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endocrine > complications of diabetes > Flashcards

complications of diabetes Flashcards

1
Q

chronic complications of diabetes

A
  • macrovascular
  • microvascular
  • cognitive dysfunction/dementia
  • erectile dysfunction
  • psychiatric
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2
Q

what annual screening for diabetes

A
  • digital retinal screening
  • foot risk assessment
  • urine albumin
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3
Q

what does excess glucose cause to happen

A

mitochondrial dysfunction

-reactive oxygen species produced

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4
Q

which pathway can glucose then be directed down

A

the polyol pathway

-producing sorbitol

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5
Q

what does sorbitol cause

A

osmotic damage

-then reactive oxygen species

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6
Q

what happens in the pentose phosphate pathway

A

GDP turns into NADPH oxidase which is harmful

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7
Q

what happens in the hexosamine pathway

A

F6P turns into UDP-GlcNAC which causes inflammation and fibrosis

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8
Q

what can happen to G3P

A

turns into diacyl glycerol which activates protein kinase C

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9
Q

when excess glucose is converted to AGE what happens

A

they bind to receptors of age which then can trigger an inflammatory response which results in reactive oxygen species

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10
Q

what eye pathologies do people with diabetes get

A
  • diabetic retinopathy
  • macular oedema
  • cataract clouding
  • glaucoma (increase in fluid pressure)
  • visual blurring
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11
Q

what are the four stages of retinopathy

A
  • mild non-proliferative
  • moderate non-proliferative
  • severe non-proliferative
  • proliferative
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12
Q

what are cotton wool spots

A

ischaemic areas

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13
Q

what are hard exudates

A

lipid break down products

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14
Q

what is IRMA

A

intra-retinal microvascular abnormalities

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15
Q

sign of bleeding in the eye

A

significant loss of vision in one eye

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16
Q

treatment of retinopathy

A
  • laser (mainstay)

- vitrectomy (if a vitreal haemorrhage)

17
Q

mainstay of treatment for diabetic macular oedema

A

intravitreal Anti-VEGF

18
Q

what is diabetic nephropathy

A

a progressive kidney disease caused by damage to the capillaries in the kidney’s glomeruli.
-characterised by the proteinuria and diffuse scarring of the glomeruli

19
Q

what are some complications of diabetic nephropathy

A
  • development of hypertension
  • relentless decline in renal function
  • accelerated vascular disease
20
Q

is dipstick positive or negative for microalbuminuria

A

negative

21
Q

dipstick positive or negative for proteinuria

A

positive

22
Q

what can give false positives for microalbuminuria

A
  • menstruation
  • vaginal discharge
  • UTI
  • pregnancy
  • other illness
  • non-diabetic renal disease
23
Q

what should you do after microalbuminuria is identified

A
  • check for retinopathy
  • investigate other causes of renal pathology
  • screen for peripheral vascular disease
  • discourage smoking
  • tighten glycemic control
  • assess fasting lipid profile
  • screen and treat hypertension
  • screen for ischaemic heart disease
  • monitor serum creatine
24
Q

what are the different types of neuropathy

A
  • peripheral
  • proximal
  • autonomic
  • focal neuropathy
25
Q

signs of proximal neuropathy

A

-pain in the thighs, hips or buttocks leading to weakness in the legs

26
Q

signs of autonomic neuropathy

A
  • changes in bowel
  • bladder function
  • sexual response
  • heart rate
  • blood pressure
27
Q

what is focal neuropathy

A

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

28
Q

risk factors for neuropathy

A
  • increased length of diabetes
  • poor glycaemic control
  • type 1 diabetes
  • high cholesterol/lipids
  • smoking
  • alcohol
  • inherited traits
  • mechanical injury
29
Q

symptoms of peripheral neuropathy

A
  • numbness
  • tingling
  • burning
  • sharp pains or cramps
  • sensitivity to touch
  • loss of balance and coordination
30
Q

what is charcot arthropathy

A
  • destructive inflammatory process
  • fractures/bony destruction
  • deformity of the foot
31
Q

presentation of charcot arthropathy

A

-hot swollen foot

32
Q

treatment for charcot arthropathy

A
  • non-weight bearing
  • total contact cast
  • aircast boot
33
Q

treatment options for painful neuropathy

A
  • amitriptyline
  • duloxetine
  • gabapentin
  • pregabalin
34
Q

how does autonomic neuropathy affect the gut

A
  • constipation/diarrhea
  • gastroparesis
  • bloating
  • loss of appetite
  • oesophagus nerve damage
35
Q

how can autonomic neuropathy affect sweat glands

A
  • affects nerves
  • body can’t regulate temperature as it should
  • can cause profuse sweating
36
Q

symptoms of cardiovascular autonomic neuropathy

A
  • blood pressure may drop sharply after sitting or standing

- heart rate may stay high

endocrine (40 decks)

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