Pathology

Diabetes Aneurysm



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One of the more serious complications that can arise from diabetes is an aneurysm, or bulge in a major blood vessel caused by weakening in the blood vessel wall. While most small aneurysms in non-diabetics resolve on their own, large aneurysms and aneurysms in certain parts of the body can be life-threatening and always require medical intervention.

An aneurysm forms when a bulge occurs in a blood vessel and fills with blood. Although aneurysms most often occur in the neck and head, they can be found in any part of the body. Small aneurysms, defined as being less than 2 centimetres (0.7 inches) long, typically provoke clotting in the blood and heal without significant intervention other than perhaps the prescription of blood-pressure-lowering drugs. A larger aneurysm (over 0.7 inches long), may, however, rupture, causing internal bleeding, which can lead to significant blood loss and potential death.

Diabetes promotes the formation of aneurysms by being partly or wholly responsible for atherosclerosis, which is the buildup of plaque on the inside of artery walls. Plaque consists of cholesterol deposits and weakens the artery, causing it to potentially bulge out. Uncontrolled diabetes, where the diabetic's sugar and cholesterol levels are too high or fluctuate wildly, is an especially frequent promoter of atherosclerosis and therefore aneurysms.

Diabetics can get aneurysms nearly anywhere in the body. The life-threatening ones are in the carotid artery in the neck and head and the aortic artery in the chest and abdomen. Carotid aneurysms often present no symptoms, and a diabetic suffering from a carotid aneurysm may not know about it until it has burst. Chest and abdominal aneurysms are usually accompanied by chest and abdominal pain, shortness of breath, and weakness, and some diabetics suffering from them may experience behavioral issues.

One non-life-threateningtype of aneurysm that occurs frequently in diabetics is on the underside of the knee. Diabetics may also experience venous aneurysms, which occur in veins carrying blood back to the heart instead of arteries carrying blood toward it.

Screening for an aneurysm includes several types of blood test and, in the case of abdominal aneurysms, palpation. Treatment may include monitoring, administration of blood pressure-lowering drugs, or surgery. The surgery used to be major, but in recent years doctors have developed microsurgery techniques in which they insert a long wire into an artery at the groin and run it up to the site of the aneurysm. Attached to the end of the wire are a tiny camera and tiny surgical tools. This nearly noninvasive procedure carries a greater risk than the more invasive, older techniques the risk that the aneurysm will recur within two years, but recovery time from surgery is usually much faster.

To minimize the chance of aneurysms, it is important that someone suffering from diabetes control her blood sugar and cholesterol levels.

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