Long term complications of diabetes Flashcards
What are the two categories of diabetic complications
Macrovascular and microvascular
What are the macrovascular complications of diabetes
Coronary vascular disease
Cerebrovascular disease
Peripheral vascular disease
What are the microvascular diabetic complications
Retinopathy
Nephropathy
Neuropathy
How does atherosclerosis occur
Macrophages and foam cells and an extracellular lipid accumulation which causes surface damage which results in exposure to platelets and clotting - this causes occlusion of a blood vessel
Why does atherosclerosis occur in diabetes
They have dyslipidaemia - Low HDL which is the good cholesterol
Oxidisation of the LDL leads to plaque formation
What is the effects of atherosclerosis in diabetes
Occlusion of blood vessels
Cerebrovascular vessels - strokes
Coronary vessels - heart failure
Peripheral vessels - lower limb ischaemia
What can prevent macrovascular disease in diabetes
Good diabetes control
Blood pressure control
Lipid control
Smoking cessation
Weight control
Regular exercise
What is the management of diabetic foot disease (ulcer specific) caused by neuropathy
Cleaning out the wound
High dosage IV antibiotics
X-rays to make sure the ulcer is not in the bone
What can be taken to improve lipid control
Statins - atorvastatin
Describe what happens in non proliferative diabetic retinopathy
Capillaries in the retina don’t function because the diabetes makes the endothelial surface of the capillary abnormal
Describe what happens in proliferative diabetic retinopathy
New blood vessels that form, form in funny shapes and in random directions so they are more prone to damage which increases chance of hameorrhage where blood leaks out from the capillary
What is the treatment for retinopathy
Laser photocoagulation - laser blocks off ischaemia so it does not spread
Describe diabetic nephropathy
The blood pressure poor control in diabetes causes damage to the glomerular basement membrane which results in leakage of proteins - first protein to leak through is albumin
What is an indicator of the beginning of nephropathy
Microalbuminuria
What is charcot foot
Entire foots become enlarged and the bones softer
