Long Term Complications - Micro and Macro Flashcards
what is the contents of atherosclerosis?
Macrophages and foam cells Intracellular lipids Extracellular lipid accumulation Fibrotic and calcific layers Damage to surface, exposure to platelets and clotting
true or false:
dyslipidaemia is present in nearly all people with diabetes
true
True or false in patients with diabetes:
HDL Cholesterol is lower
Triglycerides are higher
LDL cholesterol is in the form of small dense particles which are worse
true
what are the effects of atherosclerosis in diabetes?
Ischaemic cerebrovascular disease - strokes
Ischaemic Heart Disease - angina, myocardial infarctions
Heart Failure - related to coronary disease and abnormal cardiac myocyte glucose handling
Peripheral vascular disease
Causes lower limb ischaemia, leading to ulcers and poor healing of these ulcers. Amputations are a potential outcome.
how can you prevent macrovascular disease?
Good diabetes control
Blood pressure control
Lipid control
Smoking cessation, weight, exercise
what is the differences between non-proliferative diabetic retinopathy?
Retinal capillary dysfunction, platelet dysfunction, blood viscosity abnormality.
what is the difference between proliferative diabetic retinopathy?
Retinal ischaemia, new blood vessel formation, vitreous haemorrhage, retinal tears/detachment.
Treatment with laser photocoagulation.
what is the treatment of retinopathy?
Improve glycaemic control
laser photocoagulation
what is Nephropathy
general term for the deterioration of proper functioning in the kidneys
what are the signs of nephropathy?
Microalbuminuria - leak of protein (albumin) starts
Glomerular basement membrane changes, mesangial tissue proliferation, “glomerular hypertension” all contribute to renal dysfunction. Progressive renal impairment - note kidneys do not shrink when the disease progresses.
Progressive renal failure progresses to end-stage renal disease if unchecked.
what is the prevention and treatment of nephropathy?
Screening of urine for albumin is vital!
Diabetes control
Renin-angiotensin system blockade - ACE inhibition, angiotensin receptor blockade, renin inhibition.
Very good results in slowing/preventing progression of renal disease (ACE-I, ARB).
Hypertension control
what are the sensory effects of neurophaty?
- objective loss, particularly in feet & lower legs; subjective symptoms, especially paresthesia
what is the autonomic effect of neuropathy?
cause GI effects (stomach, intestines), or the cardiovascular system (tachycardia, blood pressure fluctuations). Watch out for silent myocardial infarction!
what is foot care?
check
protect
refer
