Diabetic Complications Flashcards
What are the five categories of diabetic complications?
Macrovascular dysfunction Microvascular dysfunction Psychiatric Dementia Erectile Dysfunction
What macrovascular complications can be caused by diabetes?
Stroke
Heart Disease
What microvascular complications can be caused by diabetes?
Retinopathy
Neuropathy
Nephropathy
What are the 4 categories of neuropathy diabetics are at risk of?
Peripheral
Proximal
Autonomic
Focal
Where does peripheral neuropathy present?
Feet- mainly
Hands
How does peripheral neuropathy present?
Foot ulcers Painless trauma Charcot's foot Burning pain Numbness Pain from normal stimuli
How do you treat peripheral neuropathy?
Amitriptyline, gabapentin or pregabalin
Where does proximal neuropathy present?
Thighs, buttocks or hips
How does proximal neuropathy present?
Weakness of legs (amyotrophy)
Usually in the elderly
What is Charcot’s foot?
Get roller looking sole due to loss of sense of joint position
What can autonomic neuropathy cause?
Change in bowel and bladder function
Changed HR and BP
Gastric stasis and difficulty swallowing
Sweat issues
What is focal neuropathy?
Sudden weakness of one nerve group leading to muscle weakness or pain- foot drop etc
What can drastically help improve microvascular issues?
Small drops in HbA1c levels
What causes diabetic nephropathy?
Damage to the capillaries surrounding the glomeruli
What complications can nephropathy cause?
Hypertension
What are the risk factors for nephropathy?
Hypertension High cholesterol Smoking Poor glycemic control Albuminuria
What is the downward spiral associated with nephropathy?
Protein leak causes damage which causes more protein leak
How do you treat nephropathy?
Reduce BP to <130/80
ACEI for microalbuminuria
Good glycemic control
How do you test renal function in diabetics?
Albumin creatinine ratio (ACR) yearly
What are the for Retinopathies associated with diabetes?
Diabetic retinopathy
Cataracts
Glaucoma
Acute hyperglycemia
What is acute hyperglycemia?
Reversible blurring of vision
What is glaucoma?
Increased fluid pressure leading to optic nerve damage
What are cataracts?
Clouding of the lenses
What is diabetic retinopathy?
Damage to the blood vessels in the eyes
What are the four types of damage seen in diabetic retinopathies?
Haemorrhage
Cotton wool spots- ischemic area
Hard exudates- Lipid breakdown products
Blood vessel abnormalities- Patent but precursor damage
What is glomerulosclerosis?
Sclerosing of glomeruli. Seen on histopatho as infiltrate round glomeruli
