Diabetes Complications Flashcards
what causes microvascular complications of diabetes?
hyperglycaemia
how often should those with diabetes get their eyes checked?
annually if low risk
what is the back of the eye called?
the retina
what is the optic disc?
where the nerves of the retina form the optic nerve
what are the stages of retinopathy (best to worst)?
mild non proliferative
moderate non proliferative
severe non proliferative
proliferative
what is another name for mild non proliferative retinopathy?
background retinopathy
what are the types of haemorrhage that can be seen on fundoscopy?
dot
blot
flame
what is a cotton wool spot on fundoscopy?
ischaemic areas
what are hard exudates on fundoscopy?
lipid breakdown products
what is IRMA?
intra retinal microvascular abnormalities
what is often the first feature of diabetic retinopathy seen?
microaneurysms
a precursor
when is a cotton wool spot concerning?
if there is more than one present
why is new vessel formation worrying in diabetic retinopathy?
risk of larger haemorrhage
how can bleeding in the retina present?
sudden changes in vision if large
floaters if smaller
what is the mainstay of treatment of diabetic retinopathy?
pan retinal photocoagulation
how does pan-retinal photocoagulation work?
reduces the oxygen requirement of the retina by killing parts
what is done if a patient suffers a vitreal haemorrhage?
vitrectomy
what is the treatment for diabetic macular oedema?
intravitreal anti-VEGF injections
what is diabetic nephropathy?
progressive kidney disease caused by damage to the glomeruli
what characterises diabetic nephropathy?
proteinuria
diffuse scarring of the glomeruli
what are other names for diabetic nephropathy?
kimmelsteil-wilson syndrome
nodular glomerulosclerosis
what microvascular change can be seen in diabetic nephropathy and how?
angiopathy of the capillaries
see on biopsy
what are three consequences of diabetic nephropathy?
hypertension
reduced GFR
accelerated vascular disease
what is a marker of high risk of diabetic nephropathy?
microalbuminuria
what is the first line treatment for diabetic nephropathy?
ACE/ARB
what are the four types of neuropathy associated with diabetes?
peripheral
proximal
autonomic
focal
what is the most common diabetic neuropathy?
peripheral
how does peripheral neuropathy present?
numbness, tingling and pain in a glove and stocking distribution
what are three possible consequences of peripheral neuropathy?
charcot foot
painless trauma
foot ulcers
what are the treatment options for painful neuropathy?
amitriptyline
duloxetine
gabapentin
pregabalin
what proximal neuropathy can occur as a complication of diabetes?
diabetic amyotrophy
how does diabetic amyotrophy present?
starts with pain in the thighs, hips, buttocks or legs
usually affects one side of the body
proximal muscle weakness
marked weight loss
what effects can autonomic neuropathy have on the digestive system?
constipation
diarrhoea
gastroparesis
difficulty swallowing
what effects can autonomic neuropathy have on the sweat glands?
prevent proper temperature regulation
gustatory sweating
anhidrosis
hyperhidrosis
