Diabetic complications Flashcards
What is peripheral neuropathy?
Pain or loss of feeling in hands/feet
What is peripheral neuropathy?
Pain or loss of feeling in hands/feet
What is autonomic neuropathy?
Changes in bowel and bladder function, HR, BP
What is focal neuropathy?
weakness in a nerve causing local muscle weakness
What type of diabetes makes neuropathy more likely?
Type 1
What analgesia can be given for painful neuropathy?
Paracetamol
Amitryptiline
Gabapentin
Pre-gabalin
What is allodynia?
When a stimulus causes pain but normally shouldn’t.
How can autonomic neuropathy present in diabetes?
Gastroparesis leading to constipation
Loss of appetite
Oesophageal nerve damage
What is gastroparesis?
Stomach slow to empty
How can gastroparesis be treated?
Metoclopramide or domperidone
Why is temperature regulation affected in diabetes?
Autonomic neuropathy affects nerves to sweat glands
Why might hypoglycaemia be difficult to diagnose in someone with autonomic neuropathy?
Shakiness, sweating and palpitations may not occur due to damage to those nerves
What changes, apart from retinopathy, may occur in the eyes?
May not be able to see well in the dark or drive at night, due to nerve changes to the pupils
What is Kimmelstein- Wilson syndrome also called?
Diabetic nephropathy
How is nephropathy screened for?
albumin- creatinine ratio in urine
When should nephropathic screening take place?
At diagnosis
Annually in all patients over 12
What is a normal ACR for men?
Less than 2.5 mg/mmol
What is a normal ACR for women?
Less than 3.5mg/mmol
Why is it necessary to repeat tests for microalbuminuria?
Changes throughout day, with exercise and fluids.
Also higher during menstruation, with vaginal discharge, pregnancy and with UTI.
How many times do you need to repeat microalbuminuria test?
3 times and must be positive twice.
What do we need to do if microalbuminuria positive?
ACEI
Smoking cessation
Tighter glycaemic control
Why are eyes checked in diabetic patients?
retinopathy
glaucoma
Cataracts
What are cataracts?
Clouding of the lens
What is glaucoma?
Increase in fluid pressure in eye which leads to optic nerve damage
What does a cotton wool spot indicate?
Ischaemia
What is a hard exudate?
Lipid break down product
Which two grading scales are present in retinal exams?
Retinopathy
Maculopathy
How common is erectile dysfunction in diabetics?
Over half over 60
Which anti-hypertensives can cause ED?
All but thiazides and beta blockers espec.
What is the correct nomenclature for viagra?
Sildenafil
What is autonomic neuropathy?
Changes in bowel and bladder function, HR, BP
What is focal neuropathy?
weakness in a nerve causing local muscle weakness
What type of diabetes makes neuropathy more likely?
Type 1
What analgesia can be given for painful neuropathy?
Paracetamol
Amitryptiline
Gabapentin
Pre-gabalin
What is allodynia?
When a stimulus causes pain but normally shouldn’t.
How can autonomic neuropathy present in diabetes?
Gastroparesis leading to constipation
Loss of appetite
Oesophageal nerve damage
What is gastroparesis?
Stomach slow to empty
How can gastroparesis be treated?
Metoclopramide or domperidone
Why is temperature regulation affected in diabetes?
Autonomic neuropathy affects nerves to sweat glands
Why might hypoglycaemia be difficult to diagnose in someone with autonomic neuropathy?
Shakiness, sweating and palpitations may not occur due to damage to those nerves
What changes, apart from retinopathy, may occur?
May not be able to see well in the dark or drive at night, due to nerve changes to the pupils
What is Kimmelstein- Wilson syndrome also called?
Diabetic nephropathy
How is nephropathy screened for?
albumin- creatinine ratio in urine
When should nephropathic screening take place?
At diagnosis
Annually in all patients over 12
What is a normal ACR for men?
less than 2.5 mg/mol creatinine
What is a normal ACR for women?
less than 3.5mg/mol creatinine
Why is it necessary to repeat tests for microalbuminuria?
Changes throughout day, with exercise and fluids.
Also higher during menstruation, with vaginal discharge, pregnancy and with UTI.
How many times do you need to repeat microalbuminuria test?
3 times and must be positive twice.
What do we need to do if microalbuminuria positive?
ACEI
Smoking cessation
Tighter glycaemic control
Why are eyes checked in diabetic patients?
retinopathy
glaucoma
Cataracts
What are cataracts?
Clouding of the lens
What is glaucoma?
Increase in fluid pressure in eye which leads to optic nerve damage
What does a cotton wool spot indicate?
Ischaemia
What is a hard exudate?
Lipid break down product
Which two grading scales are present in retinal exams?
Retinopathy
Maculopathy
How common is erectile dysfunction in diabetics?
Over half over 60
Which anti-hypertensives can cause ED?
All but thiazides and beta blockers espec.
What is the correct nomenclature for viagra?
Sildenafil
Why is diabetic blood higher in triglycerides?
Insulin promotes FFA uptake to adipose tissue and suppresses lipase.
What is gustatory sweating?
Sweating after eating
What is defined as proteinuria?
ACR >30
What is the treatment of Charcot’s foot?
No contact so put in full cast for up to 1 year
What difference can be made with gastroparesis and insulin?
Take insulin half an hour later due to risk of hypoglycaemia
