CM: Diabetes Complications Flashcards Preview

Block 8 - Endo & Repro > CM: Diabetes Complications > Flashcards

Flashcards in CM: Diabetes Complications Deck (11):

What are the findings of non-proliferative diabetic retinopathy?

capillary non-perfusion
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)
intra-retinal hemorrhages
cottons wool spots = soft exudates
venous bleeding


What are the findings of proliferative diabetic retinopathy?

new vessels = neovascularization (fine tufts)
fibrous tissue
vitreous hemorrhage
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
quarterly: pre-proliferative
individualized: proliferative, pregnant


What are important early findings in diabetic nephropathy?

BP elevation
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


How can one examine a pt for subclinical diabetic neuropathy?

quantitative sensory tests:
vibratory perception threshold - measures large nerve fiber integrity, better in upper limbs
thermal perception threshold - measures small nerve fiber integrity
also tactile perception threshold and electrical threshold