Long Term Complications of Diabetes

Question 1

what are the complication risk factor sin diabetes?

Answer 1

> duration of diabetes
> metabolic control
> smoking
> hypertension
> hyperlipidaemia
> genetics

Question 2

what macrovascular cardiovascular complications may be seen in diabetes?

Answer 2

> myocardial infarction
stroke
peripheral arterial disease

Question 3

what are the cardiovascular risk factors in diabetes?

Answer 3

> glucose control
> blood pressure
> smoking
> lipids
> proteinuria
> family history
> gender

Question 4

what is the primary prevention risk reduction in cardiovascular complications in diabetes?

Answer 4

> HbA1c: 53 mmols/mol
> BP: = 130/80
> smoking cessation
> statin therapy
> lifestyle choices

Question 5

what microvascular complications are seen in diabetes?

Answer 5

> retinopathy
neuropathy
nephropathy

Question 6

how may diabetic retinopathy be prevented?

Answer 6

> glucose control
BP control
early detection and intervention

Question 7

what retinal abnormalities might be seen in diabetes?

Answer 7

> micro aneurysm
> blot haemorrhages
> hard exudates
> cotton wool spots
> new vessels formation
> vitreous haemorrhage

Question 8

how is proliferative retinopathy treated?

Answer 8

> laser photocoagulation > vitrectomy

Question 9

what does photocoagulation achieve?

Answer 9

destruction of the peripheral ischaemic retina so there is reduction of endothelial growth factors and regression of new vessels

Question 10

what abnormalities are seen in diabetic maculopathy?

Answer 10

> exudates
blot haemorrhages at macule
macular ischaemia
oedema deforms macule

Question 11

what is the management of maculopathy>

Answer 11

> grid laser therapy
tight BP control
tight glucose control

Question 12

what increases the risk of cataract development?

Answer 12

poor glycaemic control

Question 13

what is peripheral neuropathy?

Answer 13

diffuse nerve disease

Question 14

what is mononeuritis?

Answer 14

single nerve palsy

Question 15

what is the common presentation of peripheral neuropathy?

Answer 15

> glove and stocking distribution
> feet insensitive to trauma
> unpleasant chronic symptoms (paraesthesia, burning, numbness)
> may be asymptomatic
> small muscle wasting

Question 16

what is the management of peripheral neuropathy?

Answer 16

> early detection
self care education
foot protection
pain relief (Caspian cream, amitriptyline)

Question 17

how are ulcers prevented?

Answer 17

> foot screening
education
regular podiatry in high risk
fitted footwear

Question 18

what is Charcot foot?

Answer 18

weakening of the bones in the foot so they fracture easily causing deformity

Question 19

what is the presentation of acute sensory peripheral neuropathy?

Answer 19

> rapid onset of neuropathic symptoms
precipitating factors(acute metabolic upset, rapid tightening of control)
can be severe

Question 20

what is the presentation of proximal motor neuropathy?

Answer 20

> elderly men
> legs
> wasting of thigh muscles
.> weight loss
> painful

Question 21

how may autonomic neuropathy present?

Answer 21

> erectile dysfunction 
> postural hypotension
> gastric stasis and recurrent vomiting
> diarrhoea
> abnormal sweating
> peripheral oedema
> urinary retention

Question 22

how is autonomic neuropathy diagnosed?

Answer 22

> symptoms pattern
exclude other causes
abnormal ECG rhythm response