Small-blood-vessel disease (microangiopathy) is responsible for many problems related to the kidneys (nephropathy), to the eyes (retinopathy), and to some degree to the muscle of the heart (cardiomyopathy). (While heart disease is associated mainly with macroangiopathy, some microangiopathy also occurs.)
Kideny Damage (Nephropathy) Nephropathy may be associated with infection of the kidneys, ureters, bladder, or urethra. Infection of the urinary tract is common in people with diabetes because of sugar in the urine and/or because urine may be kept in the bladder as a result of neuropathy. If the infection starts in the bladder and either occurs over and over again or goes up the ureters to the kid, neys, damage to the kidneys may occur. Any damage to the kidneys will eventually result in decreased kidney function. Diabetic nephropathy (damage of the kidney) is often a result of blood, vessel damage, with scarring of the filtration system of the major part of the kidney. This may be caused by thickening (and thus weakening) of membranes in the blood, vessel walls as a result of elevated blood, glucose levels. Bleeding could occur, or protein could leak from these blood vessels. Checking for protein in the urine helps in early detection of renal disease (note, however, that protein in the urine is not always due to kidney damage but can also be due to some other stressor, such as infection or intense exercise). Control of hypertension is extremely important, as is prompt treatment of any urinary tract infection. Where kidney damage has occurred, renal dialysis (washing the blood out through the use of a machine) or, as a last resort, renal transplant now offers hope of improved quality and quantity of life. Improved tissue, matching techniques and new immunosuppression drugs (medicine to keep the recipient from rejecting the transplant) have resulted in more successful transplantation.
