Chronic Complications of DM

Question 1

What are the complications of DM?

Answer 1

vascular problems
microangiopathy
macroangiopathy
neuropathy
infections
cataracts
pregnancy

Question 2

What causes chronic complications in DM?

Answer 2

degenerative changes in many tissues with both TI and TII
esp when blood glucose levels poorly controlled
insulin deficit and glucose excess = alterations metabolic pathways involving carbohydrates, lipids and proteins

Question 3

Vascular Problems

Answer 3

changes in small and large arteries
degeneration related to metabolic abnormalities

Question 4

Microangiopathy

Answer 4

capillary basement membrane becomes thick and hard = obstruct/rupture capillaries and small arteries = tissue necrosis, loss of function

retinopathy = blindness
diabetic nephropathy = chronic renal failure

Question 5

Macroangiopathy

Answer 5

like atherosclerosis, affects large arteries
= high incidence heart attack, stoke, peripheral vascular disease

obstruction arteries legs = ulcers of feet and legs, decreased pain sensation but intermittent claudication = impaired mobility, decreased blood flow = freq infection = gangrenous = some case amputation

Question 6

Neuropathy

Answer 6

peripheral neuropathy common
= impaired senstation , numbness, tingling weakness and muscle wasting , results from ischaemia and altred metabolic process

risk tissue trauma and infection ^ when vascular impairment +sensory impairment co exist

autonomic nerve degeneration
= bladder incontinence , impotence and diarrhoea

impaired vasomotor reflexes = dizzy on standing

Question 7

Infections

Answer 7

vascular impairment decreases tissue resistance
delay headling due insulin deficit and ^glcuose that support infection both = predisposition infection in case surgery or trauma

fungal infections, UTI, cystitis and pyleonoprhitisd, periodontal disease

Question 8

Cataracts

Answer 8

clouding lens
degenerative process relates abnormal metabolism of glucose = accumulated sorbitol and water in lens , destroying transparency
may eventually = blinders
should be removed when impart visual function

Question 9

Pregnancy

Answer 9

may cause complications for mother and foetus
maternal diabetes moresever , control more difficylu with continual hormonal and metabolic changes = increased incidcen spontaneous abortions and abnormalities in infants ad diabetic mothers