Flashcards in CM: Diabetes Complications Deck (11):
What are the findings of non-proliferative diabetic retinopathy?
leakage --> blood andv (hard) exudates (macular edema can lead to loss of visual acuity)
What are the findings of pre-proliferative diabetic retinopathy?
intra-retinal microvascular abnormalities (IRMA)
cottons wool spots = soft exudates
What are the findings of proliferative diabetic retinopathy?
new vessels = neovascularization (fine tufts)
traction retinal detachment
When should follow up visits for pts w diabetes be conducted?
annually - children, adolescents, adults w/o retinopathy
semi-annually: non-proliferative retinopathy
individualized: proliferative, pregnant
What are important early findings in diabetic nephropathy?
hyperfiltration (CCr above normal)
alterations in glomerular structure (BM thickening and mesangial expansion)
How can microalbuminuria be detected?
dipstick negative, albumin excretion 30-300 mg/24 hrs (30-300 microg/min), found in 2 of 3 urine samples w/i 6 mos
should look for 5 yrs after diagnosis of type 1 and at diagnosis of type 2
What can cause transient microalbuminuria?
poor glycemic control, UTI, physical exercise, high protein intake, cardiac insufficiency
What are the features of distal symmetrical polyneuropathy?
paresthesias (tingling, numbness), pain, impaired sensation (vibratory, pain), nocturnal exacerbation, absent knee and ankle reflexes
motor involvement variable
What are the features of neuropathic ulcers?
caused by loss of protective sensation and repetitive trauma
over areas w increased pressure
hammer-claw toe deformity of foot --> increased pressure on metatarsal heads
What are the risk factors for the dev of diabetic neuropathy?
genetic predispostion, male gender, height, alcohol, hyperglycemia