DIABETIC NEUROPATHY Flashcards
major etiology of diabetic neuropathy?
hyperglycemia
- ischemic
- metabolic
- autoimmune
what should be controlled to reduced neurologic complications?
hyperglycemia
what are the hyperglycemia causes?
nerve ischemia glycosylation of nerve protein decrease uptake of nerve myoinositol decreased activity of sodium potassium ATPase pump reduction of axonal transport
three categories of diabetic neuropathy?
combinations lead to significant clinical manifestations like?
sensory neuropathy
motor neuropathy
autonomic neuropathy
excessive stresses on tissue
formation of mechanical keratosis
undetected tissue breakdown
prolonged periods of hyperglycemia lead to impairment of immune function like?
*immunopathy consists of:
deficits in phagocyte system
*decrease in chemotaxis to the site of infection
decrease in phagocytosis
decreased intracellular killing of microorganisms
any combo of the three
major roles of macrophages in wound healing?
phagocytosis, antimicrobial fxn wound debridement cell recruitment and activation angiogensis matrix synthesis, regulation
how does immunopathy affect the tx of the patient?
antibiotics should include drugs that are bactericidal
bacteriostatic agents require an intact immune system
frequent antibiotics lead to colonization with resistant species of organisms
what is the clinical significance of angiopathy?
gangrene, which is good for infection, including anaerobes, deceased perfusion leads to decreased local antibiotic concentration
what are the wound types?
neuropathic (mal perforans) ischemic gangrenous (dry vs wet) decubitus (pressure) venous
what are the wound care principles?
infection management perfusion offloading edema management wound bed management