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*Diabetes & Endocrinology > Long Term Complications of Diabetes > Flashcards

Long Term Complications of Diabetes Flashcards

Micro and macro

1
Q

Name the main system affected by long term complications of diabetes

A

Cardiovascular

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2
Q

What are the 3 parts of the body mainly affected by micro- and macro- vascular complications?

A

Eyes
Kidneys
Nerves

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3
Q

Name 3 macrovascular complications of diabetes

A

Coronary vascular disease
Cerebrovascular disease
Peripheral vascular disease

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4
Q

Name 3 microvascular complications of diabetes

A

Retinopathy
Nephropathy
Neuropathy

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5
Q

What is present in nearly all people with diabetes?

A

Dyslipidaemia

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6
Q

Describe HDL, triglyceride and LDL levels in dyslipidaemia (from atherosclerosis)?

A

HDL cholesterol = lower
Triglyceride = higher
LDL cholesterol = in form of small dense particles which are worse

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7
Q

What happens to LDL particles in dyslipidaemia?

A

Oxidisation of these particles promotes the features that lead to plaque formation (+ glycation of the particles worsens the effect)

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8
Q

What 2 other features (other than dyslipidaemia) are found in atherosclerosis in diabetes?

A

Endothelial dysfunction

Hypercoagulation

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9
Q

Name 3 major effects of atherosclerosis in diabetes

A

Ischaemic cerebrovascular disease - strokes
Ischaemic heart disease - angina, MI, heart failure
Peripheral vascular disease

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10
Q

What is heart failure related to?

A

Coronary disease and abnormal cardiac myocyte glucose handling

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11
Q

What does peripheral vascular disease cause?

A

Lower limb ischaemia - leading to ulcers + poor healing of ulcers (possibly lead to amputations)

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12
Q

Name 4 methods of prevention of macrovascular disease in diabetes

A
  • Good diabetes control
  • Blood pressure control
  • Lipid control
  • Lifestyle: smoking cessation, weight, exercise
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13
Q

What are the 2 types of diabetic retinopathy?

A

Non proliferative

Proliferative

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14
Q

Describe non-proliferative diabetic retinopathy

A

Retinal capillary dysfunction, platelet dysfunction, blood viscosity abnormality

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15
Q

Describe proliferative diabetic retinopathy

A

Retinal ischaemia, new blood vessel formation, vitreous haemhorrage, retinal tears/detachment

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16
Q

How is proliferative diabetic retinopathy treated?

A

Laser photocoagulation

17
Q

20 years post-diagnosis, what percentage of people with type 1 diabetes will have retinopathy?

A

100% (some form mild to severe)

18
Q

20 years post diagnosis, what percentage of those with type 2 diabetes will have retinopathy?

A

60% (some form mild to severe)

19
Q

Name 2 other eye effects of diabetes

A

Glaucoma (50% increase)

Cataracts (3-fold)

20
Q

How does nephropathy begin?

A

Microalbuminuria (leak of protein (albumin) starts)

21
Q

Name 3 boring sounding things in nephropathy contributing to renal dysfunction

A

Glomerular basement membrane changes
Mesangial tissue proliferation
‘Glormerular hypertension’

22
Q

What can progressive renal failure progress to if left unchecked?

A

End-stage renal disease

23
Q

What happens to the appearance of kidneys in diabetic nephropathy?

A

They do NOT shrink (one of only kidney conditions where this does not happen)

24
Q

What percentage of people with diabetes will have some renal effects?

A

75%

25
Q

What percentage of people with renal effects will go on to have overt kidney disease that may need treatment?

A

20%

26
Q

What is the biggest single cause of end stage renal disease needing renal replacement therapy (dialysis)?

A

Diabetes

27
Q

What ultimately happens to 21% of type 1 diabetics and 11% of type 2 diabetics with renal failure?

A

Death

28
Q

Name 4 methods of prevention and treatment of nephropathy

A

Screening of urine for albumin
Diabetes control
Renin-agiotensin system blockade (ACEI, ARB - v gd results, renin inhibition)
Hypertension control

29
Q

Describe sensory neuropathy in diabetes

A

Objective loss, particularly in feet and lower legs (subjective symptoms, esp parasthesia)

30
Q

What can lack of sensation lead to?

A

Development of neuropathic ulcers, which, alongside macro-vasculature, leads to severe foot infections

31
Q

Describe autonomic neuropathy in diabetes

A

Can cause GI effects (stomach, intestines), or CVS (tachycardia, BP fluctuations)

32
Q

What is important to watch out for in a patient with diabetic neuropathy?

A

Silent myocardial infarction

33
Q

What is acronym for foot care in diabetes?

A

CPR - check, protect, refere

34
Q

Name 2 other conditions found in diabetics

A

Erectile dysfunction/sexual dysfunction

Depression

35
Q

Look at case studies

A

.

*Diabetes & Endocrinology (24 decks)

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