case 6 - disease complications Flashcards
what is the epidemiology of diabetes 1
10% of global health expenditure is spent on diabetes - 80% spent on managing complications
1,110,100 children and adolescents have type 1 diabetes
what are the microvascular complications of type 1 diabetes
diabetic retinopathy
diabetes nephropathy
diabetes neuropathy
what are the macrovascular complications of type 1 diabetes
stroke
heart disease
peripheral vascular disease
what is the macula responsible for
responsible for out central vision, most of the colour vision and detailed vision
what is the diabetic retinopathy classification and what is the scale used
Retinopathy scale:
Goes from R0 —> R3
Maculopathy:
Goes from M0-M1
Photocoagulation:
Goes from P0 —>P1
Had previous surgery - photocoagulation scars for P1
what is the prevalence of exudates and haemorrhages (R1) in type 1 diabetes
Any retinopathy 77%
Proliferative retinopathy 32%
what is the prevalence of exudates and haemorrhages (R1) in type 2 diabetes
25% any retinopathy
3% proliferative retinopathy
what are the venous changes that can happen (R2)
beading, looping and reduplication
what are the proliferative changes (R3)
new vessels
On disc or elsewhere
fibrous proliferation
On disc or elsewhere
haemorrhages
Pre-retinal
Vitreous
what are the prevention methods for diabetic retinopathy
glycemic control (UKPDS, DCCT)
Blood pressure control
Annual screening
what are the treatment options for diabetic retinopathy
photocoagulation
anti-VEGF therapy
Surgery
what are the different diabetic neuropathy characteristics
Distal symmetrical sensorimotor polyneuropathy and small fibre neuropathy
Radiculopathies
Mononeuropathy - can affect cranial nerves
Autonomic neuropathy
what is the pain in peripheral neuropathy
Burning
Paraesthesia
Persistent hyperaesthesia
Nocturnal exacerbation
what is the loss of sensation in peripheral neuropathy
postural hypotension
Diabetic gastroparesis
Small bowel bacterial overgrowth
Cardiac autonomic neuropathy
Urogenetic
what are the first line agents for neuropathy pain
Duloxetine
Pregabalin
Gabapentin
Amitryptiline
what are the treatments for gastroparaesis
Prokinetics
Botox to pylorus,
gastric pacemakers
what are the treatments for postural hypotension
Fludrocortisone
Midodrine
Compression stockings