DIABETIC COMPLICATIONS

COMPLICATIONS

COMPLICATIONS

COMPLICATIONS

COMPLICATIONS

CVD Risk Factors: Smoking - promotes atherosclerosis Sedentary lifestyle – bawal ang tamad !!! Family history Abdominal obesity – esp. central obesity Hypertension Dysglycemia Dsylipidemia

How to reduce cholesterol level ? Non – pharmacologic Pharmacologic Treatment goals

How to reduce cholesterol level ? Non – pharmacologic - diet – bawal ang apat na paa !! - exercise – more than 30 minutes, more than 3x a week

How to reduce cholesterol level ? Treatment Goals: total cholesterol – less 160 triglycerides – less 100 LDL – less 70 (high risk) HDL – >45 (male) >55 (female)

How to reduce BP ? Non – pharmacologic Pharmacologic Treatment goals

How to reduce BP ? Non – pharmacologic lifestyle modification: - low fat , low salt diet - limited alcohol use - regular physical exercise - smoking cessation

How to reduce BP ? Treatment Goal: BP should be less 120/80 pre-hpn 120/80 stage I 140/90 stage II 160/100

UTAK (CEREBROVASCULAR)

PUSO (CARDIOVASCULAR)

NGIPIN (PERIODONTAL)

MATA (RETINOPATHY)

BATO (NEPHROPATHY)

UGAT (NEUROPATHY)

PAA (PERIPHERAL ARTERIAL)

MATA (RETINOPATHY) pangunahing dahilan ng pagkabulag Type 1 diabetes= lahat may retinopathy pagkatapos ng 10 taon Type 2 diabetes= >60% may retinopathy pagkatapos ng 10 taon

maaari ring ito ang unang simtomas sa diabetes karamihan din sa mga diabetiko ay may retinopathy na sa panahong nalaman na sila ay may diabetes mas malala ang retinopathy sa mga type 1 na diabetiko

mga simtomas panlalabo ng paningin pagdilim ng paningin pagdoble ng paningin itim na ‘spots’ sa paningin

mga ‘risk factors’ hindi kontroladong asukal hindi kontroladong ‘blood pressure’ mataas na mantika ng dugo

pangangalaga ng mata Gawing regular ang pagmomonitor sa asukal sa dugo Magplano ng tamang pagkain Magpatingin sa ophthalmologist minsan sa isang taon o mas madalas pa depende sa mungkahi ng doktor Panatilihing normal ang presyon ng dugo

gamot LASER THERAPY IBA PANG ‘EXPERIMENTAL’ NA GAMOT

SAKIT SA PUSO

STROKE

THE ARTERIAL WALL The normal artery has three distinct layers: the intima is the innermost layer and is composed of a single layer of endothelial cells on the luminal surface; the media is a tube of vascular smooth muscle cells (VSMCs) and their extracellular matrix; and the adventitia, the outer protective layer, is made of loose connective tissue that holds the blood vessels and nerves that supply the artery itself.1 The endothelial cells of the intima have a number of important functions: forming a nonthrombotic, nonadherent surface; acting as a semipermeable membrane; synthesizing and releasing chemical mediators; maintaining the basement membrane; and modifying lipoproteins as they cross into the artery wall.2 The VSMCs of the media contract and relax to alter the lumen diameter of the vessel in response to a variety of circulating and local stimuli, regulating vascular tone, blood flow, and blood pressure. This is caused by the production of a number of vasoactive substances, including prostaglandins, endothelin, and nitric oxide (NO).1 As the next slides reveal, LDL cholesterol is a central culprit in disrupting the normal homeostasis of the artery and its lumen, setting the stage for vascular occlusion, ischemia, and infarction. References Weissberg PL. Atherosclerosis involves more than just lipids: Plaque dynamics. Eur Heart J. 1999;1(suppl T):T13-T18. Ross R. The pathogenesis of atherosclerosis: A perspective for the 1990s. Nature. 1993;362:801-809.

ATHEROSCLEROSIS (paninigas ng ugat) The normal artery has three distinct layers: the intima is the innermost layer and is composed of a single layer of endothelial cells on the luminal surface; the media is a tube of vascular smooth muscle cells (VSMCs) and their extracellular matrix; and the adventitia, the outer protective layer, is made of loose connective tissue that holds the blood vessels and nerves that supply the artery itself.1 The endothelial cells of the intima have a number of important functions: forming a nonthrombotic, nonadherent surface; acting as a semipermeable membrane; synthesizing and releasing chemical mediators; maintaining the basement membrane; and modifying lipoproteins as they cross into the artery wall.2 The VSMCs of the media contract and relax to alter the lumen diameter of the vessel in response to a variety of circulating and local stimuli, regulating vascular tone, blood flow, and blood pressure. This is caused by the production of a number of vasoactive substances, including prostaglandins, endothelin, and nitric oxide (NO).1 As the next slides reveal, LDL cholesterol is a central culprit in disrupting the normal homeostasis of the artery and its lumen, setting the stage for vascular occlusion, ischemia, and infarction. References Weissberg PL. Atherosclerosis involves more than just lipids: Plaque dynamics. Eur Heart J. 1999;1(suppl T):T13-T18. Ross R. The pathogenesis of atherosclerosis: A perspective for the 1990s. Nature. 1993;362:801-809.

MGA SANHI NG PANINIGAS NG UGAT Figure 3 Traditional risk factors include age, male sex, dyslipidemia, hypertension, smoking, and diabetes. More recently identified risk factors include obesity and a sedentary lifestyle.

ANO ANG DAPAT GAWIN PARA MAIWASAN ANG SAKIT SA PUSO & STROKE? sobrang pag-inom ng alak paninigarilyo matakaw sa maalat, matamis o matataba na pagkain Sobrang timbang (overweight) Regular na exercise

ANO ANG DAPAT GAWIN PARA MAIWASAN ANG SAKIT SA PUSO & STROKE? Regular check-up sa doktor Altapresyon <130/80 mmhg Diabetes Fasting - <100 mg/dl After a meal - <140 mg/dl Lahi BP check-up FBS, 2-hPGBS

ANO ANG DAPAT GAWIN PARA MAIWASAN ANG SAKIT SA PUSO & STROKE? Regular check-up sa doktor Laboratory examination: Total cholesterol - <200 mg/dl LDL cholesterol - <100 mg/dl HDL cholesterol – men >45 mg/dl women > 50 mg/dl Triglyceride - < 150 mg/dl HbA1c - < 6% ECG

DIABETIC NEPHROPATHY (Komplikasyon sa bato)

ANO ANG DIABETIC NEPHROPATHY Isang kondisyong unti-unting pagkasira ng bato dahil sa epekto ng diabetes

ANO ANG NANGYAYARI SA KIDNEYS PAG MAY DIABETIC NEPHROPATHY Glomerular Hypertension kauna-unahang pagbaba- gong abnormal sa kidneys Protina sa ihi a. Microalbuminuria b. macroalbuminuria

ANO ANG NANGYAYARI SA KIDNEYS PAG MAY DIABETIC NEPHROPATHY End Stage renal disease ( Tuluyang pag kasira ng kidneys) ay nang yayari 5-10 yrs matapos madiskubre ang komplikasyong ito.

PANO MALALAMAN KUNG MAY DIABETIC NEPHROPATHY Micral test Normal o pagiging malaki ng sukat ng kidneys sa Ultrasound Anemia

MGA SANHI NG PAGKAKAROON NG DIABETIC NEPHROPATHY Hyperglycemia - mataas na asukal sa dugo Hypertension o High blood pressure Proteinuria o Protina sa ihi Paninigarilyo Hyperlipidemia o mataas na kolesterol

PAANO MAGAGAMOT O MAIIWASAN ANG DIABETIC NEPHROPATHY Control ng blood sugar Control ng blood pressure Dialysis Kidney transplant