For most humans, the ability of blood to clot is vital.
If it couldn’t, then even a small cut could mean bleeding to death.
Simply put, blood clotting (or thrombus) involves a mass of protein fibers that trap lymph and red blood cells, eventually hardening into a cap (generally called a scab) that protects the damaged area.
The clotting reaction is thought to be platelets in the area of a cut releasing chemicals into the bloodstream, starting the formation of a clot through a series of enzyme-controlled reactions.
What is the connection between blood clotting, arteries, and diabetes?
According to the American Heart Association, diabetes increases the risk of plaque buildup in the arteries, which can cause blood clots. In fact, some studies indicated that a very high percentage of people who have diabetes will eventually die of clot-related causes.
DIABETES, BLOOD CHOLESTEROL, AND TRIGLYCERIDES
What is blood cholesterol?
Blood cholesterol (or serum blood cholesterol) is a waxy, fatlike substance. Cholesterol is found in all the cells of the human body and helps to maintain the strength and flexibility of the cell membranes (thin layers of the cell). Cholesterol is obtained from food and is also naturally produced by the body. Humans need some cholesterol, but if found in excess levels in the body, cholesterol can often result in an increase in certain diseases, especially heart problems.
Why is there a connection between cardiovascular disease and diabetes?
At this writing, researchers really do not know why there is such a strong relationship between diabetes and cardiovascular disease. This is because the majority of people with diabetes also have other heart disease risk factors, such as high blood pressure, high triglycerides, and obesity (some researchers would add higher levels of LDL, the “bad” cholesterol, and lower levels of HDL, the “good” cholesterol, to the list). But currently, many scientists are debating just how “bad” and “good” the two types of cholesterol are for people and just how much is detrimental.
HDLs are the cholesterols in your blood that help prevent clotting, while LDLs can create blockage.
What are the so-called “good and bad cholesterols”?
There are, according to doctors, “good” and “bad” elements in the human body that can affect the body’s healthy balance, especially in the circulatory system (or in other words, the heart and blood). In particular, if too much LDL, or low-density lipoprotein, often called the “bad” cholesterol, (although it is not a cholesterol; see sidebar) circulates in the blood, it can create a buildup of what is called plaque on the inner walls of the arteries that feed the heart and brain. This in turn can cause the arteries to narrow and become less flexible (in excess, such plaque buildup is called atherosclerosis).
HDL, or what is often called the “good” cholesterol (although, again, it is not a cholesterol) or high-density lipoprotein, is thought to protect the body against heart attacks by carrying blood cholesterol away from the arteries and to the liver, where it is passed from the body.
In addition, it may even slow plaque buildup.
Yet another player in the body’s cholesterol levels is Lp(a), a genetic variation of LDL cholesterol.
In particular, a high level of Lp(a) may be a high risk factor for the premature formation of fatty deposits in the arteries.
Although not much is known about Lp(a) at this time, it may be connected to the buildup of fatty deposits.
What are the suggested cholesterol levels for an adult?
Many factors affect our bodies, and one of them has to do with our cholesterol levels, especially in terms of the heart. The following, from the American Heart Association, lists what is currently thought to be the best cholesterol levels for an adult:
Cholesterol Level Guidelines
Total Cholesterol Level
Category
Less than 200 mg/dL
Desirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dL or higher raises your risk.
200 to 239 mg/dL
Borderline high
240 mg/dL and above
High blood cholesterol. A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL.
Why are terms “HDL cholesterol” and “LDL cholesterol” often confusing?
T he terms “HDL and LDL cholesterols” are often misnomers.
This is because, although they are associated with cholesterol, they are truly not types of cholesterol.
In reality, both are fat, protein compounds that transport cholesterol though the blood and thus throughout the body.
HDL tends to carry blood cholesterol away from the arteries, and LDL tends to deposit cholesterol on the artery walls.
One of the main problems with these terms is easy to see: When the blood cholesterol is attached to a lipoprotein, either HDL or LDL, the entire complex can be referred to as HDL and LDL cholesterol.
What is the connection between atherosclerosis and diabetes?
Atherosclerosis occurs when lipids, particularly cholesterol, build up on the side arterial walls. Risk factors for atherosclerosis include cigarette smoking, a high-fat/high-cholesterol diet, and hypertension. For people who have either type 1 or type 2 diabetes, conditions that include inflammation and slow blood flow, the development of atherosclerosis can be dramatically accelerated.
How do statin drugs work?
Statins are a group of drugs that work to lower cholesterol levels, particularly the “bad cholesterol,” or the low-density lipoprotein known as LDL.
The drugs work in two ways: They block an enzyme that is needed for cholesterol production, and they increase LDL receptors in the liver. (Cholesterol can only get into cells by binding to specific receptors that remove the LDL from blood.
The extra receptors that statins create help decrease the cholesterol levels.) As Americans are more aware that high cholesterol is a major risk factor for heart disease, statins have become increasingly popular.
What recent study indicated that certain statin drugs can lower the risk of amputation of the extremities, especially for people with diabetes?
Although giving cholesterol-lowering statins to people with type 2 diabetes has been around since 2010, the studies conducted have not been extensive.
But a long-term study with close to 17,000 participants conducted in 2016 found that people with PAD (peripheral artery disease), including many people with diabetes, seem to have a 22 to 33 percent lower risk of leg or other limb amputation when taking statins.
The statins, many of them routinely supplied to people who have PAD, apparently lower cholesterol levels enough to cut back on the formation of arterial plaque.
For many people with diabetes, the statin dosage has to be high, and if they can tolerate the medication, along with making other lifestyle changes (such as exercising and not smoking), they can often lower their risk of amputation. (For more about PAD, see this chapter.)
Can statins increase the risk of developing diabetes?
N o one really knows, but a study presented in 2015 suggested that statins can increase the risk of developing type 2 diabetes. In particular, the drugs appear to increase a person’s insulin resistance and also impair the ability of the pancreas to secrete insulin. But more research needs to be done, as this study pertained only to the risk of developing diabetes, and was limited to men.
What are triglycerides?
Triglycerides are a type of fat (lipid) found in the blood. When a person consumes a meal or snack, the body converts any of the calories it does not need to use right away into triglycerides. This is stored in the fat cells. If a person needs energy, then certain hormones allow the triglycerides to be released into the bloodstream. Because, like cholesterol, triglycerides cannot dissolve in the blood, they circulate throughout the body with the help of proteins called lipoproteins.
What is dyslipidemia (or dyslipidaemia)?
Dyslipidemia is a condition in which a person has an abnormal amount of lipids (mainly triglycerides), cholesterol, or both.
It can also mean the person has high triglycerides, low HDL cholesterol, and often type 2 diabetes. (The most common type is called hyperlipidemia, or elevated lipid levels).
Dyslipidemia is divided in two ways by researchers: by phenotype, or the way it is presented in the body (including the specific type of lipid that is increased in the body), and by etiology, or the reason for the condition (such as if it is genetic or secondary to another condition).
Because of its connection to fats and to being overweight or obese, dyslipidemia is often associated with people who have type 2 diabetes, and vice versa.
The Handy Diabetes Answer Book
HOW DIABETES AFFECTS THE DIGESTIVE SYSTEM
WHAT IS DIGESTION?
How does human digestion work?
The purpose of digestion is to break down large food particles into smaller molecules that can be absorbed (as nutrients) and used by the cells of the body as a source of energy for growth and reproduction.
For example, fats are broken down into glycerol and fatty acids and proteins into amino acids.
The digestive tract, also called the alimentary canal, is approximately 30 feet (9 meters) long from the mouth to the anus.
It is lined mostly with smooth muscles (involuntary) that push the food through the tract in a process called peristalsis.
What are the major parts of the digestive system?
Humans have a special digestive system that allows them to break down large food particles into smaller molecules and absorb the nutrients within the food. The following lists the details of the major parts of the digestive system:
Mouth , The mouth, tongue, and teeth are responsible for breaking the food down with mechanical action. As omnivores, humans have teeth that include incisors for cutting, canines for tearing, and molars for grinding. As the food is in the mouth, salivary glands release saliva, which then chemically breaks down the starch in the food.
Esophagus , The esophagus is where the food goes after a person swallows. Food is directed into the esophagus by the epiglottis, or a flap of cartilage in the back of the pharynx (throat), which essentially stops food from going into the windpipe (and which is why, in some circumstances, people choke on food).
Stomach , Food is churned mechanically in the stomach, an organ that secretes gastric juice, a mix of special enzymes and hydrochloric acid. A structure called a cardiac sphincter acts as a stop to prevent food in the stomach from backing up into the esophagus and thus burning it. A structure called the pyloric sphincter at the bottom of the stomach helps keep the food in the stomach long enough to be digested.
Small intestine , The upper part of the small intestine, about the first 12 inches (30 centimeters), is called the duodenum. Bile from the liver (stored in the gallbladder) is released into the small intestine, breaking fats down and helping other digestive enzymes to work. The intestine is lined with millions of elongated projections called villi that absorb all the nutrients released from the digested foods.
Large intestine , The large intestine, also called the colon, has several functions.
It removes undigested waste and excess water, and it harbors bacteria that create gas, digest some material, and help produce certain vitamins, such as biotin and vitamin K.
All together, both intestines absorb 90 percent of the water that enters the mouth, with the small intestine absorbing most of that water. (But if too much water is removed, constipation results, or if not enough water is removed, diarrhea results.) The waste is finally released at the end of the digestive tract, or the anus.
What are the general steps in the digestive process?
There are five major steps in the process of digestion, all of which can be affected if a person has diabetes. In general, the five steps are as follows:
Ingestion , The eating of any food.