Lecture 17: Pathology of Diabetes Mellitus and Its Complications

Question 1

pathology of type II diabetes mellitus

Answer 1

Combination of:
- reduced tissue sensitivity to insulin (insulin resistance) and
- inability to secrete high levels of insulin to counteract insulin resistance caused by central adiposity

Question 2

what is the annual mortality rate of type 2 diabetics

Answer 2

annual mortality is 5.4% - double the rate of non-diabetics

Question 3

life expectancy is decreased by how much due to type 2 diabetes?

Answer 3

decreased by 5-10 years

Question 4

what is the commonest cause of death in type 2 diabetes patients?

Answer 4

myocardial infarction

Question 5

what is the main complication from type 2 diabetes?

Answer 5

• damage to vessels
• DM accelerates atherosclerosis
• coronary heart disease 2-20x
• myocardial infarction 2-5x
• atherothrombotic stroke 2-3x

Question 6

describe arteriolar disease in type 2 diabetes

Answer 6

also called hyaline change
- molecules flux into subendothelail space but find it hard to flux back into blood.
- build up of ‘trapped’ molecules under endothelial cell.
- basal lamina also becomes thickened.
- narrow arteriole > poor blood flow > ischaemia.

Question 7

where is arteriolar disease (hyaline change) especially damaging in type 2 diabetes?

Answer 7

• very damaging in kidney, peripheral tissues (foot), eyes and in arterioles supplying nerves.

Question 8

relative risk of morbidites associated with arteriolar disease in type 2 diabetes

Answer 8

• amputation > 40x
• end stage renal disease > 25x
• blindness > 20x

Question 9

what complication happens to capillaries in type 2 diabetes?

Answer 9

small vessel disease
- increased connective tissue around capillaries e.g. glomerulus in kidney

Question 10

del

Answer 10

del