Diabetes

Question 1

General History Diabetes

Answer 1

Type
How long
Impact on occupation/hobbies/driving
Infections e.g. candida
Medications and side effects
Control: BMs, HbA1c, hypos
Complications and annual screening: angina, stroke, claudication, neuropathic symptoms, visual disturbance, erectile dysfunction, foot checks
Smoking
FH

Question 2

How would you investigate a diabetic foot ulcer

Answer 2

Swab ulcers
Bloods including HbA1c, fasting lipids, urine ACR
Imaging: X-rays, Doppler USS for vascular supply, MRI

Question 3

How would you manage a diabetic foot ulcer?

Answer 3

Optimise diabetic control
Regular dressings
Offloading orthotics
Antibiotics
Revascularisation
Surgical review of osteomyelitis

Question 4

Symptoms of diabetes

Answer 4

Thirst, polyuria, polydipsia
Weight loss
Blurred vision
Recurrent infections

Question 5

Causes of neuropathic ulcers

Answer 5

Diabetes
Leprosy
Tabes dorsalis
Amyloidosis
Alcoholic neuropathy
Charcot Marie tooth
Drugs
B12/thiamine deficiency

Question 6

Secondary causes of diabetes

Answer 6

Steroids
PCOS
Hyperthyroid
Cushing Syndrome
Cystic fibrosis
Haemachromatosis
Acromegaly
Phaeochromocytoma
Glucagonoma

Question 7

Symptoms of autonomic neuropathy

Answer 7

Dystegulated sweating
Constipation, bacterial overgrowth
Gastroparesis with vomiting
Diarrhoea
Postural hypotension
Bladder, erectile dysfunction
Cardiac dysrhythmias