Long Term Complications- Micro and Macro

Question 1

What are the main macrovascular complications of diabetes?

Answer 1

Coronary vascular disease
Cerebrovascular disease
Peripheral vascular disease

Question 2

What are the main microvascular complications of diabetes?

Answer 2

Retinopathy
Nephropathy
Neuropathy

Question 3

How does diabetes increase the risk of atherosclerosis?

Answer 3

Dyslipidaemia is present in nearly all diabetic patients
HDL cholesterol is lower
Triglycerides are higher
LDL cholesterol is in the form of small dense particles
Oxidisation of these particles promotes the features that lead to plaque formation

Question 4

What effects does atherosclerosis have in diabetes?

Answer 4

Can cause:
Ischaemic cerebrovascular disease
Ischaemic heart disease
Heart failure
Peripheral vascular disease

Question 5

How is macrovascular disease prevented in diabetes?

Answer 5

Good diabetic control
Blood pressure control
Lipid control
Smoking cessation, weight control, exercise

Question 6

What are the causes of non-proliferative diabetic retinopathy?

Answer 6

Retinal capillary dysfunction
Platelet dysfunction
Blood viscosity abnormality

Question 7

What are the causes of proliferative diabetic retinopathy?

Answer 7

Retinal ischaemia
New blood vessel formation
Vitreous haemorrhage
Retinal tears/detachment

Question 8

Describe the pathology of diabetic nephropathy?

Answer 8

Microalbuminaemia- leak of protein caused by glomerular basement membrane changes, mesangial tissue proliferation and glomerular hypertension

Question 9

How is nephropathy prevented in diabetics?

Answer 9

Screening of urine for albumin vital
Diabetic control
Renin-angiotensin blockade- ACE inhibition, angiotensin receptor blockade, renin inhibition
Control of hypertension

Question 10

How does sensory neuropathy present?

Answer 10

Objective loss, particularly in feet and lower legs. Most common symptom is paraesthesia