Complications of Diabetes Flashcards
(14 cards)
Microvascular complication of diabetes
Retinopathy
Nephropathy
Neuropathy
Microvascular complications
Cardiovascular disease
Cerebrovascular disease
Peripheral vascular disease
Non proliferative DR
Cotton wool spots intra retinal hemorrhages Hard exudates Micro aneurysms Visual loss is due to macular edema
Proliferative DR
Neovascularization from the dis/retinal vessels
Pre retinal and vitreous hemorrhages
High risk- moderate to severe neo vascularisation of the optic disc
Control of risk factors for retinopathy
Intense glycemic control
hypertension
High cholesterol
Smoking cessation
Diabetic Nephropathy - defined as ?
Defined as proteinuria/micro albuminuria
Intensive insulin therapy arrest/slows down the progression of nephropathy - improved the glycemic control
Endothelial layer of capillaries is hyperpermeable because of the uncontrolled diabetes .
Management of nephropathy
Annual albumin/ creatinine ration ACE inhibitor/angiotensin receptor blocker Reduction in BP < 130/80 slows the rate of disease progression Intense glycemic control
Diabetic neuropathy
Most common neuropathy in the world
Decreased sensation and reduced/absent ankle reflexes
Distal symmetrical polyneuropathy
MC form, progressive loss of distal sensation followed by motor weakness
Autonomic neuropathy
postural hypotension, gastro paresis, enteropathy with constipation or diarrhea
Diabetic amyotrophy
Acute asymmetric focal onset of pain - followed by weakness in the proximal leg, progresses over months
Mononeuropathy
3rd, nerve, median nerve
Macrovascular Complications
Premature atherosclerosis Silent MI Stroke Other risk factors; Hypertension, hyperlipidemia, smoking
Peripheral Vascular disease
Claudication (too little blood flow to arms and legs) rest pain, tissue loss, gangrene, high risk of amputations
