Chronic Long-term Complications Of Diabetes Mellitus

CHRONIC COMPLICATIONS OF DIABETES MEL­LITUS COMMON DISEASES DUE TO DM

HYPERGLYCEMIA AND MICROVASCULAR DISEASE —

  • Hyperglycemia is an important risk factor for the development of microvascular disease in patients with type 2 diabetes, as it is in patients with type 1 diabetes.

Chronic Long-term complications result in morbidity and mor­tality. Children and adolescents with type 2 diabetes are at increased risk for associated comorbidities that include:

Chronic Complications Of Diabetes Mellitus 1

CHRONIC COMPLICATIONS OF DIABETES MEL­LITUS COMMON DISEASES DUE TO DM

  • Hypertension
  • Dyslipidemia
  • Nonalcoholic fatty liver disease (NAFLD)
  • Dyslipidemia —

    • Dyslipidemia is defined as lipoprotein disorders that promote the development of atherosclerosis and include the following abnormalities: .
    • Increased low-density lipoprotein cholesterol (LDL-C)
    • Decreased high-density lipoprotein cholesterol (HDL-C)
    • Increased triglycerides (TG)
  • Hypertension —

    • However, with the increasing prevalence of obesity, primary hypertension is the most common cause of hypertension in adolescents
    • Primary hypertension (also known as essential hypertension) was once considered uncommon in children.
    • In diabetics with more than 20 years disease non­proliferative retinopathy is always present.

Microvascular Chronic Long-term Complications Of Diabetes Mel­litus

  • Eye disease:
    • · Retinopathy
    • ·Macular edema Neuropathy:
    • · Sensory and motor
    • ·Autonomic Nephropathy
  • Macrovascular
    • · Coronary artery disease
    • · Peripheral vascular disease
    • · Cerebrovascular disease
    • · Gastrointestinal
    • · Genitourinary
    • · Dermatologic
    • · Infectious
    • · Cataracts
    • · Glaucoma

Complications common from Long-term 10 – 20 years after hy­perglycemia.

  • Often complications seen at the time of diagnosis.
  • Microvascular complications occur due to hypergly­cemia in type 1 and type 2,
    • so a reduction in blood sugar levels prevents retinopathy,
    • neuropathy
    • and nephropathy.
  • Genetic factors also responsible for complication of diabetes mellitus.
  • In type 2 diabetes mellitus coronary heart disease occurs and mortality is high.
  • In Diabetes mellitus risk depends on :
    • · Blood sugar
    • · Dyslipidemia
    • · Hypertension
    • · Genetic factors.

Mechanism of Chronic Complications Of Diabetes Mel­litus

Intracellular glucose leads to formation of AGE’s (Ad­vanced glycosylation end products) which:

  • · Promote atherosclerosis
  • · Cause glomerular dysfunction
  • · Reduce NO (Nitric OXide) synthesis
  • ·Induce endothelial dysfunction.
  • Growth factors :
    • Play an important role
    • VEGF is involved locally in diabetic proliferating retinopathy.
  • Hyperglycemia :
    • Leads to increased production of reactive oxy­gen or super oxide which is responsible for the complications of diabetes mellitus.
    • Hyperglycemia increases glucose metabolism via sorbitol pathway. This causes generation of re­active oxygen species leading to generalized cellular dysfunction.

Relation of glycemic control and Chronic Complications Of Diabetes Mel­litus

  • The Diabetes Control and Complication Trial (DCCT) offers proof that controlling blood sugar levels pre­vent early complications of Diabetes mellitus type 1.
  • DCCT demonstrated that control of blood sugar leads to decreased incidence of retinopathy, nephropathy and neuropathy.
  • There is also data to support strict glycemic control to reduce complications in type Il DM.
Related Posts:
You May Also Like::