Diabetes Flashcards
1
Q
What are the macrovascular effects of diabetes?
A
Atheroma
- increased hepatic production of atherogenic lipoproteins
- suppression of lipid uptake in peripheral tissues
- abnormal endothelial function with pro-coagulant results
- develop earlier than without DM
2
Q
What are the microvascular effects of diabetes?
A
- diabetic nephropathy
- diabetic retinopathy
- delayed wound healing
- foot ulcers
- relate to long term effects of hyperglycaemia on cells and ECM –> particularly glycosylation of proteins
3
Q
What is the typical initial presentation of diabetic nephropathy?
A
Proteinuria
- later deterioration in renal function, may lead to chronic renal failure
4
Q
What are two typical histological lesions in diabetic nephropathy?
A
- spherical nodules arising in mesangium and eventually becoming balls of collagen - “Kimmelstiel-Wilson” nodules
- arteriolar wall thickening by hyaline arteriolosclerosis
5
Q
What is diabetic retinopathy?
A
Ischaemia due to microvascular injury and reduced perfusion –> retina becomes relatively ischaemic
6
Q
Why are foot ulcers difficult to treat in diabetics?
A
The combination of poor wound healing, difficulty eradicating infection and neuropathy leading to repeated minor trauma means that sometimes amputation is the only option –> amputation creates a wound on the stump which must also heal
