Macrovascular complications of diabetes Flashcards
what is the sequence of progression of atherosclerosis?
- initial lesion (silent)
- fatty streak (silent)
- intermediate lesion (silent)
- atheroma (overt)
- fibroatheroma (overt)
- complicated lesion (overt)
Initial lesion of athlerosclerosis is caused by?
Increased LDL cholesterol and lower HDL concentration, growth with lipid
mechanism: macrophage
atheroma involves hypertrophy of what?
smooth muscle
fibroatheroma involves development of what?
collagen
complicated lesions of atheroma involve?
thrombosis/haematoma
What are risk factors for coronary artery disease?
- fasting glucose >6mmol/L
- waist circumference men >102, women >88 (central adiposity)
- insulin resistance, inflammation CRP, adipocytokines, urine microalbumin
- HDL <1 men, <1.3 women
- hypertension BP >135/80
what are the macrovascular complications of diabetes?
- ischaemic heart disease
- cerebrovascular disease
- renal artery stenosis
- peripheral vascular disease
which ethnicity is more at risk of coronary heart disease?
south asian
white causasian
south asian
how can peripheral vascular disease worsen diabetic foot disease?
arteries narrowed –> ischaemia
atheroma affecting renal artery may contribute to?
hypertension
renal failure
does treatment targeted at hyperglycaemia affect cardiovascular disease?
it has a minimal effect on its own
what are the non-modifiable risk factors for macrovascular disease?
- age
- sex
- birth weight
- family history/genes
what are the modifiable risk factors for macrovascular disease?
- dyslipidaemia
- high blood pressure
- smoking
- diabetes
How can we manage risk of cardiovascular disease?
- anti-hypertensives and changes in lifestyle to treat blood pressure
- statins to treat dyslipidaemia
- blood-glucose lowering therapy
