Complications of Established Diabetes Flashcards
what is the chief cause of death in Diabetics?
Vascular Disease
MI is how much more commoner in Diabetics?
Stroke is how much more common in diabetics?
4x
2x
would you suggest a statin to a diabetic even if they didn’t have signs of IHD?
Yes
what would you give to a diabetic to reduce risk of vascular events?
clopidogrel or aspirin 75mg
commonest cause of end stage renal failure?
diabetic nephropathy
how many diabetics require renal replacement?
30%
why does hyperglycaemia lead to end stage renal failure
hypergylcaemia –> increase in growth factors —> RAAS activation –> oxidative stress
what is first clinical sign of diabetic nephropathy in patient?
albuminuria
how would you detect microalbuminuria?
what does this suggest?
urine dipstick will be -ve
but albumin:creatinine ratio will be >3mg/mmol
suggests early renal disease
if UA:CR ratio >3 in diabetic what medication do you give?
GIve ACE-i to inhibit RAAS even if BP is normal
spironolactone may also helo
how do patients get diabetic retinpoathy?
increased retinal blood flow
causes abnormal metabolism in retinal vessel walls
how often are diabetics screened for eye checks?
once a year
In Diabetics - what are the characteristic features in the following:
- Background Retinopathy
- Pre-proliferative Retinopathy
- Proliferative Retinopathy
- Maculopathy
Background Retinopathy
- microaneurysms (dots) and haemorrhages (blots)
Pre-proliferative Retinopathy
infarcts (cotton wool spots)
Proliferative Retinopathy
new vessel formation (urgent referral)
Maculopathy
hard exudates and all the above
common in T2DM
Why is cataracts common in diabetics?
how is it reversed?
osmotic changes in lens due to acute hyperglycaemia
by normoglycaemia
