1. DIABETIC COMPLICATIONS

2. COMPLICATIONS

3. COMPLICATIONS

4. COMPLICATIONS

5. COMPLICATIONS

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

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

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

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

10. How to reduce BP ?
Non – pharmacologic
Pharmacologic
Treatment goals

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

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

14. UTAK (CEREBROVASCULAR)

18. PUSO (CARDIOVASCULAR)

23. NGIPIN (PERIODONTAL)

24. MATA (RETINOPATHY)

26. BATO (NEPHROPATHY)

28. UGAT (NEUROPATHY)

29. PAA (PERIPHERAL ARTERIAL)

32. 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

33. 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

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

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

43. 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

44. gamot
LASER THERAPY
IBA PANG ‘EXPERIMENTAL’ NA GAMOT

45. SAKIT SA PUSO

46. STROKE

48. 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:

49. 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:

50. 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.

51. 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

52. 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

53. 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

54. DIABETIC NEPHROPATHY (Komplikasyon sa bato)

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

56. 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

57. 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.

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

59. 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

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