2023 comment1 Diabetes mellitus is characterized by glucose intolerance chronic hyperglycemia and disturbances of

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Diabetes mellitus is characterized by glucose intolerance, chronic hyperglycemia, and disturbances of carbohydrate, protein, and fat metabolism (Huether & Mccance, 2016). Generally, a diagnosis of diabetes mellitus is based on elevated plasma glucose concentrations and measurement of glycosylated hemoglobin (A1C). Genetic susceptibility in combination with other environmental risk factors such as obesity place someone at higher risk for DM II. Obesity contributes to metabolic syndrome, altered adipokines, increased fatty acids, inflammation, and hyperinsulinemia, increasing insulin resistance further (Huether & Mccance, 2016).

Acute complications such as diabetic ketoacidosis and hyperosmolar hyperglycemic nonketotic syndrome are life threatening (in the short term), but not as common as the long-term life-threatening chronic complications of diabetes mellitus. Most long-term complications related to hyperglycemia are sequelae of hyperglycemia on the micro and macro vasculature.

Identify a long-term complication of the vasculature (micro or macro) related to diabetes, the clinical manifestations, and other health concerns they may contribute to.

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According to (Lewis, Bucher, Heitkemper, & Harding, 2017), angiopathy is the leading cause of end organ disease secondary to chronic hyperglycemia. There are several theories as to why these complications exist that include toxic byproducts of high glucose metabolism such as sorbitol, the collection of glucose molecules in the basement membranes of capillaries, and a derangement of red blood cell function (Lewis, Bucher, Heitkemper, & Harding, 2017).  The microvascular complications are related to the thickening of the capillary membranes that result in micro occlusions. The micro occlusions lead to small herniations with swelling that lead to ischemia and tissue damage most commonly to tissues like the retina and the glomeruli of the kidneys (Lewis, Bucher, Heitkemper, & Harding, 2017).