diabetic microvascular risk factors

Question 1

what are some general risks of diabetes (5)

Answer 1

macrovascular (ischaemic HD, stroke), microvascular (neuro/nephro/retinopathy), dementia, erectile dysfunction, psychiatric

Question 2

what is the general pathway for microvascular complications (4)

Answer 2

hyperglycaemia + hyperlipidaemia –> reduced blood flow –> inflamm –> cell dysfunction

Question 3

what annual screening should diabetics get

Answer 3

retinal, foot, urine

Question 4

what type of neuropathies can occur with diabetes

Answer 4

peripheral, autonomic , proximal and focal

Question 5

what is charcot foot

Answer 5

a peripheral neuropathy from inflammation and fractures causing a severely deformed foot.

Question 6

how to you manage charcot foot

Answer 6

MRI and air-cast boot

Question 7

what peripheral neuropathies can occur in diabetics

Answer 7

charcot foot, ulcers (arterial), painless trauma

Question 8

how do you treat peripheral neuropathy if it’s painful

Answer 8

amitriptyline/ gabapentin/ pregablin

Question 9

what autonomic neuropathies can happen in diabetes

Answer 9

HR, BP, RR, GI problems, sweat glands, heart and blood vessels

Question 10

what can happen in GI autonomic neuropathy

Answer 10

gastroparesis (metroclopramide), slowing, oesophagus damage

Question 11

what can happen in sweat glands autonomic neuropathy

Answer 11

cannot regulate body temp as well

Question 12

what proximal diabetic neuropathy can occur

Answer 12

amyotrophy - pain in thighs/ hips/ buttocks - usually unilateral muscle weakness

Question 13

what is the most common cause of kidney failure

Answer 13

diabetes

Question 14

what investigations are done for nephropathy

Answer 14

urine - albumin, creatinine, U+Es

Question 15

what kidney disease is associated with diabetic nephropathy

Answer 15

Kimmelsteil-Wilson syndrome

Question 16

how do you manage diabetic nephropathy

Answer 16

ACEi

Question 17

what retinopathies are common in diabetics

Answer 17

macular oedema, cataracts, glaucoma, ischaemia

Question 18

what eye changes occur in retinopathy (increasing severity)

Answer 18

sudden blurred vision, haemorrhages, hard exudates, cotton wool spots, intra-retinal microvascualr abnormalities (IMRA)

Question 19

what causes sudden blurred vision

Answer 19

reversible hyperglycaemia

Question 20

what causes cotton wool spots

Answer 20

ischaemic areas

Question 21

what is commonly seen in diabetic retinopathy

Answer 21

neovascularisation

Question 22

how is diabetic retinopathy sometimes treated

Answer 22

laser.