Lecture 23 Long Term Complications of Diabetes

Question 1

When can complications of type 2 diabetes be present

Answer 1

At any time of diagnosis

Question 2

When can complications of type 1 diabetes be present

Answer 2

As early as 5 years after diagnosis

Question 3

Macrovascular complications of diabetes

Answer 3

Coronary vascular disease
Cerebrovascular disease
Peripheral vascular disease

Question 4

Microvascular complications of diabetes

Answer 4

Retinopathy
Nephropathy
Neuropathy

Question 5

Effects of atherosclerosis in diabetes

Answer 5

• Ischaemic cerebrovascular disease - strokes
• Ischaemic Heart Disease - angina, myocardial infarctions
• Heart Failure - related to coronary disease and abnormal cardiac myocyte glucose handling
• Peripheral vascular disease
• Causes lower limb ischaemia, leading to ulcers and poor healing of these ulcers. Amputations are a potential outcome.

Question 6

How do you prevent microvascular disease

Answer 6

• Good diabetes control
• Blood pressure control
• Lipid control
• Smoking cessation, weight, exercise

Question 7

What are the features of Non-Proliferative Diabetic Retinopathy

Answer 7

• Retinal capillary dysfunction, platelet dysfunction, blood viscosity abnormality

Question 8

What are the features of proliferative diabetic retinopathy

Answer 8

• Retinal ischaemia, new blood vessel formation, vitreous haemorrhage, retinal tears/detachment.

Question 9

How is retinopathy treated

Answer 9

Laser photocoagulation

Improve glycemic control

Question 10

Features of Nephopathy

Answer 10

Microalbuminuria
Glomerular hypertension
Progressive renal failure

Question 11

Prevention and treatment of nephropathy

Answer 11

Screening urine for albumin
Diabetes control
ACE inhibitor 
Angiotensin receptor blockade
Renin inhibition
For hypertension control

Question 12

Sensory neuropathy can lead to

Answer 12

objective loss, particularly in feet & lower legs; subjective symptoms, especially paresthesia

Question 13

Autonomic neuropathy can lead to

Answer 13

GI effects (stomach, intestines), or the cardiovascular system (tachycardia, blood pressure fluctuations). Watch out for silent myocardial infarction

Question 14

What is Charcot Foot

Answer 14

a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking, the foot eventually changes shape