Diabetes Complications Flashcards
Interventional studies demonstrate that ______ significantly decreases mortality and cardiovascular events in people with diabetes.
lipid lowering
WHAT ARE TEH MACROVASCULAR COMPLICATIONS of DIABETES
myocardial ischemia,
stroke,
peripheral vascular disease.
heart failure
_________ contributes to all microvascular and macrovascular complications of diabetes
Hypertension
what are the Interventions to decrease cardiovascular risk in diabetics
treatment with beta blockers, antihypertensives and lipid lowering agents
MICROVASCULARCOMPLICATIONS in diabetes is Caused by ______
hyperglycemia
what is the Polyol pathway and how does it relate to tissue injury
Hyperglycemia leads to an influx of glucose into cells, which can be metabolized by aldose reductase to sorbitol and fructose. These molecules can cause osmotic and oxidative stress leading to abnormal cellular function. Inhibitors of aldose reductase can block this pathway.
What is Non-enzymatic glycosylation
chronic hyperglycemia -> Advanced glycosylation end products, (AGEs) -> interfere with basement membrane function and in the vasculature can squelch nitric oxide and impair vasodilation.
Intracellular AGEs can crosslink and disrupt ______
DNA function and repair.
Hyperglycemia also result in an increase in intracellular protein kinase C activity, especially PKC beta and delta isoforms. This enzyme activation leads to the production of the extracellular matrix proteins collagen and fibronectin by renal and vascular cells which creates ______
basement membrane thickening
_______ is the leading cause of blindness in the U.S
Diabetes
what is the pathogenesis of retinopathy
loss of pericytes ( train track regulators of cap blood flow) -> loss of autoregulation of blood flow to the retinal capillary bed -> capillary dropout, -> basement membrane thickening, -> leakage of intravascular fluids -> soft and hard exudates
Macular edema is the most common complication of the eye in type 2 diabetes, Tx includes ______
Photocoagulation, steroids, and VEGF inhibitors all effective
Diabetes is the most common cause of kidney failure, accounting for nearly ______ of new cases
44 percent
Aggressive control of ______ and ____ can prevent or retard the progression of nephropathy in DM patients.
hyperglycemia (with intensive therapy), blood pressure (with ACE inhibitors or beta blockers)
What is Distal symmetric polyneuropathy:
Stocking glove distribution, can be painless or painful. Superficial pain/ paresthesias involve the c-fibers; deep seeded gnawing pain involves the delta fibers.
