Chronic diabetic complications
Chronic diabetic complications
Updated: 01/21/2021
© Jun Wang, MD, PhD
General features
- Multisystem involvement
- Hyperglycemia associated cellular dysfunction, including lymphocytes
Key pathogenesis
- Advanced glycation end products
Bind to receptor (RAGE) on inflammatory
cells, endothelium and vascular smooth muscle, promoting inflammatory process and smooth
muscle proliferation
Cross-linking structural proteins, such as
collagen in matrix, promoting trapping of other proteins like LDL
- PKC: Activating plasminogen activator inhibitor-1 (PAI-1)
- Oxidative stress and disturbances in polyol pathways: Intracellular increased fructose and reduced glutathione
- Hexosamine pathways: Excess proteoglycans
Clinical features
- Macrovascular diseases: Most common cause of mortality in long-standing diabetes
Myocardial infarction
Renal vascular insufficiency
Cerebrovascular accidents
- Microvascular diseases:
- Compromised immune function
Susceptibility to skin infections, tuberculosis,
pneumonia, and pyelonephritis, etc
- Others: Cataract, glaucoma, etc
Back to diabetes
Back to pathology
of endocrine pancreas
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of endocrine system
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