Long Term Complications of Diabetes Flashcards
Microvascular complications of Diabetes
- R…pathy
- N…pathy
- N…apathy
- Retinopathy
- Neuropathy
- Nephropathy
Macrovascular complications of Diabetes
- I..
- C..
- P..
- IHD
- CVD
- PVD
Microvascular Complications
- Most cells are able to reduce glucose transport in response to extracellular hyperglycaemia (ones below are not able to)
- … endothelial cells
- Mesangial cells of …
- … cells and peripheral … cells
- Most cells are able to reduce glucose transport in response to extracellular hyperglycaemia (ones below are not able to)
- Retinal endothelial cells
- Mesangial cells of glomerulus
- Schwann cells and peripheral nerve cells
Microvascular Complications
- Take … … to develop
- Rare before … years of T1 diabetes
- May be detected at presentation of …
- Take many years to develop
- Rare before 5 years of T1 diabetes
- May be detected at presentation of T2 diabetes
What disease is shown?
Retinopathy
Retinopathy
- … commonest cause of blindness in those of working age
- …+ in England blind from diabetic retinopathy
- Risk of blindness increased 1..-.. fold by DM
- (G… and c… increased)
- Second commonest cause of blindness in those of working age
- 4000+ in England blind from diabetic retinopathy
- Risk of blindness increased 10-20 fold by DM
- (Glaucoma and .. increased)
The Retinal Microcirculation
- … density of capillaries
- … functional reserve
- Flow needs to respond to … needs
- … key to local regulation of flow
-
Low density of capillaries
- Little functional reserve
- Flow needs to respond to local needs
- Pericytes key to local regulation of flow
Pericytes
- Pericytes are present around blood vessels in the normal ….
- Pericyte dropout is one of the major hallmarks of diabetic ….
- Pericytes are present around blood vessels in the normal retina.
- Pericyte dropout is one of the major hallmarks of diabetic retinopathy.
Pathological Findings of Diabetic Retinopathy
- Loss of …
- Basement membrane …
- Capillary …
- Is…
- … production
- Increased capillary …
- Loss of pericytes
- Basement membrane thickening
- Capillary closure
-
Ischaemia
- VEGF production
- Increased capillary permeability
Normal retina?
Yes
Normal retina?
No - small dot - early sign of diabetic eye disease (dot haemorrhage or a microaneurysm)
Normal retina?
No - developing hard exudates - leaking vessels - cholesterol and protein rich fluid
Normal retina?
No - lots of hard exudates - leaking fluid out full of cholesterol and protein rich
Normal retina?
No - circinate exudates
Normal retina?
No - cotton wool spots
Normal retina?
No - cotton wool spots
Normal retina?
No - retina ischaemia - produce growth factors - new vessels developed - weaker than original vessels
Normal retina?
No - very advanced diabetic eye disease - hard exudate, haemorrhages, cloud of new vessels growing out
Normal retina?
No - new vessels - blood leaking out (rupture)