Diabetes complications

Question 1

Prevalence of complications at diagnosis of T2DM

Answer 1

Macrovasuclar 20%
retinopathy 12%
nephropathy 20%
neuropathy 10%

Question 2

microvascular risk screening

Answer 2

ACR, GFR, Retinas, foot check
Type one is annually after 5 years
type two is annually (or 2 years for low risk retinopathy) starting at diagnosis

Question 3

Diabetes retinopathy physiopathology

Answer 3

Macular edema from vascular leakage
nonproliferation diabetic retinopathy from micro aneurysms and hemorrhage
capillary non-perfusion, stop working and grow like crazy

Question 4

Peripheral neuropathy effects

Answer 4

neuropathic pain, loss of lower limb mobility, loss of sensation

Question 5

Autonomic neuropathy effects

Answer 5

Decreases vagus nerve innervation decreases slowing of heart which can limit activity
Decreases GI innervation causing gastroparesis, constipation/diarrhea
Decreases Bladder innervation and prevents urination

Question 6

Neuropathy overall complications

Answer 6

-Inflammatory
-spontaneous discharge
-abnormal signal spread leading to excessive or loss of signal

Question 7

Neuropathy screening techniques

Answer 7

temperature sensation, pinprick, monofilament, vibration, cotton swab

Question 8

Foot ulcer pathophysiology

Answer 8

Causes break down and ulceration, low blood flow leads to infection and gangrene then amputation

Question 9

what do you add to ACE/ARB therapy?

Answer 9

amlodipine

Question 10

lipid panel frequency

Answer 10

every 1-3 yearsw

Question 11

when to start statins

Answer 11

> 40 with diabetes
30 if diabetes for >15 years
microvascular disease
or history of CV disease

Question 12

Diabetes platelets

Answer 12

increased turnover
enhanced aggregation
increased thromboxane
Can have asprin resistance

Question 13

diabetes asprin dose

Answer 13

162 since some are resistant to asprin, only used as secondary prevention