1.What is diabetes mellitus?
Diabetes mellitus is a group of endocrine metabolic diseases characterized by hyperglycemia. It is characterized by disorders of carbohydrate, protein, fat, electrolytes and water metabolism due to absolute or relative deficiency of insulin and reduced sensitivity of target cells to insulin.
Diabetes mellitus is one of the most common chronic diseases. With the improvement of people’s living standards, the aging of the population and the increase in the incidence of obesity, the incidence of diabetes is increasing year by year. The prevalence of diabetes in China has reached 2%, and according to statistics, 40 million people have been diagnosed with diabetes in China, and the number is increasing at a rate of 1 million per year. Among them, type 1 diabetics account for 10% and type 2 diabetics account for 90%.
2.What are the main complications of diabetes?
(1) Cardiovascular disease
Diabetic heart disease is characterized by typical angina pectoris (long duration, mild pain, ineffective coronary expansion drugs), myocardial infarction is mostly painless and intractable heart failure. Extremity gangrene. The incidence of cerebrovascular disease is also high, all of which are important factors in death from diabetes.
(2) Renal lesions
Glomerular filtration rate and blood flow increase in the early stage due to thickening of the glomerular tract and the base, and then gradually and significantly decrease. Intermittent proteinuria appears, which is found to be persistent proteinuria, hypoproteinemia, edema, azotemia and renal failure. The normal renal glycemic threshold is to ensure that blood glucose does not rise severely, and if blood glucose can often exceed 28 mmol/L (504 mg/dL) it suggests that there must be permanent or temporary renal damage, and progressive renal disease is difficult to reverse under present conditions.
(3) Neuropathy
Most often seen in middle-aged patients and above, accounting for about 4-6% of the diabetic population. With electrophysiological examination, it can be found that more than 60% of all diabetics have varying degrees of neuropathy. The clinical picture can be seen in peripheral neuropathy (including sensory, motor and vegetative nerves), spinal cord lesions, (including spinal muscular atrophy, pseudospinal consumption, amyotrophic lateral sclerosis syndrome; posterior lateral sclerosis syndrome, spinal cord tenderness, etc.), and brain lesions (such as cerebrovascular disease, cerebral tenderness, etc.). Timely and effective treatment of diabetes often has a good impact on neuropathy, but sometimes, diabetic neuropathy may still occur and develop even when diabetes is more satisfactorily controlled.
(4) Ocular complications
They are more common, especially in those with a disease duration of more than 10 years, with a prevalence of more than 50%, and are more serious, such as retinal lesions with microangiomas, hemorrhages, exudates, neovascularization, proliferation of mechanized substances, retinal exfoliation and vitreous hemorrhage. Others include vascular changes in the conjunctiva, iritis, iris rosacea, regulatory muscle palsy, hypotony, hemorrhagic glaucoma, cataract, transient refractive abnormalities, optic neuropathy, extraocular muscle palsy, etc. Most of them progress slowly, but a few patients progress rapidly and become blind in a short period of time. Good control of diabetes has the potential to delay the onset and progression of ocular comorbidities.
(5) Other
Dilatation of subcutaneous blood vessels due to tissue hypoxia, resulting in a flushed face. There is often subcutaneous bleeding and petechiae due to small arterial and microvascular lesions. Areas of poor blood supply can develop purpura and ischemic ulcers with severe pain, mostly in the feet. Neurodystrophy can also affect the joints, known as Charcot joints, and is prevalent in all joints of the lower extremities. The affected joints may have extensive bone destruction and deformity.
3.How can stem cell transplantation treat diabetes?
Human embryonic pancreatic stem cell transplantation is mainly for islet-dependent diabetes mellitus, i.e. type I diabetes mellitus. Cells extracted from artificially bred or aborted embryos are cultured in vitro to induce and differentiate into immortal islet cells, i.e. pancreatic stem cells, which are then transplanted into the patient’s body to “pass on” and secrete insulin continuously, thus achieve the purpose of controlling blood sugar and treating diabetes.
4.What is diabetic foot?
Diabetic foot is a foot infection, ulcer and/or deep tissue destruction associated with local nerve abnormalities and peripheral vascular lesions in the lower extremities that occur in diabetic patients. Diabetic foot is a chronic and serious complication of diabetes, mostly seen in elderly diabetic patients, and currently lacks effective treatment and has a high amputation rate.
5.How can stem cell transplantation treat diabetic foot?
The treatment of diabetic foot mainly adopts stem cell transplantation vascular regeneration technology, also known as cellular vascular bypass surgery, because there are vascular endothelial progenitor cells in the bone marrow, which can generate new blood vessels at the ischemic site of the lower limbs, so this technology can obviously promote the formation of new blood vessels at the ischemic site, improve local blood supply, effectively relieve symptoms, and reduce the rate of amputation and disability.