Flashcards in Diabetes - Complications, Emergencies & Acute Illness Deck (81)
What complication occurs in at least 50% of diabetic men because of a vascular disease and/or nephropathy?
In which type of diabetes is neuropathy most common?
Describe the typical distribution of symptoms of peripheral neuropathy?
'Glove and stocking'
What are some potential complications of peripheral neuropathy?
Painless trauma, foot ulcers, Charcot foot
What oral painkillers can be used to treat peripheral neuropathy?
What topical treatment can be used in the management of localised pain from peripheral neuropathy?
What is the main gastrointestinal problem which occurs as a result of autonomic neuropathy?
Autonomic neuropathy can lead to abnormal temperature regulation. This can cause sweating when?
At night or when eating
What effect does autonomic neuropathy have on the eyes?
Makes them less responsive to changes in light
What is the name for the type of neuropathy which appears suddenly and affects only specific nerves?
Which type of neuropathy usually starts with unilateral pain in the thighs/hips/buttocks and is more common in elderly type 2 diabetics?
What is used to screen for diabetic nephropathy?
Urinary albumin: creatinine ratio
What type of urine sample should ideally be used to take a urinary albumin: creatinine ratio?
Early morning sample
All patients with microalbuminuria should be started on what medication?
ACE inhibitor or ARB
Diabetes is a risk factor for which pathologies affecting the eyes?
Retinopathy, maculopathy, cataracts and glaucoma
What effect does acute hyperglycaemia have on the eyes, but is reversible?
A blood glucose of less than what value is generally considered as hypoglycaemia?
What are some factors which may contribute to reduced awareness of hypoglycaemia?
Frequent hypos, long duration of disease
What are some examples of common drugs (other than diabetic drugs) which may cause hypoglycaemia as a side effect?
Beta blockers, ACE inhibitors, aspirin (in overdose) and alcohol
What other endocrine condition, not specifically affecting the pancreas, can cause hypoglycaemia?
How should hypoglycaemia be managed if the patient is able to swallow?
Oral glucose and a long-acting carbohydrate
How should hypoglycaemia be managed if the patient cannot swallow but there is IV access?
200-300mls 10% IV dextrose
How should hypoglycaemia be managed if the patient cannot swallow and there is no IV access?
1mg IM glucagon (repeat after 20 mins)
Once an individual who has been hypoglycaemic regains consciousness, what adverse effect may they experience?
The production of acetone as a by-product of ketoacidosis produces what clinical sign?
Fruity smelling breath
What happens to the blood glucose level in DKA?
It is significantly raised, usually > 11mmol/L
The lack of insulin in DKA can lead to what electrolyte abnormality?
Kussmaul's respiration is a sign of what diabetic emergency?
In DKA, what abnormal sign may occur, even in the absence of infection?