macrovascular complications Flashcards
1
Q
what does macrovascular disease include?
A
- early widespread atherosclerosis
- ischaemic HD
- cerebrovascular disease
- peripheral vascular disease
2
Q
how is insulin resistance linked to atheroma formation?
A
- insulin resistance contributes to first 4 stages of atheroma formation
(initial lesion, fatty streak, intermediate, atheroma)
3
Q
what is hyperglycaemia associated with?
A
- significantly reduced life expectancy
- metabolic syndrome associated with hyperglycaemia
- women lose protection of their gender when they have diabetes in atheroma formation, suffer more than men
4
Q
what does microvascular disease cause?
A
morbidity and mortality macrovascular disease
- ischaemic HD big cause of mortality in diabetics
- malignancy reduced as cause of death, many diabetics die before cancer has a chance to manifest
5
Q
what is macrovascular disease? give examples
A
systemic disease, commonly present in multiple arterial beds
- IHD (major cause of morbidity, mortality in diabetes)
- CVD (earlier than without diabetes)
- peripheral vascular disease (diabetic foot problems)
- renal artery stenosis (contribute to HT)
6
Q
what are the non-modifiable risks for macrovascular disease?
A
- age
- sex
- birth weight
- FH/ genes
7
Q
what are the modifiable risks for macrovascular disease?
A
- dyslipidaemia
- high BP
- smoking
- diabetes
8
Q
how do you prevent macrovascular disease?
A
- aggressive management of multiple modifiable risk factors
- BP and cholesterol managed
- taking statins has an effect in reducing macrovascular disease risk
9
Q
what are the treatment goals?
A
- blood glucose lowering therapy (via metformin, sulphonylurea, insulin)
- BP management
- management of blood lipids
10
Q
is management of glucose alone successful in macrovascular disease?
A
no
management of glucose alone does not address vascular risk
11
Q
what is the major risk factor for arterial disease?
A
hyperglycaemia
