… and is very likely to progress to gangrene and eventually an amputation.
PS: This has happened to a loved one.
In: 18
Type II diabetes in particular causes a certain amount of immune suppression.
Further complicating this is that it also causes poor circulation and neuropathy (reduced nerve sensation) in extremities like hands and feet so that diabetics often don’t feel small wounds and may not clean and dress them properly because they’re unaware they have them, so a small problem often isn’t noticed until it’s already become a big problem.
Stuff with energy in it can cause damage when it goes wrong; with cars we burn things with air to get power. Combining with air goes wrong sometimes and makes metal go rusty – it gets damaged by the energetic bits in the air around it.
In bodies, sugar has the energy to keep us alive, and the risk that parts can get damaged by combining with sugar in unwanted ways.
When we eat, sugar from food goes into our blood so it can be carried around to all the muscles which need it. Diabetics can’t get the sugar out of the blood. Type 1 diabetics can’t send the dinner gong signals the muscles are looking for, and type 2 diabetics have muscles which no longer listen. so sugar hangs around too long in the blood and then the blood tubes get damaged by it.
Near the heart, lots of blood moves in large tubes, at the fingers and toes tiny amounts of blood moves in tiny tubes, so as damage happens the tiny tubes in toes clog up first.
Without good blood flow, nutrients and repair things can’t get to the cuts very well. healing and fighting infection can’t happen properly.
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Non ELI5 quote:
> Nevertheless, the increased amount and duration of glucose in the blood allows more glycosylation [combining with sugar] to occur[…] The excessive cleavage of glucose, especially with important protein amino groups, can affect cell function and structure and create an inbalance which leads to cell destabilization.[iii] [iv]
> This condition seems to target organs and tissues that are not dependent on insulin for their absorption of glucose. Kidneys, blood vessels, peripheral nerves and lenses of the eye are more susceptible to damage from periods of hyperglycemia than other organs due to their lack of insulin dependence.
– https://www.diabetesincontrol.com/glycosylation/
When big muscles aren’t taking sugar (glucose) out of the blood, these things are damaged by the sugar hanging around for long times.
A few reasons.
First, diabetes damages the nerves in the hands and feet, so people with bad diabetes can’t always feel when they get a cut. When you don’t know you have a cut, you don’t take proper precautions, like washing the cut, covering it, and keeping it clean, so it’s more likely to get infected.
Also, diabetes does a number on your blood vessels. Normally, when you get an injury, your body sends white blood cells and “healing fluids” to the cut to fight off any invading germs and promote healing. When your blood vessels are damaged, that process is much less effective.
The combination of increased risk of infection and decreased ability to heal from that infection can lead to tissue death and ultimately amputation.
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