Flashcards in Diabetes Complications Deck (36):
What are the macrovascular complications of diabetes?
What are the microvascular complications of diabetes?
neuropathy; nephropathy; retinopathy; cognitive dysfunction/dementia; erectile dysfunction; psychiatric
what are the types of neuropathy in diabetes?
peripheral; autonomic; proximal; focal neuropathy
What are the risk factors for developing neuropathy?
increased length of diabetes; poor glycaemic control; type 1 diabetes; high cholesterol/lipis; smoking; genetic; mechanical injury
What is periphaeral neuropathy?
distal symmetric or sensorimotor
What are the symptoms of periphaerla neuropathy?
numbness/insensitivity; tingling/burning; sharp pains or cramps; sensitivity to touch; loss of balance and coordination
What are the complications of peripheral neuropathy?
charcot foot; painless trauma; foot ulcer
What are the treatments for painful neuropathy?
amitriptyline; duloxetine; gabapentin
What is the next step is one drug does not work in painful neuropathy?
change or titrate up, combinations are not recommended
What is focal neuropath?
appears suddenly and affects specific nerves, most often head, torso or leg
What are symptoms of focal neuopathy?
inability to focus eye; double vision; aching behind eye; bells palsy; pain in thigh/chest/lower back/pelvis; pain on outside of foot
What is entrapment neuropathy?
weakness in one nerve or a group of nerves causing muscle weakness or pain- carpal tunnel
What other names is proximal neuropathy known as
lumbosacral plexus neuropathy; femoral neuropathy or diabetic amyotrophy
How does proximal neuropathy start?
starts with pain in the thighs, hips, buttocks or legs, usually on one side of the body; prox. muscle weakness, weight loss
Who gets proximal neuropathy?
What does autonomic neuropathy affect?
nerves regulating HR, BP as wel as control of internal organs involved in gastric motility, resp function , rintaion, sexual function and vision
What are the signs of autonomic neuropathy in the digestive system?
gastroparesis; gastric slowing/frequency-constipation/diarrhoea; dysphagia
What are the treatments for gastroparesis?
improving glycaemic control; diet- smaller, more frequent meals, low fat, low fibre; promotility drugs; anti-nauea drugs; abdo pain treatment- NSAIDs; gastric pacemaker
How does autonomic neuropathy affect the eyes?
makes the pupils less responsive to changes in light
What is diabetic nephropathy?
progressive kidney disease caused by daamge to teh capillaries in the kidneys glomeruli, characterized by nephrotic syndrome and diffuse scarring of the glomeruli
What are the consequences of diabetic nephropathy?
HT; decline in renal function; accelerated vascular disease
How is nephraopthy screened for?
urinary albumin creatinine ratio
What are the risk factors for nephropathy progression?
HT; cholesterol; smoking; glycamic control; albuminuria
What is the blood pressure target in diabetes pts with nephropathy?
What drug should be commenced in pateints with microalbuminuria or proteinuria?
ACEI or ARB
What eye pathologies do diabetic patients get?
diabetic retinopathy; cataracts; glaucome; acute hyperglycaemia
What are the stages of retinopathy?
mild non-proliferative; moderate non-proliferative; sever non-proliferative; proliferative
What are cotton wool spots?
What are hard exudates?
lipid break down products that have leaked from vessels
What are IRMAs?
intra-retinal microvascular abnormalities- precursor to neovascularisation
What is seen with mild background retinopathy?
haemorrages and microaneurysms
What is seen in pre-proliferative retinopathy?
microaneuryms; hard exudates; haemorrages
What is seen in severe non-proliferative retinopathy?
IRMA; venous beading; haemorrages
What is seen in severe proliferative retinopathy?
new vessel formation which causes fibrosis
What are the treatments for retinopathy?