Pathology of diabetes and its complications Flashcards
what is the mechanism by which type 1 diabetes occurs?
autoimmune attack on the islet cells of the pancreas
destruction of B cells
severe damage can cause lymphocyte infiltration resulting in insulitis (very rare)
destruction of islets = no insulin produced
what is the mechanism by which type 2 diabetes occurs?
increase in free fatty acids in the blood due to being over weight causes insulin receptor resistance
reduced sensitivity to insulin
failure of the B cells to meet an increased demand for insulin in the body
what is the annual mortality for diabetes?
5.4%
diabetes reduced life expectancy by how many years?
5-10 years
what is the most common cause of death in diabetics?
MI
How can diabetes cause large vessel/ macrovascular disease?
diabetes accelerates atherosclerosis
glucose attaches to LDL which stops them from binding to its receptors on the liver
LDL isn’t removed from liver cells therefore LDL stays in the blood = hyperlipidaemia
describe how arteriolar disease can occur as a complication from diabetes.
in diabetes molecules flux into the sub endothelial space but cannot flux back out
this is due to glycosylated collagen binding to albumin (glycosylated albumin then gets trapped)
this results in a build up of trapped molecules under the endothelial cell
the basal lamina also becomes thickened
this all narrow the lumen = poor blood flow = ischaemia
how can diabetes cause small vessel/ microvascular disease in capillaries?
diabetes can increase connective tissue around capillaries
what are the complications of microvascular disease from diabetes?
amputation
end stage renal disease
blindness
what are the complications from macrovascular disease from diabetes?
CHD
MI
atherothrombotic stroke
what is the process by which there is accumulation of albumin within the sub endothelial space of arterioles called?
hyaline change
is large and small vessel disease in diabetes reversible or irreversible?
irreversible once established
