diabetic complications

Question 1

give examples of diabetic complications

Answer 1

• blindness
• stroke
• CVD
• DPN
• peripheral vascular disease
• diabetic nephropathy
• diabetic retinopathy

Question 2

how many diabetes patients suffer from diabetic polyneuropathy

Answer 2

Diabetic polyneuropathy (DN) affects 30-50% of patients with diabetes

Question 3

pain like symptoms of diabetic neuropathy

Answer 3

burning
paraesthesia
hyperaesthesia
allodynia
nocturnal-
exacerbation

Question 4

autonomic like symptoms of diabetic neuropathy

Answer 4

Orthostatic Hypotension
Cardiac AN
gastroparesis
diarrhoea
constipation
incontinence
Erectile Dysfunct

Question 5

insesntivity like symptoms of diabetic neuropathy

Answer 5

foot ulceration
infection
amputation
falls
Charcot foot

Question 6

describe pain in Diabetic peripheral neuropathy (DPN

Answer 6

typical ‘glove and stocking’ sensory loss

significant motor deficit is not common

painful symptoms in 30%

Question 7

risk factors of diabetic neuropathy

Answer 7

• hypertension
• smoking
• HBa1c
• diabetes duration
• bmi
• triglycerides
• total cholesterol

Question 8

Treatment of Diabetic Painful neuropathy

Answer 8

Good glycaemic control
Tricyclic antidepressants / SSRIs
Anticonvulsants (carbamazepine, Gabapentin)
Opiods (Tramadol, oxycodone)
IV lignocaine
Capsaicin
Transcutaneous nerve stimulation / acupuncture / spinal cord stimulators
Psychological interventions / hypnosis

Question 9

cause of diabetic amputation

Answer 9

1. neuropathy or vascular disease
2. trauma
3. ulcer
4. failiure to heal
5. infection
6. amputation

Question 10

Diabetic peripheral neuropathy
screening tests

Answer 10

Test sensation
- 10 gm monofilament
- neurotips

Vibration perception
- Tuning fork
- biothesiometer

Ankle reflexes

Question 11

describe peripheral vascular disease

Answer 11

Decreased perfusion due to macrovascular disease

Sites: more distal

Question 12

symptoms of peripheral vascular disease

Answer 12

Intermittent claudication
Rest pain

Question 13

signs of vascular disease

Answer 13

Diminished or absent pedal pulses
Coolness of the feet and toes
Poor skin and nails
Absence of hair on feet and legs

Question 14

treatment of peripheral vascular disease

Answer 14

Quit smoking
Walk through pain
Surgical intervention

Question 15

what does MDT foot ulcer management include

Answer 15

Wound care
Offloading
Revascularisation
Infection control.

Question 16

pathogenesis of leakage in eyes

Answer 16

Basement membrane thickening
Pericyte loss
reduces junctional contact with endothelial cells
LEAKAGE

Question 17

pathogenesis of ischaemia in eyes

Answer 17

Pericyte loss, endothelial cells respond by increasing turnover > thickening > ISCHAEMIA
Glial cells grow down capillaries > OCCLUSION
Ischaemia/Occlusion > Proliferation

Question 18

describe diabetic nephropathy

Answer 18

Characterized by progressive kidney fibrosis resulting in loss of function
Hallmark is development of proteinuria
Followed by progressive decline in renal function

Question 19

risk factors for diabetic nephropathy

Answer 19

poor BP and BG control