Macrovascular Complications of Diabetes Flashcards
What are the microvascular diseases in diabetes?
- Early widespread atherosclerosis
- Ischaemic heart disease
- Cerebrovascular disease
- Peripheral vascular disease
What are the fasting glucose measures for CAD risk factor?
> 6.0mmol/l
What are the waist circumference measures for CAD risk factor?
Men>102
Women>88
What are the HDL measurements for CAD risk factor?
Men<1.0
Women<1.3
What are the hypertension measurements for CAD risk factor?
BP>135/80
What are some metabolic complications?
- DKA
* Hyperosmolar
What are some macrovascular complications?
•Ischaemic heart disease •Cerebrovascular •Renal artery stenosis •Peripheral vascular disease -More atheroma and contributes to cardiovascular morbidity
What is the pathogenesis of atheroma?
- Initial lesion
- Fatty streak (third decade)
- Intermediate lesion: intracellular lipid and small extracellular lipid pools
- Atheroma: intracellular lipid accumulation and core of extracellular lipid
- Fibroatheroma: single or multiple lipid cures and fibrotic layer
- Complicated. lesion: surface defect, thrombosis, and haematoma-haemorrhage
What is the initial lesion?
Mechanism: macrophage
Age: 10
Growth with: lipid
Clinical: silent
What is the fatty streak?
Mechanism: intracellular lipid
Age: 20
Growth with: lipid
Clinical: silent
What is the intermediate?
Mechanism: +extraceullar lipid
Age: 30
Growth with: lipid
Clinical: silent
What is the atheroma?
Mechanism: + core of extracellular lipid
Age: 30
Growth with: smoothmuslce
Clinical: overt
What is the fibroatheroma?
Mechanism: + fibrotic/calficifc layers
Age: 40
Growth with: +collagen
Clinical: overt
What is the complicated lesion?
Mechanism: +surface defect, thrombosis
Age: 50
Growth with: thrombosis/haematoma
Clinical: overt
What is the initial lesion related to?
Diabetic dyslipideiama, increase LDL cholesterol a and lower HDL cholesterol
What are other markers for coronary artery disease?
- Insulin resistance
- Inflammation CRP
- Adipocytokines
- Urine microalbumin
When can insulin resistance be implicated?
In non-diabetic microvascular disease
What is hyperglycaemia associated with?
- Significantly reduced life expectancy
- Diabetes in young people especially more lost years