Long term complications micro and macro Flashcards
Name some macrovascular complications of diabetes (3)
Coronary vascular disease
Cerebrovascular disease - strokes
Peripheral vascular disease - lower limb ischaemia - ulcers (poor healing leads to amputations)
Name some microvascular complications of diabetes (3)
Retinopathy
Nephropathy
Neuropathy
Name 3 Cardiovascular problems that can arise from diabetes
MI
Heart failure - related to coronary disease and abnormal cardiac myocyte glucose handling
Stroke
Describe what Atherosclerosis is
Build up of plaque in your arteries
Involves Macrophages and foam cells, intracellular lipids and extracellular lipid accumulation
Results in fibrotic and calcific layers which damages the surface and exposes it to platelets and clotting
Describe what is meant when you say that people with diabetes have dyslipidaemia
People with diabetes have an abnormal level of lipids in their blood
Have lower HDL cholesterol (Good cholesterol)
Higher triglyceride level
LDL cholesterol is in the form of small dense particles which are worse
oxidation of these particles promotes plaque formation + glycation of the particles worsens the effect
How can you prevent macrovascular disease (5)
Good diabetes control Blood pressure control Lipid control Smoking cessation weight/exercise
Foot ulcer care
Debridement
Specialist podiatry
Rest and avoidance of pressure on ulcer
What is non-proliferative diabetic retinopathy
Early stage of the disease in which symptoms will be mild or nonexistent
What problems might have occurred by the early non-proliferative stages of diabetic retinopathy
Retinal capillary dysfunction
Platelet dysfunction
Blood viscosity abnormality
Problems associated with the more progressed proliferative stage of diabetic retinopathy
Retinal ischaemia
New blood vessel formation
Vitreous haemorrhage
Retinal tears/detachment
Treatment with laser photocoagulation
Name some other eye effects of diabetes other than retinopathy
Glaucoma 50% increase in chance with diabetes
Cataracts
Treatment of diabetic retinopathy
Improve glycaemic control
Laser photocoagulation
What is Nephropathy
deterioration of proper functioning in the kidneys - in the advanced stages it transforms into end-stage renal disease
Describe the progression of Nephropathy
It starts with microalbuminuria - leakage of albumin into urine
Over time, poorly controlled diabetes causes damage to blood vessel clusters in your kidneys that filter waste from your blood.
This can lead to kidney damage and cause high BP. Hypertension causes glomerular hypertension
Progressive renal failure progresses to end-stage renal disease if unchecked.
Impact of diabetic nephropathy
75% of people with diabetes have some renal effects, and 20% go on to overt kidney disease that may need treatment.
Diabetes is the biggest single cause of end stage renal disease needing renal replacement therapy (dialysis).