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Question
Asked 6th Aug, 2012
In diabetic patients different organs are under stress and are influenced by the altered metabolic condition. However some of the organs are affected readily and some take longer . I want to know which organ is influenced readily or which is the organ that gets damage at the early stage of diabetes only.

Most recent answer

16th Feb, 2013
Universidade NOVA de Lisboa
We believe that parasympathetic nervous system degeneration is a primary defect.
Understanding postprandial glucose clearance by peripheral organs: the role of the hepatic parasympathetic system.
Fernandes AB, Patarrão RS, Videira PA, Macedo MP.
J Neuroendocrinol. 2011 Dec;23(12):1288-95.
2 Recommendations

Popular Answers (1)

23rd Aug, 2012
City College of New York
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The issue is really how you define damage. Even before diabetes developes there is loss of beta cells from the pancreas and as diabetes progresses, there is continued loss of pancreatic cell function, so that would be my vote. Aftet that, the pathology from diabetes results from glucose binding to proteins which impacts basement membranes. So any tissue which relies of circulation (that is all tissues) are impacted and those with the most rapid metabolism are most effected (nerves & kidneys). We first see the damage in the eyes because they are the only neural tissue we can easily observe, but brain & peripheral nerves are likewise effected, as is the kidney which just takes longer to manifest the damage as one needs to lose many nephrons before function begins to decline. I imagine that the liver is spared as so much of its circulation is redundant (both portal and hepatic). The real question is what tissues get damaged along with the pancreas even before diabetes is diagnosed!
7 Recommendations

All Answers (19)

6th Aug, 2012
Manipal Hospital, KAYA
Diabetes is inherited and acqiured. There are two types of diabetes and each has its own course.
Regarding which organ gets affected first depends on the vascular compromise. It may be renal or eye first.
Concrete evidence is lacking.
1 Recommendation
7th Aug, 2012
Clarivate Analytics
In most of the cases Eyes are seen to be affected first in diabetic patients and the second is kidney.
1 Recommendation
7th Aug, 2012
South Australian Health and Medical Research Institute
Weakness, fatigue. Other complications includes diabetic neuropathy, nephropathy, retinopathy, terminal ulceration which might lead to having got feet amputated. But, those are the most severe condition. Recent findings have found that there is a strong association between diabetes complication and cognitive imparement.
1 Recommendation
7th Aug, 2012
Translational Health Science and Technology Institute
Thank You Dr. Satyaprasad, Guruprasad and Rajesh.
I have gone through different articles and got confused because in some articles I will get eye as the first organ, In some I will get heart. However I am also thinking that eye may be the first as Satyaprasad and Guruprasad said. But I need to know apart from vasculature what else is there in these organs, so that they gets affected easily?
7th Aug, 2012
Manipal Hospital, KAYA
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You are always welcome
8th Aug, 2012
Clarivate Analytics
Next to brain, eye is the organ which uses large amount of glucose in system. thus eventually eye would be the first organ which could be in trouble under hyperglycemic conditon.
9th Aug, 2012
Translational Health Science and Technology Institute
Thanks Guruprasad....
11th Aug, 2012
La Jolla Institute for Allergy & Immunology
Hi Pankaj, interesting question. I am not at all qualified to answer this, but i will have a go anyway!
the obvious choice would be capillary damage in the eyes or kidneys. my brother has type 1 and after 18 years the only sign of damage is a tiny amount in the eye.
Very early on however, he lost the ability to recognize changes in his blood sugar levels (hypoglycemic unawareness) after spending too much time out of a healthy glucose range.
So i dont know that it is an 'organ' as such, but I would propose that the absolute initial damage in T1D occurs to the mechanisms that in a healthy person surround and protect the glucose-insulin balance. i.e. the safeguards such as triggering hunger to gain more energy, or the messages that integrate it with the different endocrine systems. Once insulin production is removed, the support pathways collapse.
once again though, i am not a scientist or a doctor!
1 Recommendation
13th Aug, 2012
Translational Health Science and Technology Institute
Thanks Juliet for sharing your views.
13th Aug, 2012
Manipal Hospital, KAYA
Early damage of organs and mononeuropathy ie nerves bieng affected due to micro capillary compromise can be prevented by judicious control of blood sugar..
Early organ damage is always due to late detection of diabetes and variable blood sugar levels.
2 Recommendations
15th Aug, 2012
Medplus,Colombia
We know that in the microvascular complications of diabetes, cells are more committed capillary endothelial cells of the retina, mesangial cells in the renal glomerulus and neurons and Schwann cells in peripheral nerves, so we must start thinking that makes these cells vulnerable to hyperglycemia, this response is based on that most cells are able to reduce the transport of glucose into the cell when exposed to hyperglycemia so that their internal glucose concentration remains constant, in contrast to these cells above which do not efficiently, So their rates of glucose transport does not fall rapidly as a result of hyperglycemia.
We now know that hyperglycemia triggers 5 main channels of cellular damage:
Polyol pathway
Hexosamine pathway
Protein Kinase C pathway
AGE pathway
Each of these routes damages the cells under discussion, we must understand is which is the most labile cell for damage, you can find several articles that looks to diabetic retinopathy as the most important but you must have intoaccount that this is that is the most disabling occupationally, (The cutoff for the diagnosis of diabetes mellitus was performed when the prevalence of retinopathy increases) but if you review is neuropathy which can be found even in patients with pre-diabetes where there is already damage by hyperglycemia, that is if we talk about microvascular damage, because if we speak of macrovascular the relationship is to other insulin-resistance metabolic finding
3 Recommendations
15th Aug, 2012
Zagazig University
Regarding the periority of organ damage in diabetes :
Hyperglycemia in subsequent to uncontrolled diabetes may lead to certain cell alterations. If we can agree that these changes are mostly directed to the vasculature system ( micro and macro angiopathy ) , mainly the Retina and the kidneys are involved. Accordingly hyperglycemia her may activate synthesis and expression of adhesion molecules , Thicknening of basement membrane for the glomeruli , release of transcriptional factors , pro-inflammatory cytokines , growth factors . Also it induces the release of Reactive oxygen for 1 last update 03 Jun 2020 species ( ROS) in turn oxidative stress , apoptosis and lasltly necrotic cell death.
This doesn't mean the involvement of other organs like skin , Tests.....etc
Regarding the periority of organ damage in diabetes :
Hyperglycemia in subsequent to uncontrolled diabetes may lead to certain cell alterations. If we can agree that these changes are mostly directed to the vasculature system ( micro and macro angiopathy ) , mainly the Retina and the kidneys are involved. Accordingly hyperglycemia her may activate synthesis and expression of adhesion molecules , Thicknening of basement membrane for the glomeruli , release of transcriptional factors , pro-inflammatory cytokines , growth factors . Also it induces the release of Reactive oxygen species ( ROS) in turn oxidative stress , apoptosis and lasltly necrotic cell death.
This doesn't mean the involvement of other organs like skin , Tests.....etc
1 Recommendation
23rd Aug, 2012
City College of New York
The issue is really how you define damage. Even before diabetes developes there is loss of beta cells from the pancreas and as diabetes progresses, there is continued loss of pancreatic cell function, so that would be my vote. Aftet that, the pathology from diabetes results from glucose binding to proteins which impacts basement membranes. So any tissue which relies of circulation (that is all tissues) are impacted and those with the most rapid metabolism are most effected (nerves & kidneys). We first see the damage in the eyes because they are the only neural tissue we can easily observe, but brain & peripheral nerves are likewise effected, as is the kidney which just takes longer to manifest the damage as one needs to lose many nephrons before function begins to decline. I imagine that the liver is spared as so much of its circulation is redundant (both portal and hepatic). The real question is what tissues get damaged along with the pancreas even before diabetes is diagnosed!
7 Recommendations
24th Aug, 2012
Rio de Janeiro State University
The first complications of diabetes are the microangiopaties. However, the damage, of course, depend on the type of diabetes. Subjects who develop diabetes with 30-35 years of age showed severe damage in the vascular system (coronary artery disease).
1 Recommendation
31st Dec, 2012
Jain University
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Excellent reply by dr. Deen.
31st Dec, 2012
Jain University
The key is glucose mediated damage. And therefore we have to consider organs that do not depend on insulin for glucose uptake.
1st Jan, 2013
National Institute of nutrition, Indian council of Medical Research
Glucose uptake by brian and kidney is not depending on insulin like muscle and adipose tissue. So during diabetic conditions this organs expose directly to glucose toxicity and excess glucose convert to sorbitol and fructose through polyol pathway and formation of advanced glycated endproducts which leads alteration of structural protiens which leads damage of organs.
2 Recommendations
16th Jan, 2013
Kuwait diabetes program ,Kuwait, ministry of health
Earliest system affected is peripheral nervous the 1 last update 03 Jun 2020 system , some sugget that yoiu may have some degree of neuronal dammage even in prediabetics as measured by bioesthetic techniques
earliest pathological changes are seen in vessles esp coronaries
Earliest system affected is peripheral nervous system , some sugget that yoiu may have some degree of neuronal dammage even in prediabetics as measured by bioesthetic techniques
earliest pathological changes are seen in vessles esp coronaries
1 Recommendation
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