Chronic DM Complications Flashcards
What are the MACROvascular complications of DM?
- coronary artery dz
- cerebral vascular dz
- peripheral arterial dz
What physical signs can happen to diabetics with peripheral arterial dz?
- claudication
- gangrene
- amputations
Tx of MACROvascular Complications
- lifestyle modifications
- ACE/ARB decreases CV complications
- start a statin based on risk
- baby aspirin
- glycemic control
What are the MICROvascular complications of DM?
- retinopathy
- nephropathy
- neuropathy
What are possible retinopathy findings in DM?
- small hemorrhages
- hard exudates
- microaneurysms
- edema
- cotton wool spots
What screening is used for retinopathy?
-yearly dilated eye exam
What might happen long-term in diabetics with nephropathy?
leading cause of end stage renal dz
What screening is used for nephropathy?
urine albumin/creatinine ratio (goal <30)
How is nephropathy treated in DM?
- ACE or ARB can decrease the risk
- they are 1st line tx even without HTN
What findings are possible with neuropathy for DM?
- sensory, focal/multifocal, autonomic
- peripheral sensory is most common
- stocking/glove distribution
What screening is used for neuropathy?
- monofilament exam annually
- foot exam on every visit
Tx of Neuropathy in DM
- prevention!
- gabapentin, pregabalin
- amitriptyline for peripheral sensory
Manifestations of Autonomic Neuropathy
- gastroparesis
- cardiovascular: orthostasis, resting tachycardia
- erectile dysfunction
- neurogenic bladder
What infections can occur as DM complications?
- pseudomonas otitis externa
- increase in UTI, PNA, skin and soft tissue
- diabetic foot infections
- mucormycosis (fungal sinus infx)
- emphysema infxs of GB and urinary tract
What skin changes may occur with diabetes complications?
- poor wound healing and ulcerations
- pretibial ulcerations (necrobiosis lipoidica)
- eruptive xanthomas (firm yellow nodules)
- acanthosis nigricans (hyperpigmentation)
