Elevated blood glucose is not merely an issue of having to avoid sweets. High blood glucose can cause severe damage throughout the entire vascular network, from microscopic capillaries to large arteries. This condition is known as diabetic angiopathy, and it is largely divided into two categories.
The first involves microvascular complications, which damage tiny capillaries in the eyes, kidneys, and nerves. When blood glucose remains persistently high, inflammation develops in the vascular endothelium, and circulating sugars bind with proteins to form toxic compounds called advanced glycation end products. These substances stiffen the vascular wall, reduce its elasticity, and impede blood circulation. Consequently, damage to retinal vessels can cause blurred vision and even lead to blindness, known as diabetic retinopathy. Damage to the glomerulus of the kidney can cause proteinuria and eventually result in end-stage renal failure, known as diabetic nephropathy. Decreased blood supply to peripheral nerves in the hands and feet leads to numbness or reduced sensation, known as diabetic neuropathy. Diabetic foot, where minor injuries fail to heal and progress to ulcers or necrosis, is another severe outcome of these microvascular issues.
The second category involves macrovascular complications, which occur in major arteries supplying the heart, brain, and legs. High blood glucose accelerates arteriosclerosis as lipids and inflammatory substances accumulate along the vascular wall, narrowing and hardening the lumen. This is a primary driver of coronary artery disease such as myocardial infarction and angina pectoris, cerebral blood vessel disorders such as stroke, including cerebral infarction and cerebral hemorrhage, and peripheral artery disease, which impairs arterial flow to the legs and causes pain while walking. Because macrovascular complications can threaten life or leave enduring sequelae once they manifest, vigilance is essential.
What makes this process especially concerning is that vascular damage progresses silently over an extended period. Like gradual soil erosion, it can eventually surface as a sudden crisis. The Donguibogam's description of a deep, thin, and weak pulse reflects this depletion of bodily vitality and circulatory disorder resulting from chronic vascular injury. Managing blood glucose consistently helps preserve overall health and protect these vital vessels.
