Macrovascular Complications of DM Flashcards
What’s the most common cause of death in diabetes?
CV mortality - 75%
Does diabetes increase CV mortality? What comparison does the professor like to use?
Diabetes increases CV mortality comparably to having a prior MI.
What’s the difference in the way duration of diabetes increases CV disease risk between T1D and T2D?
In T1D, duration of diabetes increases risk, mainly after about 20-25 years.
In T2D, risk for CV is usually high at the time of diagnosis.
8 factors that link insulin resistance to athersclerosis?
Hyperglycemia Hyperinsulinemia Increased LDL Decreased HDL Hypertension Obesity Endothelial Dysfunction Hypercoaguability
Does intensive glucose control have more of an effect on microvascular or macrovascular complications of DM?
More important for reducing microvascular sequelae.
Some studies showed not much effect on CV disease.
Does it matter when you start intensively controlling glucose?
Yes. The early, the less progression to complications.
Does intensive glucose control have more of an effect in T1D or T2D?
Seems to have a bigger effect in T1D, but it’s still very helpful in T2D. (not that surprising, considering T1D is usually more severe in general)
Is glucose control the only important thing?
No. Controlling hypertension and dyslipidemia is also very important.
Especially hypertension for retinopathy and nephropathy.
How does screen recommendations for retinopathy vary between T1D and T2D? Does pregnancy affect this?
Start screening right away with T2D.
Can wait a little (up to 5 years) with new T1D diagnosis.
If pregnant, should also start screening right away.
Screening for nephropathy?
Same as for retinopathy: screen right away in T2D, within 5 years for T1D.
Measure albumin and creatinine in urine, and all sorts of stuff that will make more sense after we’ve had renal.
Should you test feet for ulcers and neuropathy?
yep. (same timeframe as retinopathy and neuropathy)
What does the mnemonic “PLAGUE-F” for screening for complications of diabetes stand for?
Pressure Lipids Aspirin (for secondary prevention) Glucose Urine (microalbuminuria, creatinine Eyes Feet
