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Diabetes > Complications of Diabetes > Flashcards

Complications of Diabetes Flashcards

1
Q

Diabetic nephropathy is also known as

A

diabetic kidney disease

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2
Q

What is the most common cause of acute kidney failure

A

diabetic nephropathy

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3
Q

poor glycaemic control causes kidney hypertrophy why

A

due to the increase in GFR

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4
Q

An increase in GFR causes what to happen

A

increased arterial dilatation which causes an increased intraglomerular pressure

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5
Q

Increased glomerular pressure in diabetic nephropathy causes what

A

glomerular sclerosis (thickening of the basement membrane and disruption of protein links) causing protein to leak out of the urine

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6
Q

Protein in the urine is called

A

proteinuria

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7
Q

Increased ________ is a sign of renal failure

A

creatinine

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8
Q

What is the investigation for diabetic nephrophathy

A

microalbuminaemia (urinalysis)

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9
Q

What increases the risk of getting diabetic nephropathy

A 
Hypertension 
high cholesterol 
smoking 
poor glycaemic control 
albuminuria
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10
Q

what is the treatment for diabetic nephropathy

A

ACEI/ARBs for patients with proteinuria

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11
Q

A chronically high HbA1c can cause what

A

diabetic retinopathy and peripheral neuropathy

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12
Q

What does abnormal amount of glycosylated sugars do to the retina

A

causes basement membrane thickening and increased permeability

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13
Q

An increase in basement membrane thickening and increased permeability of the retina causes

A

increased passive movement of protein which reacts with the retina to cause a fibrous (scarring) response - damages the retina neural network

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14
Q

what is the investigation for retinopathy

A

annual retina scan

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15
Q

What does an annual retina scan look for

A

haemorrhages
cotton wool spots (areas of ischaemia)
hard exudates

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16
Q

Diabetics are also predisposed to getting what other ocular conditions

A

cataracts

glaucomas

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17
Q

What si the treatment for retinopathy

A

laser
vitrectomy
anti -VEGF injections (stop new blood vessel growth)

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18
Q

What increases the risk of getting diabetic neuropathy

A 
increased length of diabetes 
Type 1
poor glycaemic control 
increased cholesterol 
smoking/alcohol
genetics
mechanical injury
19
Q

What is an example of peripheral neuropathy

A

pain/loss of feeling of feet and hands

20
Q

What are likely symptoms of peripheral neuropathy

A 
distal and symmetrical
numbness/insensitivity
tingling/burning
sharp pain/cramps
sensitivity to touch 
loss of balance and coordination
21
Q

What is the treatment for peripheral neuropathy

A 
amitriptyline 
duloxetine 
gabapentin
pregabalin 
topical capsaicin cream
22
Q

What is an example of focal neuropathy

A

carpal tunnel
foot drop
Bell’s palsy

23
Q

what can focal neuropathy be described as

A

sudden weakness in one/a group of nerves that cause muscle weakness and pain

24
Q

Where is focal neuropathy common

A

head
torso
leg

25
Q

What else might be a focal neuropathy symptom

A 
inability to focus eye
double vision
aching behind the eye
pain in the thigh, chest lower back or pelvis
pain on outside of foot
26
Q

What is an example of proximal neuropathy

A

pain in thigh, hip or bum leading to weakness in legs (amyotrophy)

27
Q

Is proximal neuropathy usually unilateral or bilateral

A

unilateral

28
Q

Who is more likely to get proximal neuropathy

A

elderly T2DM

29
Q

Proximal neuropathy can be described as

A

proximal muscle weakness

30
Q

What is proximal neuropathy associated with

A

weight loss

31
Q

What is an example of autonomic neuropathy

A

changes in bowel/bladder function, sexual response, sweat, HR and BP

32
Q

What symptoms may present in someone with autonomic neuropathy

A

gastric slowing/frequency (constipation/diarrhoea)
gastroparesis - persistent N&V, bloating, loss of appetite
Oesophageal nerve damage - difficulty swallowing can lead to weight loss
If affects HR and BP -> dizziness
can affect sweat glands - can’t control temp

33
Q

what is the treatment for autonomic neuropathy

A

topical gylcopyrrolate
clonidine
botulinum toxin

34
Q

what is the investigations for neuropathy

A

nerve conduction studies/EMG
HR variability
USS
Gastric emptying studies

35
Q

what is the treatment for gastroparesis in autonomic neuropathy

A 
improve glycaemic control 
smaller, more frequent food portions
metoclopramide, domperidone 
erythromycin to improve motility 
prochlorperazine/ondansetron for N&V
NSAIDs for abdo pain
36
Q

What is a complication of peripheral neuropathy

A

foot ulcers

37
Q

What are the 2 types of foot ulcers

A

neuropathic

ischaemic

38
Q

How do foot ulcers occur in peripheral neuropathy

A

damage to nerves causes absence of sweating which causes cracking of skin due to excessive dryness which can lead to infection

39
Q

Where do neuropathic foot ulcers occur

A

in high pressure areas

e.g. metatarsal head/big toe

40
Q

where do ischaemic foot ulcers occur

A

more common in margins of feet

41
Q

Ischaemic foot ulcers are caused by

A

atriovenous shunting which causes ischaemia and decreased nutrients

42
Q

what else will be seen in ischaemic foot ulcers

A

absent pulses
cold feet
gangrene

43
Q

How does charcot foot occur

A

injury to the foot causes decreased bone density and joints are destroyed causing gross deformity

44
Q

what will be seen on an X-ray of charcot foot

A

bag of bones appearance

Diabetes (5 decks)

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