Chronic Complications- Microvascular Flashcards Preview

PHM 602- Diabetes > Chronic Complications- Microvascular > Flashcards

Flashcards in Chronic Complications- Microvascular Deck (11)
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1
Q

Microvascular complications

A

Retinopathy, nephropathy, neuropathy

2
Q

Nephropathy treatment

A

Optimize glucose and blood pressure control

Consider use of SGLT2i or GLP-1 RA in patients with T2DM and CKD

Assess urinary albumin once a year

ACEi/ARB is recommended when urinary albumin-to-creatinine ratio is ≥300mg/g (macroalbuminuria) and/or eGFR is <60 mL/min (basically Stage 3a, 3b, 4, 5 CKD)

3
Q

A1C goal for hyperglycemia

A

<6.5%

4
Q

Management recommendation for hyperglycemia in CKD

A

Avoid metformin in moderate-severe CKD

Consider dose reductions in other antidiabetic medications for risk of hypoglycemia and other renal-related ADEs

5
Q

BP goal for hypertension

A

<130/80 or <140/90 if diabetic with HTN but low CV risk

6
Q

Management recommendation for HTN in CKD

A

ACEi/ARB and other agents as needed

7
Q

Proteinuria treatment in CKD

A

ACEi/ARB

8
Q

LDL goals for dyslipidemia treatment

A

LDL <100, LDL <70 for patients at high risk

9
Q

Dyslipidemia treatment in CKD

A

Statin recommended, fibrate dose reduction may be required

10
Q

Retinopathy treatment

A

Optimize glycemic control, blood pressure, and lipid control to reduce risk and slow progression

T1DM: eye exam within 5 years of onset of DM

T2DM: eye exam at time of diagnosis of DM

Patients should get yearly eye exams

11
Q

Neuropathy treatment

A

Annual foot exams

Pharmacological therapy options exist like antidepressants (TCAs, SSRIs, SNRIs, etc.), opioids, and anticonvulsants (gabapentin) exist, but they only help with symptoms and not the progression of the disease

The earlier you catch this, the better!