Long-term complications of DM (Risk factors of getting long term…
Long-term complications of DM
occurs when both enough insulin is being produced
occurs when too much insulin is being produced
Macrovascular = big blood vessels
Damage to blood vessels providing circulation to the brain, heart & extremities
Development of atheroma = is accelerated in diabetes and are more prone to developing = ATHEROSCLEROSIS
Disease which plague builds up inside arteries. Over time plague hardens and narrows your arteries. (major cause of coronary artery disease which increase stroke risk)
Four stages :
Damaged endothelium = decreased blood flow and ischaemia
Fatty streak = macrophages go to injured endothelium - release inflammatory cytokines. Macrophages ingest lipids and become FOAM CELLS, once foam cells occur in significant amounts they become a lesion called FATTY STREAK. Macrophages release growth factors that stimulate smooth muscle proliferation.
Fibrous plaque = forms, this can calcify protrude onto vessels lumen & obstruct blood flow to distal tissue.
Complicated lesion = thrombus forms due to endothelial damage.
PERIPHERAL ARTERY DISEASE
it is common circulatory problem in which, narrowed arteries reduce blood flow to limbs.
Extremities can't keep up with demand. Blockage of lower extremity arteries; may lead to:
Impairment in function
High blood sugar levels damage the nerves which can lead to tingling, prickling, numbness and weakness in muscles.
Nerves do not require insulin for glucose transport therefore vulnerable to pathological effects of hyperglycaemia
Distal part of neutron effected first
Damaged Schwann cells
Decreased O2 delivery because there is thickening of nutrients walls that supply nerve
Sensory distal = legs and hands
Autonomic = Body systems may lead to hypoglycaemic unawareness, bowel incontinence, diarrhoea and urine retention.
Microvascular = small blood vessels
Thickening in capillary basement membrane
RETINOPATHY: (Bodies lack of fluid therefore pulls fluid from the eye in an attempt to compensate for loss of fluid in blood = trouble focussing)
Hyperglycaemia disrupts platelet function and causes abnormal thickening of basement membranes in capillaries.
Three stages: (asymptomatic (reversible) until damage is advanced and permanent)
microaneurysms and small haemorrhages in retinal capillaries
Doesn't usually affect visual acuity (sharpness)
Preproliferative & proliferative
further damage to retinal capillaries = capillary neurovascularation (proliferative is managed by laser photocoagulation)
Signs and symptoms:
Difficultly with vision
Bumps and bruises on legs
Appears confused or unsure about placement of objects and people
Glomerulosclerosis thickening of the capillary basement membrane in the glomeruli in kidneys, filtration occurs in glomerulus
Damage to the glomeruli causes increased albumin (protein) to leak out into urine
Leads to HYPONATREMA = oedema
Signs and symptoms:
Protein in urine
Glucose in urine
Risk factors of getting long term complications =
Delayed wound healing due to glucose crowding inside blood vessels, which hinders the passage of white blood cells needed for healing.