Complication of Diabetes

Diffculty concentrating; Confusion; Weakness; Vision changes; Dizziness; Tiredness

Blood glucose below 4.0mmol/L; Blood glucose below 3.0mmol/L is classified as clinically significant

Level 1: Between 3 and 3.8mmol/L; Level 2: less than 3 mmol/L; Level 3 : severe hypoglyaemia

Glucagon; Adrenaline; Cortisol; GH

Skipped meals when taking medications; Increasing physical activity without adjusting food or medications; Renal impairment; Excess alcohol consumption

Hypoglyacemia is delayed after physical activity that appears during the night

Reduced cointer regulatory hormone response; Reduced autonomic symptoms; Lowered glycaemic tresholds for triggeriing symtptoms and hormonal responses

Continuous glucose monitoring

Automated insulin delivery system

An abnormal amount of lipids in the blood

Microvascular - kidney disease, nerve disease, blindess; Macrovascular - atheroscleroiss and cardiovascular events

Activation of pro inflammatory signalling cascades —> impaired vasodillation and increased vascoconstriction

Advanced glycation end products which increase expression of TNF alpha and NOX

Advanced glycation end products caused by non enzymaticc reactions

Increased glycolysis increases ROS levels; Activation of enzymes involved in DNA repair can impair glycolysis and lead to generation of AGEs; AGEs increase oxidative stress and ROS; Cycle begins again

Cause structual protein modification - basement membrane thickness, reduced vascular elasticity; Interactions with AGE receptors - gene expression of pro inflammatory molecules

Chronic progressive disease of the retinal microvasculature

Progressive kidney disease caused by long standing diabetes

Proteinuria; Glomerular hypertrophy; Renal fibrosis; Reduced glomerular filtration

Chronic progressive disorder of the peripheral nervous system due to damage to the vasa nervorum

Stroke; Heart disease - MI, heart failure; Peripheral artery disease

Community aquired pneumonia