Please enable JavaScript.
Coggle requires JavaScript to display documents.
macrovascular complications (singns and symptoms (exercise-induced nausea,…
macrovascular complications
definition
these are complications of any large blood vessels in the body.
they include the coronary arteries, the aorta and the arteries in the brain and in the limbs.
these complications occurs if an individual has been diabetic for an extended period of time.
comprise arthrosclerosis with deposit of lipids within the inner layer of vessel walls.
classifications
cerebrovascular disease, risk of stroke
cardiovascular disease, risk of heart attack
peripheral vascular disease, poor circulation to the limbs
management
screening high risk patients such as those with history of diabetes
encourage patient to exercise to manage obesity
encourage patients to stop smoking
conducting regular blood pressure checks
treating peripheral vascular diseasess
encourage patient to use self glucose monitoring
emphasize medication compliance and follow up
maintain lipid and lipoprotein profiles that reduce risk for macrovascular disease
phathophysiology
results from hypergycaemia, excess free fatty acid and insulin resistance.
these causes increased oxidative stress, protein kinase activation, and activation of the receptor for advanced glycation end products.
factors that act on the endothelium
decreased nitric oxide, increased endothelin, and increased angiotensin two cause vasoconstriction that lead in hypertension and vascular smooth muscle cell growth.
decreased nitric oxide, activated nuclear factor-KB, increased angiotensin two, and activation of activated protein-1 increase inflammation, which results in the release of chemokines, cytokines, and expression of cellular adhesion molecules.
decreased nitrict oxide, increased tisue factor, increased plasminogen activator inhibitor-1, and decreased prostacyclin result in thrombosis, hypercoagulation, platelet activation, and decreases fibrinolysis.
then all this pathways lead to atherosclerosis, the cause of the macrovascular complications of diabetes.
singns and symptoms
exercise-induced nausea
reduced exercise tolerance
dyspnea
angina
erectile dysfunction
claudication