Macrovascular Diabetic Complications

Question 1

list macrovascular complications in diabetes

Answer 1

early widespread atherosclerosis
ischaemic heart disease
cerebrovascular disease
peripheral vascular disease

Question 2

sequences in progression of atherosclerosis

Answer 2

initial lesion > fatty streak > intermediate lesion > atheroma > fibroatheroma > complicated lesion

Question 3

what is associated with macrovascular complications of diabetes?

Answer 3

weight
lipids
central adiposity
blood pressure

Question 4

what stages of atheroma development are clinically silent?

Answer 4

initial lesion
fatty streak
intermediate

Question 5

what stages of atheroma development are clinically overt?

Answer 5

atheroma
fibroatheroma
complicated

Question 6

mechanism of initial lesion? growth with?

Answer 6

macrophage

lipid

Question 7

mechanism of fatty streak? growth with?

Answer 7

intracellular lipid

lipid

Question 8

mechanism of intermediate? growth with?

Answer 8

+extracellular lipid

lipid

Question 9

mechanism of atheroma? growth with?

Answer 9

+core of extracellular lipid

smooth muscle

Question 10

mechanism of fibroatheroma?

growth with?

Answer 10

+fibrotic/calcific layers

+collagen

Question 11

mechanism of complicated? growth with?

Answer 11

+surface defect, thrombosis

thrombosis/haematoma

Question 12

describe the relationship between hyperglycaemia and life expectancy

Answer 12

hyperglycaemia significantly reduces life expectancy

Question 13

describe the relationships between morbidity, mortality, microvascular and macrovascular complications

Answer 13

microvascular > morbidity

macrovascular > morbidity + mortality

Question 14

is macrovascular disease present in multiple arterial beds?

Answer 14

yes

it is a systemic disease

Question 15

compare ischaemic heart disease as a diabetic complication to ischaemic heart disease to patient w/o diabetes

Answer 15

similar to patients w/o diabetes

just occur in younger demographic in those w/ diabetes

Question 16

compare cerebrovascular disease as a diabetic complication to cerebrovascular disease to patient w/o diabetes

Answer 16

occurs much younger

more widespread in those with diabetes

Question 17

peripheral vascular disease contributes with neuropathy to develop what common diabetic complication?

Answer 17

diabetic foot (infarct, gangrene, loss of toes)

Question 18

atheroma can contribute to what renal issue?

Answer 18

renal artery stenosis > renal failure, hypertension

Question 19

how does intensive treatment of hyperglycaemia affect increased risk of cardiovascular disease?

Answer 19

has a minor effect

Question 20

prevention of macrovascular disease requires?

Answer 20

aggressive management of multiple risk factors

Question 21

list non-modifiable risk factors for macrovascular disease

Answer 21

age
sex
birth weight
family history/genetic risk

Question 22

list modifiable risk factors for macrovascular disease

Answer 22

dyslipidaemia
high blood pressure
smoking
diabetes

Question 23

in prevention of macrovascular disease, what will have a larger benefit, treating dyslipidaemia or hyperglycaemia?

Answer 23

treating dyslipidaemia

Question 24

what are blood pressure targets for those with type 2 diabetes?

Answer 24

if kidney, eye, cerebrovascular damage <130/80 mmHg

other <140/80 mmHg