Complications of diabetes Flashcards
List the microvascular complications caused by diabetes?
Retinopathy
Nephropathy
Neuropathy
What is neuropathy?
Disease / dysfunction of nerves typically causing numbness or weakness
What are the clinical features of diabetic neuropathy?
Pain
- paraesthesia
- burning
- nocturnal exacerbation
Autonomic
- postural hypotension
- diarrhoea + constipation
- incontinence
- erectile dysfunction
Insensitivity
- foot ulceration
- infection
- amputation
Describe what the sensation loss in diabetic peripheral neuropathy feels like?
Glove and stocking
When you touch the limb it feels like it is being touched through a glove or stocking
Some people also get pain feels like electric shocks, broken glass
Treatment of painful diabetic neuropathy?
Good control of diabetes
Tricyclic antidepressants
Anticonvulsants
Many more
Why do diabetic patients often get foot ulcers?
They lose sensation in their legs, so they don’t feel when they inflict trauma on the foot
The injury is not able to heal because the person is not treating it or preventing infection
It gets worse and becomes an ulcer
Diabetic neuropathy only affects sensory nerves. True or false?
False, it can affect motor nerves too
Risk factors for getting diabetic retinopathy?
Poorly controlled diabetes Long duration diabetes Hypertension Being on insulin treatment Pregnancy
How can you prevent diabetic retinopathy?
By screening diabetes patients for eye damage
Describe the pathogenesis of diabetic retinopathy?
Hyperglycaemia causes death of pericyte cells (cells that surround the capillaries)
This leads to thickening of basement membrane
The vessels become incompetent and damage the retina
Clinical features of diabetic retinopathy?
Blurred vision
Eye floaters and spots
Double vision
Eye pain
Treatment of diabetic retinopathy?
Laser treatment
Does not improve sight but prevents it worsening
Risk factors of diabetic nephropathy?
High BP
High blood glucose
Clinical features of diabetic nephropathy?
Proteinuria
Progressive decline in renal function
Give some macroscopic complications of diabetes?
Cardiovascular disease: stroke, MI
Peripheral vascular disease: reduced blood flow to peripheries
