diabetes complications

Question 1

what types of eye problems do people with diabetes get?

Answer 1

Diabetic Retinopathy
Diabetic Macular Oedema (Maculopathy)
Cataract- clouding of the lens (develops earlier in people with diabetes)
Glaucoma- increase in fluid pressure in the eye leading to optic nerve damage. 2 x more common in diabetes
Acute hyperglycaemia- visual blurring (reversible)

Question 2

what is the main treatment for retinopathy?

Answer 2

laser
(vitrectomy if a vitreal haemmorhage)

Question 3

what is diabetic nephropathy?

Answer 3

A progressive kidney disease caused by damage to the capillaries in the kidneys’ glomeruli. It is characterized by proteinuria and diffuse scarring of the glomeruli

Also known as Kimmelsteil- Wilson Syndrome or Nodular Glomerulosclerosis

Question 4

what is the most common cause of kidney failure / dialysis in the UK?

Answer 4

diabetes

Question 5

what are the consequences of diabetic nephropathy?

Answer 5

Development of hypertension
Relentless decline in renal function
reduction in GFR of 1 ml/min/month if untreated
Accelerated vascular disease

Question 6

what are the different types of neuropathy?

Answer 6

Peripheral e.g. pain/ loss of feeling in feet, hands

Proximal e.g.pain in the thighs, hips or buttocks leading to weakness in the legs (Amyotrophy)

Autonomic e.g. changes in bowel, bladder function, sexual response, sweating, heart rate, blood pressure

Focal Neuropathy e.g. sudden weakness in one nerve or a group of nerves causing muscle weakness or pain e.g. carpal tunnel, ulnar mono neuropathy, foot drop, bells palsy, cranial nerve palsy

Question 7

what are the risk factors for neuropathy?

Answer 7

Increased length of diabetes
Poor glycaemic control
Type 1 diabetes > Type 2 diabetes
High Cholesterol/ Lipids
Smoking
Alcohol
Inherited Traits (genes)
Mechanical Injury

Question 8

what is charcot arthrpathy?

Answer 8

deformity of the foot, presents as hot swollen foot.

treated with non weight bearing- total contact cast or aircast boot

Question 9

what are the treatment options for painful neuropathy?

Answer 9

amitriptyline (off-label), duloxetine, gabapentin, or pregabalin; combinations not recommended. Titrate up as needed.

If localized neuropathic pain and patient wishes to avoid, or cannot tolerate, oral treatments then topical Capsaicin Cream

Question 10

describe diabetic amyotrophy

Answer 10

Starts with pain in the thighs, hips, buttocks or legs, usually on one side of the body. More common in elderly T2D. Proximal muscle weakness. Often associated with marked weight loss.