Homeostase pressórica e complicações microvasculares em pacientes diabéticos

Abstract

The retinopathy and nephropathy are among the most prevalent and disabling complications associated to microvascular damage in diabetes mellitus. The severity of hyperglycaemia and the presence of arterial systemic hypertension are among the main risk factors for these complications. The ambulatory blood pressure provided a better understanding of patterns of blood pressure in diabetic patients. There is a growing number of evidence relating diabetic patients with abnormal 24 h blood pressure patterns. Even subtle modifications of these patterns, frequently shown by patients diagnosed as normotensives in office blood pressure measurings, may be implicated in an increased risk of microvascular complications. Hyperglycaemia and these abnormal pressure patterns appear to have a synergistic effect on promoting and aggravating diabetic retinopathy. Impairment of the normal retinal autoregulation is one of the implicated physiopathological mechanisms. Probably, ABP may be useful in predicting an increased risk of microvascular complications on diabetic normotensive patients. The objective of this paper is to provide an updated and clinically oriented review in blood pressure homeostasis and diabetes mellitus.

Digital Ulcers: Multidisciplinary Approach and Dermatological Management

“…Our literature search could not identify any studies that collected such a large number of cases regarding DU of both fingers and toes, making a subdivision based on clinical aspects must be carried out [19]. It is important to assess the pedal pulses, and unless a pulse is clearly palpable, all patients with foot ulcers should undergo non-invasive vascular testing, to determine if the patient would benefit from revascularization.…”

“…Then, a laboratory evaluation based on their metabolic status, and the monitoring for any complications (e.g. heart disease, renal failure, retinopathy, neuropathy) must be carried out [ 19 ]. It is important to assess the pedal pulses, and unless a pulse is clearly palpable, all patients with foot ulcers should undergo non-invasive vascular testing, to determine if the patient would benefit from revascularization.…”