Complications of Diabetes

Question 1

What are the microvascular complications of diabetes?

Answer 1

Neuropathy - glove + stocking, tingle, numb, paraesthesia, pain
Retinopathy - diplopia, blurring
Nephropathy

Question 2

What are the macrovascular complications of diabetes?

Answer 2

MI (coronary artery disease)
Cerebrovascular events
Peripheral vascular disease

Question 3

What are the non vascular complications of diabetes?

Answer 3

Diabetic foot (combination of (vasculopathy + neuropathy)
T1DM: DKA, hypoglycaemia
T2DM: HHS
Erectile dysfunction

Question 4

Which non-diabetic drugs should diabetic patients be on for prevention of complications?

Answer 4

Flu vaccine
ACE inhibitor/ARB
Statin

Question 5

When is a statin started in diabetic patients?

Answer 5

> 40 years old if type 1

If 10 year CVD risk > 10% in type 2

Question 6

What are the components of the annual diabetic review?

Answer 6

CV: lipids, BP
Renal: U&Es, urine albumin
Eyes: retinal photography
Neuropathy testing
Foot checks
Ask about erectile dysfunction

Question 7

What are the different components of ‘diabetic foot’?

Answer 7

Neuropathy (may be painful or painless)
PVD --> intermittent claudication (may be painless due to neuropathy)
Neuropathic ulcers (+ arterial ulcers)
Deformities
Infection (cellulitis, osteomyelitis)

Question 8

Which deformities are associated with diabetic foot?

Answer 8

Charcot foot
Toe clawing
High arched foot

Question 9

What are the features of a neuropathic ulcer?

Answer 9

Punched out
Callus base/border
On plantar surface (arterial ulcers on toes or malleoli)
May be signs of infection: cellulitis, pain, smell (anaerobes), fever

Question 10

Which eye problems are associated with diabetes?

Answer 10

Diabetic retinopathy

Increased risk of cataracts + glaucoma