Long Term Complications of Diabetes Flashcards
List some of the potential macrovascular complications of diabetes.
Coronary vascular disease
Cerebrovascular disease
Peripheral vascular disease
List some of the potential microvascular complications of diabetes.
Retinopathy
Nephropathy
Neuropathy
What are some of the heart and vessel based conditions which diabetic patients are at increased risk of?
CVD
Atherosclerosis
Stroke
MI
Which is ‘good’ cholesterol- HDL or LDL?
HDL
In those with diabetes, what is higher, LDL or HDL?
LDL
-> therefore, this is why those with type 2 diabetes are at higher risk of atherosclerosis
Diabetes also causes dysfunction of the endothelium. How does this link to increased risk of atherosclerosis as a complication?
Disruption of smooth endothelium which is required to prevent clots and build up of fat
What can atherosclerosis lead to?
Ischaemic heart disease
Peripheral vascular disease
Ischaemic cerebrovascular disease
What are some of the ways macrovascular disease can be prevented in diabetics?
Good control of diabetes
Blood pressure control
Lipid control
Smoking cessation, weight management and exercise
What can be done in the management of severe foot ulcers?
Foot ulcer care
IV antibiotics
Sometimes xrays for osteomyelitis
Rest and avoidance of pressure on ulcer
Improve glycaemic status
-> ulcers have a slow healing process
Retinopathy?
Disease of the retina
What are the two types of diabetic retinopathy?
Non proliferative diabetic retinopathy
Proliferative diabetic retinopathy
What happens in non-proliferative diabetic retinopathy?
Retinal capillary dysfunction
Platelet dysfunction
Blood viscosity abnormality
What happens in proliferative diabetic retinopathy?
Retinal ischaemia
New blood vessel formation
Vitreous haemorrhage
Retinal tears/detachment
What is more serious- non-proliferative diabetic retinopathy or proliferative diabetic retinopathy?
Proliferative diabetic retinopathy
-> can lead to blindness
What is the treatment for proliferative diabetic retinopathy?
Treated with laser photocoagulation
->this blocks off areas of ischaemia and prevents it from spreading
In those with type 1 diabetes, what % of patients will have some form of diabetic retinopathy?
100%
In those with type 2 diabetes, what % of patients will have some form of diabetic retinopathy?
60%
What are some of the other eye conditions that diabetic patients are at greater risk of?
Glaucoma
Cataracts
Nephropathy?
Deterioration in kidney function
What happens in diabetes which causes nephropathy?
Microalbuminuria, there’s a leak of albumin
This means the blood pressure ratio changes and the renal filter system is not able to function properly
-> kidneys and retina are effected due to having many tiny blood vessels in a small place
What happens if renal function is not checked in those with diabetes?
May end up with end stage renal disease and require dialysis
-> diabetes is the biggest single cause of end stage renal disease requiring dialysis
What % of all diabetic patients have some renal complications?
75%
-> 20% go on to overt kidney disease which needs treatment
What can be done to prevent complications of nephropathy?
Screening of urine for albumin is vital
Good diabetic control
Hypertension control
Renin-angiotensin system blockade
Neuropathy?
Nerve damage causing numbness or various parts of the body
Neuropathy can also contribute to which other complication of diabetes?
Foot ulcers
->[patient has reduced sensation so cannot feel the ulcer
What are the three types of neuropathy?
Sensory
Motor
Autonomic
Where does sensory neuropathy typically effect?
Feet and lower legs
What is the name of the foot related condition that can occur in diabetic patients?
Charcot Foot
What happens in Charcot Foot?
Foot becomes enlarged and bones become soft and bulky
What causes Charcot Foot?
Broken bones which settle in strange positions after not healing correctly. Diabetic patients often do not feel this due to neuropathy affecting the perception of pain
