Diabetes 3

Question 1

What is the risk of someone with DM to develop neuropathy?

Answer 1

40-50% of diabetics

Question 2

Give examples of autonomic neuropathies and acute-onset neuropathies.

Answer 2

autonomic neuropathies: cardiovascular, gastrointestinal, genito-urinary, sudomotor

acute onset: mononeuropathy, mononeuropathy multiplex, radiculopathy, plexopathy

Question 3

What is the most common neuropathy of patients with DM?

Answer 3

distal, symmetrical sensory polyneuropathy affecting the toes and ascending; destruction is mostly sensory (pain, proprioception, vibration, temperature and touch

Question 4

What are the key points of evaluation of a diabetic foot?

Answer 4

assessment of blood flow, foot architecture (Charcot’s foot), skin/hair/nail condition and neurologic exam with vibration, proprioception, 10g monofilament and ankle reflexes

*patients should be instructed in good foot care

Question 5

What are the key points of evaluation of a diabetic foot?

Answer 5

assessment of blood flow, foot architecture (Charcot’s foot), skin/hair/nail condition and neurologic exam with vibration, proprioception, 10g monofilament and ankle reflexes

*patients should be instructed in good foot care

Question 6

How much does DM increase your risk of macrovascular complications like heart disease and stroke?

Answer 6

2-4x more likely to have heart disease

> 65% of all diabetes related deaths are associated with CVD

Question 7

What are the symptoms that suggest gastroparesis or cardiac neuropathy?

Answer 7

gastroparesis- fullness, constipation and diarrhea, hard to control blood glucose

cardiac neuropathy: fixed pulse, is highly correlated with sudden death

**gustatory sweating (around head and neck when eating) is another sign of additional neuropathy

Question 8

What interventions target CV risk reduction?

Answer 8

good glycemic control (A1c