Complications of diabetes Flashcards
What are the risk factor for developing diabetic neuropathy?
Length of disease T1DM>T2DM poor glycaemic control Smoking Alcohol High cholesterol/lipids
What are the symptoms of peripheral neuropathy?
Numbness Tingling/burning sensation Sharp pain/cramps Sensitivity to touch Loss of balance/coordination
What are the complications of peripheral neuropathy?
Ulceration infection charcot foot (midfoot collapse) Hammer toe Amputation
What happens in focal neuropathy?
sudden weakness in one nerve
What can be a sign/symptom of focal neuropathy?
Carpal tunnel
foot drop
What happens in proximal neuropathy?
pain in leg/buttocks etc
Muscle weakness in thigh
What is amyotrophy?
assymmetrical muscle weakness
How does autonomic neuropathy present in sweat glands?
gustatory sweating
inability to control body temperature
How does autonomic neuropathy present in GI system?
Gastroparsesis
Constipation/diarrhoea
Dysphagia
What is the treatment for gastropaesis?
gastric pacemaker
motility agent
What are the symptoms of gastroparesis?
nausea
vomiting after meal
bloating
How does gastroparesis affect blood glucose?
Slow absorption
Fluctuating blood glucose
How does autonomic neuropathy present in CVS?
postural hypotension
prolonged tachycardia after physiological response
What is the name for diabetic nephropathy?
Kimelsteil Wilson Syndrome
What happens histologically in Kimelsteil Wilson Syndrome?
Nodular Glomerulosclerosis
Angiopathy of capillaries
What are the consequences of diabetic nephropathy?
Hypertension
Reduced GFR if untreated
Accelerated vascular disease
What is the target blood pressure in diabetic patients?
130/80
What is the first line drug when treating hypertension in diabetics?
ACE inhibitors
work on RAAS
What screening tests can be done for diabetic nephropathy?
Urinary ACR (ablumin:creatinine ratio)
Dipstick for proteinuria
U+Es
Annual screening on over 12year olds
What are the normal ACR values for a) males b) females?
a) <3.5
What needs to be done if microalbuminuria is found?
screen for retinopathy screen for IHD/PVD look for other renal causes screen for hypertension tighten glycaemic control moniter serum creatinine
What levels of albumina consitiute a) microalbuminuria and b) macroalbuminuria
a) 30-300 mg
b) >300 mg
What are the macrovascular complications of diabetes?
Stroke
MI
What are the microvascular complications of diabetes?
neuropathy
nephropathy
retinopathy
erectile dysfunction
What are the psychological complications of diabetes?
depression
eating disorders
schizophrenia
bi-polar disorder
