File Name: microvascular and macrovascular complications of diabetes .zip
Microvasular and macrovascular complications in diabetes mellitus: Distinct or continuum? Diabetes and related complications are associated with long-term damage and failure of various organ systems. The line of demarcation between the pathogenic mechanisms of microvascular and macrovascular complications of diabetes and differing responses to therapeutic interventions is blurred. Diabetes induces changes in the microvasculature, causing extracellular matrix protein synthesis, and capillary basement membrane thickening which are the pathognomic features of diabetic microangiopathy. These changes in conjunction with advanced glycation end products, oxidative stress, low grade inflammation, and neovascularization of vasa vasorum can lead to macrovascular complications. Hyperglycemia is the principal cause of microvasculopathy but also appears to play an important role in causation of macrovasculopathy. There is thought to be an intersection between micro and macro vascular complications, but the two disorders seem to be strongly interconnected, with micro vascular diseases promoting atherosclerosis through processes such as hypoxia and changes in vasa vasorum.
In parallel with the growing diabetes pandemic, there is an increasing burden of micro- and macrovascular complications, occurring in the majority of patients. The identification of a number of synergistic accelerators of disease, providing therapeutic pathways, has stabilised the incidence of complications in most western nations. However, the primary instigators of diabetic complications and, thus, prevention strategies, remain elusive. This has necessitated a refocus on natural history studies, where tissue and plasma samples are sequentially taken to determine when and how disease initiates. In addition, recent Phase III trials, wherein the pleiotropic effects of compounds were arguably as beneficial as their glucose-lowering capacity in slowing the progression of complications, have identified knowledge gaps. Recently the influence of other widely recognised pathological pathways, such as mitochondrial production of reactive oxygen species, has been challenged, highlighting the need for a diverse and robust global research effort to ascertain viable therapeutic targets.
The management of type 1 and 2 diabetes mellitus DM requires addressing multiple goals, with the primary goal being glycemic control. Maintaining glycemic control in patients with diabetes prevents many of the microvascular and macrovascular complications associated with diabetes. This chapter presents a review of the prevalence, screening, diagnosis, and management of these complications. Microvascular complications of diabetes are those long-term complications that affect small blood vessels. These typically include retinopathy, nephropathy, and neuropathy. Macrovascular complications of diabetes are primarily diseases of the coronary arteries, peripheral arteries, and cerebrovasculature.
Diabetes mellitus is becoming more prevalent and even with new advancements which improve glycaemic control, complications of diabetes are common. Vascular complications of diabetes include the microvascular complications: retinopathy, nephropathy, and peripheral and autonomic neuropathy. Macrovascular complications are also common in patients with diabetes and arguably more concerning as they confer a high mortality risk yet are sometimes under-treated. Risk factors for diabetes complications start to occur in childhood and adolescents and some youths may be diagnosed with complications before transition to adult care. This article discusses the prevalence, risk factors, screening, and treatment recommendations for vascular complications in children and adolescents with diabetes.
Generally, the injurious effects of hyperglycemia are separated into macrovascular complications (coronary artery disease, peripheral arterial disease, and stroke) and microvascular complications (diabetic nephropathy, neuropathy, and retinopathy).
Ann Endocrinol Metab 3 1 Accepted: March 14, Published Online: March 16, The aim of this study was to assess the prevalence of microvascular complications of type 1 diabetes mellitus, to define the relationship between the disease duration and the onset of these complications among Congolese children, adolescents and young adults with type 1 diabetes mellitus.
It is the best journal to keep up to date with endocrine pathophysiology both in the clinical and in the research field. It publishes the best original articles of large research institutions, as well as prestigious reviews. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two receding years.
Metrics details. The global prevalence of type 2 diabetes-related complications is not well described. We assessed prevalence of vascular complications at baseline in DISCOVER NCT; NCT , a global, prospective, observational study program of 15, patients with type 2 diabetes initiating second-line therapy, conducted across 38 countries. Patients were recruited from primary and specialist healthcare settings. Data were collected using a standardized case report form.
Diabetes mellitus DM is a worldwide public health problem that affects millions of people from all age, gender, and racial and ethnic groups. DM is the leading cause of blindness and amputation and contributes substantially to kidney disease, cardiomyopathy, and cerebrovascular and peripheral artery diseases. Of importance, recent advances in biology and medicine have introduced new technologies to study the molecular pathology underlying DM-related complications, the development of novel strategies to treat these conditions, and the evaluation of outcomes. The present special issue has been designed to stimulate the continuing efforts to develop novel drugs and therapeutic targets and new perspectives of combined therapies for decreasing micro- and macrovascular complications in DM. It includes one review article and ten original research papers, from leading and emerging scientists with diverse expertise and interests, and covers three thematic areas: a epidemiology and pathogenesis of DM-related complications; b microvascular complications nephropathy, retinopathy, and neuropathy ; and c macrovascular complications cardiovascular disease, stroke, and peripheral artery disease. In all these thematic areas, pathophysiological and molecular mechanisms are discussed and novel drug-target therapies, as well as stem cell-based therapy, are documented in either preclinical or clinical studies.
Microvascular and macrovascular complications. Macrovascular Introduction. The long-term vascular complications of diabetes attachments/dipdf).
Microvascular and macrovascular complications in relation to diabetes mellitus are responsible for major morbidity and mortality condition. Prevention of these complications should be the aim while managing diabetes. Retinopathy, nephropathy and neuropathy are microvascular complications and macrovascular complication affects heart, brain and foot. In preventing retinopathy, glycaemic and blood pressure control is essential. Laser photocoagulation therapy can prevent loss of vision in non-proliferative or proliferative diabetes mellitus. The aim of preventing nephropathy lies on meticulous glycaemic control, dietary protein limitation and vigorous control of blood pressure. The highest priority at present to prevent diabetic neuropathy is the education of patients and their physicians about the potential for detection and treatment of early neuropathy.
С интервалом в три минуты была зарегистрирована вторая серия команд запирания-отпирания. Согласно регистру, кто-то открывал ее компьютер, пока ее не было в комнате. Но это невозможно. У нее перехватило дыхание. Единственным кандидатом в подозреваемые был Грег Хейл, но Сьюзан могла поклясться, что никогда не давала ему свой персональный код. Следуя классической криптографической процедуре, она выбрала пароль произвольно и не стала его записывать. То, что Хейл мог его угадать, было исключено: число комбинаций составляло тридцать шесть в пятой степени, или свыше шестидесяти миллионов.
- Прости меня, Мидж. Я понимаю, что ты приняла всю эту историю близко к сердцу. Стратмор потерпел неудачу.
Сьюзан отвернулась. - Не имеет значения. Кровь не. Выпустите меня отсюда.
Наверное, хотел сюда переехать, - сухо предположил Беккер. - Да. Первая неделя оказалась последней. Солнечный удар и инфаркт.
Стратмор задумался. - С какой стати он должен на него смотреть? - спросил .
- Панк снова сплюнул в проход. - Чтоб мы не надоедали. - Значит, я не могу сойти. Парень захохотал. - Доедешь до конечной остановки, приятель.
Этот прибор он купил в магазине электроники, оплатив покупку наличными, чтобы сохранить анонимность. Никто лучше его не знал, как тщательно следило агентство за своими сотрудниками, поэтому сообщения, приходящие на этот пейджер, как и отправляемые с него, Стратмор старательно оберегал от чужих глаз. Сьюзан опасливо огляделась. Если до этого Хейл не знал, что они идут, то теперь отлично это понял. Стратмор нажал несколько кнопок и, прочитав полученное сообщение, тихо застонал.
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