Microvascular Complications of Diabetes Flashcards Preview

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Flashcards in Microvascular Complications of Diabetes Deck (47)
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1

What are the 3 main microvascular complications of diabetes?

  1. Retinopathy
  2. Nephropathy
  3. Neuropathy

2

Why do microvascular complications occur in diabetes?

Hyperglycaemia and hyperlipiaemia contribute to hypoxia, oxidative stress, inflammation, mitochondrial dysfunction and damaged nerves

3

What are the 4 types of neuropathy experienced in diabetes?

  1. Peripheral
  2. Autonomic
  3. Proximal
  4. Focal neuropathy

4

Neuropathy is more associated with which type of diabetes?

Type 1

5

Which things increase an individuals risk of developing neuropathy?

  1. Poor glycaemic control
  2. Increased length of time with diabetes
  3. Alcohol
  4. High cholesterol
  5. Smoking
  6. Inherited
  7. Mechanical injury

6

What is the most common neuropathy?

Peripheral

7

What is peripheral neuropathy and how does it present?

Distal or sensorimotor neuropathy

  1. Numbness/insensitivity
  2. Tingling/burning
  3. Sharp pains/cramps
  4. Sensitivite touch is maintained
  5. Loss of balance and coordination

8

What are some complications of peripheral neuropathy?

  1. Charcot foot
  2. Painless trauma
  3. Foot ulcer

9

What is a Charcot foot?

Progressive degeneration of a weight bearing joint, marked by bony destruction, bone resorption, and eventual deformity

10

Why is it so key that intensive treatment is started from the outset of diabetes?

Good glycaemic control from the start decreases long term risks

11

Why are injuries obtained from peripheral neuropathy particularly dangerous?

  1. They can worsen more than normal due to lack of pain
  2. Infection may occur and healing is poor

12

Which treatment may slow progression of Charcot foot?

Bisphosphonates

13

How may peripheral neuropathy be treated if it is painful?

  1. Amitriptyline
  2. Duloxetine
  3. Gabapentin
  4. Pregabalin
  5. Capsaicin cream

14

What is focal neuropathy?

Acute neuropathy affecting specific nerves, or groups of nerves most often in the head, torson or leg

15

How may focal neuropathy present?

  1. Inability to focus eye
  2. Double vision
  3. Aching behind eye
  4. Bell's palsy
  5. Pain in thigh/chest/lower back/pelvis
  6. Pain on outside of foot

16

What is entrapment neuropathy and give an example?

Weakness in one nerve or group of nerves causing muscle weakness or pain

Carpal tunnel

17

What is proximal neuropathy and how does it present?

  1. Lumbosacral plexus neuropathy
  2. Femoral neuropathy
  3. Diabetic amyotrophy

Presents with:

  • Pain in thighs, hips, buttocks or legs
  • Usually occurs on one side
  • More common in elderly T2DM

18

What is proximal neuropathy associated with?

Weight loss

19

What is autonomic neuropathy?

Neuropathy affecting the nerves of the autonomic nervous system

20

How may autonomic neuropathy present?

  1. Changes in HR/BP
  2. GI motility changes e.g. gastroparesis
  3. Sexual function change
  4. Urination
  5. Vision

21

How may gastroparesis present?

  1. Becoming full easily
  2. GORD
  3. Vomiting
  4. Diarrhoea

22

How is gastroparesis best treated?

  1. Improve glycaemic control
  2. Lower fat intake
  3. Smaller meals
  4. Promotility drugs
  5. Botox into sphincter
  6. Gastric pacemaker

23

Why may someone with diabetes experience "gustatory sweating"?

Autonomic neuropathy affecting sweat glands

24

How can autonomic neuropathy of sweat glands be treated?

  1. Topical glycopyrrolate
  2. Clonidine
  3. Botuliunum toxin (botox)

25

When autonomic neuropathy affects the heart how is blood pressure generally affected?

Postural hypotension

26

How does autonomic neuropathy affect the eyes?

Makes pupils less responsive to light

 

27

In terms of neuropathy, what may USS be used for in terms of diagnosis?

Bladder or urinary tract to show normal emptying and function

28

What is the use of nerve conduction studies or electomyography?

Determines type and extent of nerve damage in neuropathy

(how well muscles respond)

29

What does the FRAME project stand for?

Foot Risk Awareness and Management Education

30

What is diabetic nephropathy?

Progressive disease

Damage to capillaries surrounding glomeruli

Leads to scarring and renal failure