Macrovascular Diabetic Complications Flashcards
list macrovascular complications in diabetes
early widespread atherosclerosis
ischaemic heart disease
cerebrovascular disease
peripheral vascular disease
sequences in progression of atherosclerosis
initial lesion > fatty streak > intermediate lesion > atheroma > fibroatheroma > complicated lesion
what is associated with macrovascular complications of diabetes?
weight
lipids
central adiposity
blood pressure
what stages of atheroma development are clinically silent?
initial lesion
fatty streak
intermediate
what stages of atheroma development are clinically overt?
atheroma
fibroatheroma
complicated
mechanism of initial lesion? growth with?
macrophage
lipid
mechanism of fatty streak? growth with?
intracellular lipid
lipid
mechanism of intermediate? growth with?
+extracellular lipid
lipid
mechanism of atheroma? growth with?
+core of extracellular lipid
smooth muscle
mechanism of fibroatheroma?
growth with?
+fibrotic/calcific layers
+collagen
mechanism of complicated? growth with?
+surface defect, thrombosis
thrombosis/haematoma
describe the relationship between hyperglycaemia and life expectancy
hyperglycaemia significantly reduces life expectancy
describe the relationships between morbidity, mortality, microvascular and macrovascular complications
microvascular > morbidity
macrovascular > morbidity + mortality
is macrovascular disease present in multiple arterial beds?
yes
it is a systemic disease
compare ischaemic heart disease as a diabetic complication to ischaemic heart disease to patient w/o diabetes
similar to patients w/o diabetes
just occur in younger demographic in those w/ diabetes
compare cerebrovascular disease as a diabetic complication to cerebrovascular disease to patient w/o diabetes
occurs much younger
more widespread in those with diabetes
peripheral vascular disease contributes with neuropathy to develop what common diabetic complication?
diabetic foot (infarct, gangrene, loss of toes)
atheroma can contribute to what renal issue?
renal artery stenosis > renal failure, hypertension
how does intensive treatment of hyperglycaemia affect increased risk of cardiovascular disease?
has a minor effect
prevention of macrovascular disease requires?
aggressive management of multiple risk factors
list non-modifiable risk factors for macrovascular disease
age
sex
birth weight
family history/genetic risk
list modifiable risk factors for macrovascular disease
dyslipidaemia
high blood pressure
smoking
diabetes
in prevention of macrovascular disease, what will have a larger benefit, treating dyslipidaemia or hyperglycaemia?
treating dyslipidaemia
what are blood pressure targets for those with type 2 diabetes?
if kidney, eye, cerebrovascular damage <130/80 mmHg
other <140/80 mmHg
