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2 ENDOCRINE > Microvascular complications of diabetes > Flashcards

Microvascular complications of diabetes Flashcards

1
Q

what are common microvascular complications

A

blindness
dialysis
amputation

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2
Q

what is the relationship between HbA1c and risk of microvascular complications

A

higher HbA1c = higher risk

esp. retinopathy

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3
Q

what is peripheral neuropathy

A

peripheral - pain/loss of feeling in feet, hands

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4
Q

what is autonomic neuropathy

A

changes in bowel, bladder function, sexual response, heart rate, blood pressure

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5
Q

what is proximal neuropathy

A

pain in the thighs, hips or buttock leading to weakness in the legs

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6
Q

what is focal neuropathy

A

sudden weakness in one nerve or a group of nerves causing muscle weakness or pain eg. carpal tunnel, ulnar mono neuropathy, foot drop, bells palsy

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7
Q

what is the basic pathophysiology of microvascular disease

A

hyperglycaemia and hyperlipidaemia leads to hypoxia, oxidative stress, inflammation and mitochondrial dysfunction

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8
Q

what factors increase the risk of neuropathy

A 
increased length of diabetes 
poor glycaemic control 
type 1 diabetes>type 2 diabetes 
high cholesterol/lipids 
smoking 
alcohol 
inherited traits 
mechanical injury
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9
Q

peripheral neuropathy symptoms

A 
numbness/insensitivity 
tingling/burning 
sharp pains or cramps 
sensitivity to touch 
loss of balance and coordination
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10
Q

what are some complications of peripheral neuropathy

A

Charcot foot
painless trauma
foot ulcers

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11
Q

how do you treat painful neuropathy

A

amitriptyline, duloxetine or gabapentin (titrate up as needed)

topical capsaicin cream can be used as another option

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12
Q

symptoms of focal neuropathy

A 
inability to focus eye 
double vision 
aching behind eye 
Bell's palsy 
pain in thigh/chest/lower back/pelvis 
pain on outside of foot
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13
Q

symptoms of proximal neuropathy

A

starts with pain in thighs, hips, buttocks or legs usually on one side of the body

more common in elderly type 2

often associated with marked weight loss

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14
Q

what is autonomic neuropathy

A

neuropathy affecting the nerves regulating heart rate, blood pressure and control of internal organs

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15
Q

autonomic neuropathy affect on digestive system

A

gastric slowing/frequency-constipation
diarrhoea
gastroparesis (slow emptying)
oesophagus nerve damage (may make swallowing difficult)

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16
Q

what is the treatment for gastroparesis

A 
improved glycemic control 
diet - smaller more frequent food portions 
promotability drugs 
antibiotics 
botulinum toxin 
gastric pace maker
17
Q

affect of autonomic neuropathy on swear glands

A

prevents the sweat glands from working properly

body cannot regulate its temperature as it should

profuse sweating at night or while eating ‘gustatory sweating’

18
Q

how to treat autonomic neuropathy affects on swear glands

A

topical glycopyrrolate
clonidine
botulinum toxin

19
Q

Affect of autonomic neuropathy on heart and blood vessels

A

cardiovascular system nerve damage interferes with bodies ability to adjust to blood pressure and heart rate

blood pressure may drop sharply after sitting or standing causing a person to feel light headed/faint

heart rate may stay high instead of rising and falling in response to activity

20
Q

what are some diagnostic tools for neuropathy

A

nerve conduction studies or electromyography
heart rate variability
ultrasound
gastric emptying studies

21
Q

what is diabetic nephropathy

A

progressive kidney disease caused by damage to the capillaries in the kidneys and glomeruli

22
Q

consequences of diabetic nephropathy

A

development of hypertension
relentless decline in renal function
accelerated vascular disease

23
Q

how to screen for nephropathy

A

albumin creatinine ratio
screen all patients ages 12 or over
dipstick test at point of care
U&Es

24
Q

risk factors for nephropathy progression

A 
hypertension 
cholesteral 
smoking 
glycemic control 
albuminuria
25
Q

treatment for nephropathy

A

maintain blood pressure <130/80
ACE or ARB
good glycemic control

26
Q

what are the stages of diabetic retinopathy

A

mild non-proliferative
moderate non-proliferative
severe non-proliferative
proliferatice

27
Q

what eye diseases to diabetics get

A

diabetic retinopathy
cataracts
glaucoma
acute hyperglycaemia

28
Q

how often do low risk diabetics get retinopathy screening

A

annually

29
Q

what causes erectile dysfunction in diabetic men

A

vascular and neuropathy

30
Q

what does a haemorrhage look like

A

dot/blot/flame on eye

31
Q

what are cotton wool spots on eye

A

ischaemic areas

32
Q

what are hard exudates

A

lipid break down products

2 ENDOCRINE (32 decks)

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