Diabetic Complications

Question 1

What what 3 patient groups should diabetes be screened in

Answer 1

Risk factors

Patient who have recently been diagnosed with polycystic ovaries

Recurrent fungal infections

People with symptoms should not be screened but instead should undergo diabetic tests

Question 2

What are the clinical features of diabetes neuropathy

Answer 2

Loss of sensation, painless ulcers on pressure points, or pain

Often occurs in the periphery i.e. feet and hands.

Question 3

Describe the pathogenesis of diabetic nephropathy

Answer 3

As the kidney becomes damaged by diabetes, the afferent arteriole (leading to the glomerulus) becomes vasodilated to a greater extent than the efferent glomerular arteriole.

This increases the intraglomerular filtration pressure, further damaging the glomerular capillaries.

This process eventually leads to glomerular sclerosis.

In consequence, there is a progressive leak of large molecules (particularly protein) into the urine.

Question 4

What is the earliest sign of diabetic nephropathy

Answer 4

Presence of microalbuminuria (high levels of albumin in the urine)

Question 5

How is diabetic nephropathy managed

Answer 5

Optimise glycaemic control

ACE inhibitor

Question 6

What are the two main acute diabetic complications seen in patients with T1DM

Answer 6

Hypoglycaemia

Diabetic ketoacidosis (DKA)

Question 7

Diabetic foot is thought to occur secondary to the combination of which two things?

Answer 7

peripheral neuropathy and poor vascular supply.

Question 8

Name four types of macrovascular diabetic complications

Answer 8

Coronary artery disease

Peripheral arterial disease

Stroke

Hypertension