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Flashcards in Diabetic complications 1 Deck (17)
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1
Q

Give an overview of the pathophysiology causing microvascular complications of diabetes

A
  1. Hyperglycaemia and hyperlipidemia
  2. Result in hypoxia, oxidative stress, inflammation etc
  3. This causes complications e.g. Retinopathy, Nephropathy, Neuropathy, Erectile dysfunction
2
Q

Define neuropathy

A

Disease or dysfunction in one or more nerves (most commonly peripheral nerves)

3
Q

What are the different types of neuropathy caused by diabetes ?

A
  • Peripheral
  • Autonomic
  • Proximal
  • Focal neuropathy
4
Q

Define peripheral neuropathy

A

Pain/loss of feeling in feet, hands

5
Q

What are the symptoms of peripheral neuropathy ?

A
  • Numbness/lack of sensation
  • Tingling/burning
  • Sharp pains or cramps
  • Sensitivity to touch
  • Loss of balance and co-ordination
6
Q

What are some of the complications of peripheral neuropathy ?

A
  • Charcots foot - weakening of the bones, until fracture occurs, with continued walking the foot changes shape
  • Painless trauma
  • Foot ulcer
7
Q

Define what focal neuropathy is

A

Appears suddenly and affects specific nerves, most often head, torso or leg

8
Q

What are the symptoms of focal neuropathy ?

A
  • Inability to focus eye
  • Double vision
  • Aching behind eye
  • Bells palsy
  • Pain in thigh/chest/lower back/pelvis
  • Pain on outisde of foot
9
Q

What is entrapment neuropathy ?

A

Weakness in one nerve or a group of nerves causing muscle weakness or pain e.g. carpal tunnel syndrome

10
Q

What is proximal neuropathy ?

A

e.g. pain in the thighs, hips or buttocks leading to weakness in the legs (often associated with marked weight loss)

11
Q

What is autonomic neuropathy ?

A

Affects the nerves regulating HR&BP as well as control of interal organs such as those involved in gastric motility, resp function, urination, sexual function and vision

12
Q

What affects can autonomic neuropathy have on the digestive system ?

A

Gastric slowing/frequency/constipation/diarrhoea, gastroparesis etc

13
Q

What affect can autonomic neuropathy have on HR and blood vessels ?

A

CV system nerve damage interfers with the bodies ability to adjust HR&BP e.g. BP may drop suddenly after sitting or standing causing a person to feel light headed/faint

HR may stay high instead of rising & falling in response to normal body functions and physical activity

14
Q

What affects can autonomic neuropathy have on the eyes ?

A
  • Can make the pupils less responsive to changes in light
  • Sign may be person is not able to see well when a light is turned on in a dark room or may have trouble driving at night
15
Q

What are some of the tests for neuropathy ?

A
  • Nerve conduction studies or electromyogrpahy - determine the extent of nerve damage
  • Heart rate variability - shows how HR responds to normal body functions
  • Ultrasound - to assess bladder bowels etc
  • Gastric emptying studies
16
Q

What should all diabetic patients have to try to catch potential complications developing ?

A

Annual screening of eyes, feet and kidneys (urninary albumin creatinine ratio ACR and Us and Es)

17
Q

What are the treatment options for painful neuropathy ?

A
  • Amytriptyline
  • Pregabalin
  • OR Gabapentin
  • OR Duloxetine

Or if they cannot tolerate oral treatments - topical capsaicin cream