complications of diabetes mellitus

Question 1

what are the acute complications of diabetes ?

Answer 1

diabetic ketoacidosis
hyperglycemic hyperosmolar non-ketotic syndrome
hypoglycaemia

Question 2

what are the chronic complications of DM ?

Answer 2

microvascular complications
macro vascular complications
foot ulcers
infections

Question 3

what are the three major metabolic derangements of DKA and how is a definitive diagnosis made ?

Answer 3

hyperglycemia
ketosis
metabolic acidosis ( low bicarb and low pH )
along with ketonemia

Question 4

when does pseudohyponatremia happen ?

Answer 4

diabetic ketoacidosis

Question 5

what is the clinical manifestation of DKA ?

Answer 5

• person typically has a history of 1 or 2 days of polyuria, polydipsia, nausea and vomiting
• stupor that can progress to a coma
• characteristic fruity/acetone breath

Question 6

which signs in DKA are related to compensatory mechanisms ?

Answer 6

increase in heart rate
increase in rate and depth of inspiration

kussmaul breathing

Question 7

what is the treatment for DKA ?

Answer 7

administration of IV fluids, insulin and electrolyte replacement solutions

Question 8

what is hyperglycemic hyperosmolar non-ketotic syndrome characterized by ?

Answer 8

hyperglycaemia 
hyperosmolarity 
dehydration 
no ketoacidosis 
depressed sensorium

Question 9

what two main factors contribute too the hyperglycaemia that precipitates in HHNK ?

Answer 9

• increased resistance to the effect of insulin ( insulin resistance )
• increased carb intake

- an excessive carbohydrate intake

Question 10

what is the treatment of HHNK ?

Answer 10

judious medical observation

correction of potassium loss levels

Question 11

what can hypoglycaemia occur from ?

Answer 11

excessive insulin in the blood

Question 12

how can hypoglycaemia happen in a T1DM patient ?

Answer 12

• error in insulin dose
• failure to eat
• increased exercise
• decreased need of insulin after stress situations
• medication changes

Question 13

what is the presentation of hypoglycaemia ?

Answer 13

brain affection 
headaches 
coma 
seizures 
altered behaviour 
" cool and clammy"

Question 14

what is the treatment of hypoglycaemia ?

Answer 14

immediate source of a conc fast acting carbohydrate source such as sugar, honey, candy or orange juice

Question 15

what is the leading cause of end stage renal disease ?

Answer 15

diabetic nephropathy

Question 16

what is the best early predictor of end stage renal disease ?

Answer 16

microalbuminuria

Question 17

what is a major risk factor for foot ulcers ?

Answer 17

distal symmetric neuropathy

Question 18

what are the common sites of trauma in diabetic foots ?

Answer 18

back of the heel
plantar metatarsal are
great toe

Question 19

generally when does kussmaul breathing happen ?

Answer 19

in cases of metabolic acidosis

Question 20

what is the main difference between hyperglycemic hyperosmolar nonketotic syndrome and DKA ?

Answer 20

1- HHNK has no ketosis or acidosis whilst DKA does
2- there are more prominent neurological symptoms associated with HHNK