Long term Micro/Macrovascular complications

Question 1

What are the macrovascular complications of DM?

Answer 1

Coronary vascular disease
Cerebrovascular disease
Peripheral vascular disease

Question 2

What are the microvascular complications of DM?

Answer 2

Retinopathy
Nephropathy
Neuropathy

Question 3

What is the relative risk of HF in a diabetic patient?

Answer 3

2.2x higher

Question 4

How does dyslipidaemia typically present in diabetics?

Answer 4

↑LDL (changed)
↑Triglycerides
↓HDL

Question 5

How do LDLs act in diabetic patients?

Answer 5

Oxidised/clumped up forms that lead to plaque formation

Question 6

Why is atherosclerosis worsened in diabetics?

Answer 6

Dyslipidaemia
Endothelial dysfunction
Hypercoagulability

Question 7

How does ischaemic heart disease present?

Answer 7

MI
Angina
HF

Question 8

How does peripheral vascular disease present?

Answer 8

Lower limb ischaemia
Ulcers
Poor healing

Question 9

How is macrovascular disease prevented in DM?

Answer 9

Good Glycaemic control
Control BP
Control Lipids
Smoking cessation
Weight loss
Exercise

Question 10

What is non-proliferative diabetic retinopathy?

Answer 10

Retinal capillary dysfunction
Platelet dysfunction
Abnormal blood viscosity

Question 11

What is proliferative diabetic retinopathy?

Answer 11

Retinal ischaemia
New blood vessel formation
Vitreous haemorrhage
Retinal tears

Question 12

How is proliferative diabetic retinopathy treated?

Answer 12

Laser photocoagulation

Question 13

Diabetic retinopathy falls into which classes?

Answer 13

Proliferative and non-proliferative retinopathy

Question 14

What is proliferation in diabetic retinopathy?

Answer 14

Whether or not new vessels are formed

Question 15

What proportion of diabetic patients suffer diabetic retinopathy?

Answer 15

After 20 years:
100% type 1
60% type 2

Question 16

What proportion of registered blind people have advanced diabetic retinopathy?

Answer 16

7%

Question 17

What is the increase in risk of glaucoma in diabetic patients?

Answer 17

50%

Question 18

What eye conditions are more common in diabetics?

Answer 18

Retinopathy
Glaucoma
Cataracts

Question 19

What is the increase in risk of cataracts in diabetic patients?

Answer 19

3x higher risk

Question 20

What is microalbuminaemia?

Answer 20

Small leak of protein

Question 21

How does diabetes cause progression to nephropathy?

Answer 21

Microalbuminaemia leading to glomerular basement membrane changes
Mesangial tissue proliferation
Progressive renal impairment

Question 22

What proportion of diabetics have renal effects?

Answer 22

75%

Question 23

What proportion of diabetics go onto overt kidney disease?

Answer 23

20%

Question 24

Renal failure leads to death in what % of diabetics?

Answer 24

21% - Type 1

11% - Type 2

Question 25

What is the 5y survival rate on dialysis in diabetics compared to non-diabetics?

Answer 25

15% lower

Question 26

How is nephropathy screened for?

Answer 26

Screening the urine for albumin

Question 27

How is nephropathy prevented/treated in diabetes?

Answer 27

Screening
Glycaemic control
RAAs blockade - ACEI, ARB
HTN control

Question 28

What is the most common form of neuropathy in diabetics?

Answer 28

Sensory loss
Lower legs
Paraesthesia
Autonomic

Question 29

How does diabetes lead to foot infections?

Answer 29

Neuropathy leading to loss of sensation combined with poor peripheral micro-vasculature

Question 30

What is the common presentation of autonomic neuropathy in diabetes?

Answer 30

GI effects - stomach, SI

CV effects - tachycardia, BP

Question 31

What other conditions are more common in diabetics?

Answer 31

Sexual dysfunction

Depression (2x higher)