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Endocrine > Diabetes Complications > Flashcards

Diabetes Complications Flashcards

1
Q

What are the macrovascular complications of diabetes?

A

IHD; stroke

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2
Q

What are the microvascular complications of diabetes?

A

neuropathy; nephropathy; retinopathy; cognitive dysfunction/dementia; erectile dysfunction; psychiatric

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3
Q

what are the types of neuropathy in diabetes?

A

peripheral; autonomic; proximal; focal neuropathy

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4
Q

What are the risk factors for developing neuropathy?

A

increased length of diabetes; poor glycaemic control; type 1 diabetes; high cholesterol/lipis; smoking; genetic; mechanical injury

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5
Q

What is periphaeral neuropathy?

A

distal symmetric or sensorimotor

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6
Q

What are the symptoms of periphaerla neuropathy?

A

numbness/insensitivity; tingling/burning; sharp pains or cramps; sensitivity to touch; loss of balance and coordination

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7
Q

What are the complications of peripheral neuropathy?

A

charcot foot; painless trauma; foot ulcer

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8
Q

What are the treatments for painful neuropathy?

A

amitriptyline; duloxetine; gabapentin

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9
Q

What is the next step is one drug does not work in painful neuropathy?

A

change or titrate up, combinations are not recommended

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10
Q

What is focal neuropath?

A

appears suddenly and affects specific nerves, most often head, torso or leg

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11
Q

What are symptoms of focal neuopathy?

A

inability to focus eye; double vision; aching behind eye; bells palsy; pain in thigh/chest/lower back/pelvis; pain on outside of foot

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12
Q

What is entrapment neuropathy?

A

weakness in one nerve or a group of nerves causing muscle weakness or pain- carpal tunnel

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13
Q

What other names is proximal neuropathy known as

A

lumbosacral plexus neuropathy; femoral neuropathy or diabetic amyotrophy

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14
Q

How does proximal neuropathy start?

A

starts with pain in the thighs, hips, buttocks or legs, usually on one side of the body; prox. muscle weakness, weight loss

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15
Q

Who gets proximal neuropathy?

A

elderly T2D

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16
Q

What does autonomic neuropathy affect?

A

nerves regulating HR, BP as wel as control of internal organs involved in gastric motility, resp function , rintaion, sexual function and vision

17
Q

What are the signs of autonomic neuropathy in the digestive system?

A

gastroparesis; gastric slowing/frequency-constipation/diarrhoea; dysphagia

18
Q

What are the treatments for gastroparesis?

A

improving glycaemic control; diet- smaller, more frequent meals, low fat, low fibre; promotility drugs; anti-nauea drugs; abdo pain treatment- NSAIDs; gastric pacemaker

19
Q

How does autonomic neuropathy affect the eyes?

A

makes the pupils less responsive to changes in light

20
Q

What is diabetic nephropathy?

A

progressive kidney disease caused by daamge to teh capillaries in the kidneys glomeruli, characterized by nephrotic syndrome and diffuse scarring of the glomeruli

21
Q

What are the consequences of diabetic nephropathy?

A

HT; decline in renal function; accelerated vascular disease

22
Q

How is nephraopthy screened for?

A

urinary albumin creatinine ratio

23
Q

What are the risk factors for nephropathy progression?

A

HT; cholesterol; smoking; glycamic control; albuminuria

24
Q

What is the blood pressure target in diabetes pts with nephropathy?

A

<130/80

25
Q

What drug should be commenced in pateints with microalbuminuria or proteinuria?

A

ACEI or ARB

26
Q

What eye pathologies do diabetic patients get?

A

diabetic retinopathy; cataracts; glaucome; acute hyperglycaemia

27
Q

What are the stages of retinopathy?

A

mild non-proliferative; moderate non-proliferative; sever non-proliferative; proliferative

28
Q

What are cotton wool spots?

A

ischaemic areas

29
Q

What are hard exudates?

A

lipid break down products that have leaked from vessels

30
Q

What are IRMAs?

A

intra-retinal microvascular abnormalities- precursor to neovascularisation

31
Q

What is seen with mild background retinopathy?

A

haemorrages and microaneurysms

32
Q

What is seen in pre-proliferative retinopathy?

A

microaneuryms; hard exudates; haemorrages

33
Q

What is seen in severe non-proliferative retinopathy?

A

IRMA; venous beading; haemorrages

34
Q

What is seen in severe proliferative retinopathy?

A

new vessel formation which causes fibrosis

35
Q

What are the treatments for retinopathy?

A

laser; vitrectomy

36
Q

What drugs commonly cause erectile dysfunction?

A

anti-hypertensive drugs- thiazides and beta blockers; CNS- antidepressatns; sedatives; analgesics

Endocrine (27 decks)

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