intro and macrovascular complications of diabetes W6 Flashcards
chronic complications of diabetes?
coronary heart disease
diabetic neuropathy
peripheral arterial disease
diabetic foot
peripheral neuropathy
eye damage
cerebrovascular disease
what is macrovascular disease
refers to any disease of any large blood vessel, including coronary arteries, aorta, and sizable arteries in the brain or limbs.
what is microvascular disease?
refers to disease of the smaller blood vessels, including those supplying the retina, kidneys and nerve endings.
what has proven good outcomes with regards to cardiovascular risk reduction?
lowering glucose
central pathological mechanism of macrovascular disease? what does this arise due to?
atherosclerosis
arises due to chronic inflammation and injury to the arterial wall
macrovascular disease pathophysiology?
endothelial injury/ inflammation caused oxidised lipids from LDL particles to accumulate in endothelial wall of arteries.
angiotensin II may promote their oxidation.
monocytes infiltrate the arterial wall, differentiate into macrophages, which accumulate oxidised lipids to foam cells.
foam cells stimulate macrophage proliferation and attraction of T lymphocytes, which induce smooth muscle proliferation in arterial walls and collagen accumulation.
results in formation of lipid rich atherosclerotic lesion with fibrous cap.
additional processes to atheroma formation? (type 2 diabetes)
increased platelet adhesion
hypercoagulability
impaired nitric oxide generation
increased free radical formation in platelets
altered calcium regulation
promote platelet aggregation
impaired fibrinolysis
combination of what further increases risk of vascular occlusion and cardiovascular events in type 2 diabetes?
increased coagulability
impaired fibrinolysis
other manifestations of macrovascular disease?
dementia
peripheral arterial disease (manifests as claudication, poor wound healing, slow healing ulcers
