function of small sensory nerves of the feet that are supplied by the smallest of blood vessels, the capillaries; and kidney function is tested in a number of ways in order to assess whether the tangle of blood vessels that make up each filtration unit (the nephron) is working properly.
Damaged vascular tissue leads to vessels that don’t supply and transport blood properly. They first become leaky, then they just plug up with these small blood clots and just don’t work any more. When it happens to a small number of blood vessels in one place, such as in a bruise, there’s chance for recovery. This is especially true when there are no further insults.
With diabetes that is not controlled, the process of blood vessels becoming damaged does so continually, and first at the outer limits of our circulation, where our smallest capillaries are, then as the process continues, ever-larger blood vessels become similarly involved.
Once the arterioles are involved, small plaques of cholesterol may further add to the miserable situation of poor blood supply. Add smoking to the situation and the process becomes catastrophic. Blood supply to vital tissues of our bodies becomes increasingly compromised, and the organ, being brain and other nerve tissue, heart, kidney, and skin, begins to learn how to make compromises with the lower oxygen environment, and slowly the tissue becomes more acidic, and tissue function falls. It’s a predictable outcome in most cases.
Diabetics in poor control have very high rates of stroke and heart attack, not to mention having much poorer kidney function, worse eye sight, and delayed wound healing capabilities. All of this is due to poor blood (and oxygen) supply, and can be appreciated for being worse when smoking and high cholesterol are added to the picture. A diabetic has as much chance for a first heart attack as a person with known heart disease does, as just one statistic. This does not take into account whether the patient smokes or also has high cholesterol.
If so, BEWARE! When those factors are also involved, the patient has the equivalent of a metabolic train wreck happening in slow motion. This is what leads to premature aging, and now is easy to see.
Diabetic patients who let their diets and exercise routine go by the wayside, and allow their blood sugars to become more elevated, are aging their blood vessels accordingly, and thereby becoming much older than they really are. Most of the damage that is done in this way is irreversible, just as you would expect aging itself, to be irreversible.
Unless committed steps are taken to keep blood sugars down, especially two hours following meals, for those that do blood sugar monitoring (goal is less than 130), the process of premature aging, is under way. There may not be a fountain of youth in your life, but it would sure help knowing how not to take a drink from the fountain of accelerated aging, as the next best thing.
In good health.
Dr. Sardina is the Medical Director at Katahdin Valley Health Center, with health care clinics in Millinocket, Patten, Island Falls and Houlton. November is American Diabetes Month; for more information about diabetes, go to www.diabetes.org.
