Chronic Diabetes Complications

Question 1

name the three main microvascular diabetic complications

Answer 1

retinopathy
nephropathy
neuropathy

Question 2

name the three main macrovascular diabetic complications

Answer 2

stroke
heart disease
peripheral vascular disease

Question 3

controlling blood glucose reduces the risk of macro or microvascular issues?

Answer 3

microvascular has best evidence

Question 4

what are the two main types of diabetic retinopathy?

Answer 4

non proliferative and proliferative

Question 5

explain the pathogenesis of non proliferative diabetic retinopathy

Answer 5

thickened capillary basement membrane

loss of pericytes leads to hemorrhages and exudates

Question 6

explain the pathogenesis of proliferative diabetic retinopathy?

Answer 6

stenosis of vessels cause ischemia and you get neovascularization

Question 7

aside from prolif anf non prolif diabetic retinopathy what can happen with eye in diabetes?

Answer 7

clinically significant macular edema

Question 8

name the four findings of non proliferative diabetic retinopathy

Answer 8

microaneurysms
inraretinal hemorrhages
cotton whool spots
hard exudates

Question 9

what are patients with proliferative diabetic retinopathy at an increased risk for?

Answer 9

traction retinal detachments

vitreous hemorrhage

Question 10

which of NPDR and PDR is worse?

Answer 10

PDR has greater chance of leading to blindness if untreated

Question 11

what is pathology of clinically significant macular edema?

Answer 11

permeable vascular walls lead to leakage and accumulation of intraretinal fluid

Question 12

what is the leading cause of vision loss in diabetic retinopathy?

Answer 12

macular edema is number 1

Question 13

what is the diabetic nephropathy change that happens at level of glomeruli?

Answer 13

glomerulosclerosis

Question 14

what is the pathophys of glomerulosclerosis in diabetic nephropathy?

Answer 14

increase basement membrane and mesangium

Question 15

what is histo finding in diabetic glomerulosclerosis?

Answer 15

kimmelstein wilson nodules

Question 16

what are findings in diabetic glomerulosclerosis?

Answer 16

permeable capillaries lead to proteinuria

Question 17

what is the microvascular change seen in diabetic nephropathy?

Answer 17

arteriolosclerosis

Question 18

what is result of arteriolosclerosis in vessels in diabetic nephropathy?

Answer 18

ischemia

Question 19

what is most common finding of diabetic nephropathy?

Answer 19

albuminuria

Question 20

what is second finding that is common in diabetic nephropathy?

Answer 20

low GFR

Question 21

what is screening tool for diabetic nephropathy?

Answer 21

spot urine albumin:creatinine ratio and serum creatinine

Question 22

what is the approved rx for diabetic nephropathy?

Answer 22

ACE and ARBs

Question 23

what diet change can be made to help diabetic nephropathy?

Answer 23

low protein diet

Question 24

what is the most common type of diabetic neuropathy?

Answer 24

symmetric peripheral neuropathy (stocking glove pattern)

Question 25

aside from the PNS, what other nervous system can have diabetic neuropathy?

Answer 25

autonomic neuropathy

Question 26

what are some common symptoms of autonomic neuropathy?

Answer 26

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Question 27

what sense is lost in lower leg that contributes to ulcers etc

Answer 27

sensation

Question 28

what deformity can occur in diabetes?

Answer 28

charcot foot

Question 29

what is a common test for the foot exam in diabetes?

Answer 29

semmes weinstein monofilaent

Question 30

what three meds can be given for painful peripheral symptoms of diabetes neuropathy?

Answer 30

gabapentin pregabalin and duloxetine

Question 31

what increases in diabetes that can lead to cardiovascular issues?

Answer 31

triglycerides

Question 32

what should you give to lower triglycerides in diabetes?

Answer 32

statin therapy