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3 Cards in this Set
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Pathogenesis - 3 metabolic pathways
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1. Enhances advanced glycosylation end-products Glucose binding irreversibly to proteins. Over years, forms cross-links, stimulates growth factors, causes fibrosis. 2. Activation of Protein Kinase C Inc VEGF, vasoconstriction, ECM deposition, procoagulant production, pro-inflamm cytokine prod. 3. Intracellular hyperglycaemia Inc cellular susceptibility to oxidative stress |
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Outcome of hyperglycaemia |
- BM thickening, hyalinisation of vessel walls, less elasticity of vessel walls, thickening of mesang matrix. - Proteoglycans not as readily retained by thickened glom BM = reduced charge barrier = proteinuria. - Accelerated atherosclerosis - Vasc damage leading to downstream effects - cellular damage |
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Diabetic microangiopathy |
Capillary basement membrane thickening/hyaline ateriolosclerosis. Contributes to disease in: - kidney, retina, peripheral nerves, brain (e.g. lacunar infarcts, ICH). |
