CÁC BIẾN CHỨNG CỦA BỆNH TIỂU ĐƯỜNG

biến chứng tiểu đường CÁC BIẾN CHỨNG CỦA BỆNH TIỂU ĐƯỜNG

Bệnh tiểu đường là một trong những căn bệnh mãn tính nguy hiểm. Không chỉ gây ảnh hưởng đến sinh hoạt thường ngày, bệnh tiểu đường có thể dẫn đến những biến chứng nguy hiểm như suy giảm thị lực, huyết áp cao, bệnh tim mạch, suy thận… một số biến chứng kể trên có thể gây tử vong. Dưới đây là 4 biến chứng nguy hiểm nhất của bệnh tiểu đường:

Biến chứng thận

Biến chứng thận ở bệnh nhân đái tháo đường là do đường huyết tăng cao kéo dài gây tổn hệ thông lọc của thận, dẫn đến suy giảm chức năng thận. Căn bệnh này xảy ra ở khoảng 20 -40 % bệnh nhân tiểu đường. Dấu hiệu giúp nhận biết sớm căn bệnh này là sự rò rỉ một lượng nhỏ albumin (một loại protein) vào trong nước tiểu.

Trong giai đoạn đầu của bệnh, người bệnh thường khó phát hiện ra do có rất ít triệu chứng. Khi người bệnh phát hiện ra tức là bệnh đã bắt đầu nặng. Chức năng của thận lúc này đã bị suy giảm trầm trọng, các chất thải như creatinin, ure tích lũy nhiều trong cơ thể gây nguy hại đến tính mạng người bệnh. Người bệnh lúc này cần phải được điều trị bằng cách lọc máu thường xuyên để đẩy bớt chất độc ra ngoài.

Các triệu chứng của bệnh thận tiểu đường cũng tương tự như các triệu chứng của bệnh thận mạn tính, bao gồm:

  • Nước tiểu bất thường
  • Phù
  • Thiếu máu
  • Ngứa ở da
  • Mất cảm giác ngon miệng, vị kim loại ở trong miệng và hơi thở có mùi amoniac
  • Buồn nôn và nôn
  • Khó thở

Để ngăn ngừa bệnh thận do tiểu đường, người bệnh tiểu đường cần phải thực hiện chế độ ăn ít protein( để làm giảm bớt áp lực lên thận), kiểm soát huyết áp, ngưng hút thuốc…

Biến chứng mắt

Đây cũng là một trong những biến chứng phổ biến ở người bị tiểu đường. Biến chứng thường gặp nhất là bệnh cườm khô, cườm nước và võng mạc tiểu đường.

Cườm khô

Cườm khô (hay còn gọi là đục thủy tinh thể) là tình trạng thủy tinh thể bị mờ đục do cấu trúc của thủy tinh thể bị thay đổi và kết tụ với nhau. Điều này làm thay đổi hướng đi của tia sáng lên võng mạc (đáy mắt), khiến người bệnh bị suy giảm thị lực. Bệnh này không nguy hiểm và thường tiến triển từ từ.

Bệnh này thường xảy ra ở người già và người bị mắc các chứng bệnh như tiểu đường, huyết áp cao, suy dinh dưỡng… Đến nay, vẫn chưa có thuốc làm tan được thủy tinh thể bị đục, do đó, việc điều trị chủ yếu dựa vào phương pháp phẫu thuật thay thủy tinh thể nhân tạo.

Cườm nước

Tỷ lệ mắc bệnh này ở bệnh nhân tiểu đường cao gấp 1,4 lần người bình thường.

Bệnh cườm nước (hay còn gọi là glaucoma) là một dạng bệnh về mắt, xảy ra khi áp lực trong mắt tăng lên do tràn dịch kính. Khi áp lực tăng lên sẽ khiến các mao mạch nuôi võng mạc và dây thần kinh thị giác bị chèn ép. Các tế bào võng mạc không nhận được máu từ các mao mạch nên bị chết đi và suy giảm dần, gây mất thị lực.

Triệu chứng suy giảm thị lực thường xuất hiện ở chu vi xung quanh trong khi thị lực trung tâm và thị lực đọc lại không bị ảnh hưởng. Vì vậy, bệnh này thường dễ bị bỏ qua khi người bệnh không chú ý. Nhưng dần dần, vùng bị suy giảm thị lực ngày càng lan ra, nếu không chữa trị kịp thời người bệnh sẽ bị mất thị lực vĩnh viễn.

Để điều trị bệnh cườm nước, bạn cần phải mổ mắt để làm giảm bớt áp lực lên mắt. Sau khi mổ, bạn nên:

+ Duy trì nếp sống lành mạnh, ăn nhiều rau, củ, quả và đặc biệt bạn nên kiêng ăn mỡ động vật vì mỡ động vật làm ảnh hưởng đến các mạch máu nuôi võng mạc. Bạn cũng nên lựa chọn các loại thực phẩm giàu vitamin C, A và E vì chúng rất tốt cho mắt.

+ Thường xuyên tập thể dục: Lựa chọn những môn thể dục giúp bạn tăng lượng oxi nạp vào cơ thể như yoga, chạy bộ, bơi lội… sẽ giúp bạn giảm áp lực lên mắt và hỗ trợ điều trị bệnh.

+ Giữ tinh thần thư thái, thoải mái, tránh lo nghĩ nhiều và xúc động mạnh.

+ Luyện tập xoa mắt: làm tăng lượng máu lưu thông lên mắt và giúp nuôi dưỡng các tế bào mắt.

Võng mạc tiểu đường

Bệnh Võng mạc tiểu đường xảy ra trong 90% các trường hợp tiểu đường tiến triển sau 10-15 năm, bất kể phụ thuộc Insulin hay không.

Bệnh đái tháo đường gây nên tổn thương các mạch máu của toàn bộ các cơ quan trong cơ thể, biểu hiện rõ nhất ở các vi mạch máu. Đường máu cao gây tổn thương, phá hủy thành các mao mạch ở đáy, hậu quả là dịch từ trong lòng mạch thoát ra ngoài gây xuất huyết và phù nề. Bản thân các mao mạch bị phá hủy và bị tắc gây thiếu máu ở võng mạc, khi đó cơ thể sẽ có phản ứng sinh ra một số yếu tố kích thích sự hình thành các mao mạch mới. Các mạch máu mới này rất dễ vỡ và thường gây xuất huyết nặng làm đục dịch kính.

Các mạch máu mới cũng gây ra các vết sẹo xơ ở võng mạc và trong quá trình liền sẹo nó có thể co rút gây ra bong võng mạc. Hậu quả là mắt bị giảm hoặc mất khả năng thu nhận các tín hiệu ánh sáng, biểu hiện lâm sàng là giảm thị lực hoặc mất thị lực hoàn toàn. Nếu không được phát hiện và điều trị sớm, những tổn thương của bệnh ở đáy mắt sẽ rất nặng nề và dễ dẫn đến mù lòa.

Cách điều trị tuỳ theo từng giai đoạn:

+ Ở giai đoạn đầu khi chưa có tổn thương võng mạc, người tiểu đường chỉ cần khám định kỳ hàng năm, luôn kiểm soát tốt đường huyết và các yếu tố nguy cơ như huyết áp, mỡ máu. Khi có phù võng mạc trung tâm cần điều trị bằng laser.

+ Ở giai đoạn không tăng sinh, người bệnh cần khám mắt thường xuyên để phát hiện biến chứng. Khi có tắc mạch máu rộng gây thiếu máu, bác sĩ sẽ điều trị bằng laser quang đông.

+ Ở giai đoạn tăng sinh, người bệnh bắt buộc phải điều trị bằng laser quang đông võng mạc.

Biến chứng tim mạch

Các biến chứng tim mạch là các biến chứng xuất hiện trên cơ sở tổn thương xơ vữa động mạch của các mạch máu lớn và vừa.

Bệnh đái tháo đường (ĐTĐ) làm cho quá trình xơ vữa động mạch của các động mạch lớn và vừa xuất hiện sớm hơn và tiến triển nhanh hơn ở những người không mắc bệnh này. Chứng tắc nghẽn động mạch vành khiến cho lưu lượng máu lên não bị giảm, dễ dẫn đến đột quỵ.

Bệnh ĐTĐ là một yếu tố nguy cơ làm gia tăng sự xuất hiện và mức độ trầm trọng của các biến cố tim mạch (ở cả nam và nữ): tăng nguy cơ bệnh mạch vành lên gấp 1,8 lần, tăng nguy cơ bị tai biến mạch não lên gấp 2,4 lần, tăng nguy cơ viêm tắc động mạch chi dưới lên gấp 4,5 lần.

Để phòng chống biến chứng tim mạch, bạn nên tránh ăn nhiều thịt đỏ, mỡ động vật và tăng cường chất xơ. Đồng thời, bạn cũng không nên ăn quá mặn và cố gắng uống nhiều nước.

Biến chứng thần kinh

Đây là biến chứng xuất hiện sớm nhất ở người bệnh tiểu đường, bao gồm tổn thương thần kinh ngoại biên và tổn thương thần kinh thực vật. Tổn thương thần kinh ngoại biên thể hiện ở việc bệnh nhân giảm cảm giác, tê bì hoặc kim châm, yếu cơ. Các dấu hiệu này thường hay xảy ra ở bàn chân mà cụ thể là gây loét bàn chân. Nếu không được điều trị kịp thời có thể dẫn tới bệnh nhân phải đoạt chi cao, thậm chí tử vong.

Ở tổn thương thần kinh thực vật sẽ dẫn đến các biểu hiện loạn nhịp tim, da khô, tiêu chảy, táo bón, đại tiện không kiểm soát được, khô âm đạo ở nữ giới hay rối loạn cương dương ở nam giới…

Biến chứng thần kinh xảy ra do lượng đường trong máu quá cao gây chèn ép lên các dây thần kinh. Bệnh này thường ảnh hưởng đến dây thần kinh ở chân là chủ yếu. Để phòng chống và kiểm soát biến chứng thần kinh, bạn cần phải:

+ Kiểm soát huyết áp: tránh uống rượu bia, hút thuốc hay ăn nhiều đồ dầu mỡ.

+  Kiểm soát cân nặng: áp dụng chế độ ăn cân bằng dinh dưỡng ( ăn nhiều rau xanh, trái cây, ngũ cốc nguyên hạt) và tập luyện thể lực hợp lý.

Đối với những người bị tổn thương thần kinh ngoại biên (đặc biệt là ở chân):

+ Kiểm tra chân mỗi ngày: kiểm tra xem chân có dấu hiệu sưng phồng, viêm nhiễm hay có vết thương nào không.

+ Giữ chân sạch sẽ, khô ráo: Rửa chân bằng nước ấm và lau khô chân nhẹ nhàng. Lau khô khu vực giữa các kẽ chân và thoa dung dịch dưỡng ẩm nếu da chân bị khô.

+ Cắt móng chân cẩn thận: Không nên cắt khóe quá sâu.

+ Dũa cục chai: dùng đá bọt hay dũa móng tay để dũa cục chai.

+ Mang vớ sạch và khô: nên mang vớ cotton kể cả khi ở trong nhà.

+ Tránh làm chân bị thương và chọn giày vừa chân: nên chọn giày vào buổi tối vì lúc đó bàn chân to hơn buổi sáng.

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