Macrovascular disease in diabetes Flashcards
What are the four forms of macrovascular disease in diabetes?
Early widespread atherosclerosis
Ischaemic heart disease
Cerebrovascular disease
Peripheral vascular disease
What is an atheroma?
Intracellular lipid accumulation
Core of extracellular lipid
What is a fibroatheroma?
Single or multiple lipid cores
Fibrotic calcific layers
Which cells are involved in the formation of an initial lesion?
Macrophages (growth with lipid)
What is the mechanism for forming a fatty streak?
Intracellular lipid
What forms an atheroma?
There is a core of extra-cellular lipid concerned with the smooth muscle
What is the mechanism of a fibroatheroma?
Fibrotic/calcific layers associated with collagen
What are the markers of macrovascular disease in diabetes?
Fasting glucose > 6.0mmol/L
Waist circumference: Men >102
Women >88
Insulin resistance, inflammation CRP, adipocytokines, urine microalbumin.
HDL < 1.0 and <1.3 in women
Hypertension BP >135/80
What is the range for fasting glucose within patients with diabetes?
> 6.00mmol/L
What is the waist circumference range for men at risk of cardiovascular diabetes?
men >102
What are the HDL markers in both men and women?
HDL <1.0 (Men)
<1.3 (Women)
What is the marker for hypertension in patients with diabetes?
BP >135/80
What are the three forms of microvascular complications?
1) Retinopathy
2) Nephropathy
3) Neuropathy
What is the relationship between HbA1c and microvascular disease?
The higher the HbA1c the greater the microvascular and myocardial infarction risk.
What is the main cause of death in patients with diabetes?
Ischaemic heart disease