Microvascular Complications Flashcards
name the 2 branched of complications of diabetes
macrovascular and microvascular
name the 2 macrovascular complications
IHD and stroke
name the 3 microvascular complications
neuropathy
nephropathy
retinopathy
what are the 3 other complications of diabetes?
dementia
erectile dysfunction
psychiatric
name the 4 types of neuropathy
peripheral
autonomic
proximal
focal
what type of neuropathy is the following:
changes in bowel, bladder function, sexual response, sweating, heart rate, blood pressure
autonomic
what type of neuropathy is the following:
pain/loss of feeling in feet and/or hands
peripheral
what type of neuropathy is the following:
sudden weakness in one nerve or a group of nerves causing muscle weakness or pain e.g. carpal tunnel, ulnar mono neuropathy, foot drop, bells palsy, cranial nerve palsy
focal
what type of neuropathy is the following:
pain in the thighs, hips or buttocks leading to weakness in the legs (amyotrophy)
proximal
a patient with T_DM is more likely to have neuropathy as a complication
a patient with T1DM is more likely to have neuropathy as a complication
what are the symptoms of peripheral neuropathy?
numbness/insensitivity tingling/burning sharp pains or cramps sensitivity to touch loss of balance and coordination
name the 3 common peripheral neuropathy complications of the foot
painless trauma
foot ulcer
Charcot foot
a condition causing weakening of the bones in the foot that can occur in people who have significant neuropathy - the bones are weakened enough to fracture and the foot eventually changes shape defines what?
charcots foot
painful neuropathy drug treatment?
amitriptyline
gabapentine
pregabalin
what neuropathy appears suddenly and often affects the head, torso or leg?
focal
focal neuropathy symptoms?
inability to focus double vision aching behind eye pain pain on outside of foot
name the common palsy seen in focal neuropathy
Bell’s palsy
name the condition that causes a temporary weakness or paralysis of the muscles in the face
Bell’s palsy
lumbosacral plexus neuropathy, femoral neuropathy and diabetic amyotrophy are all types of what neuropathy?
proximal neuropathy
proximal neuropathy is more common in who?
elderly T2DM
proximal muscle weakness
marked weight loss
starts with pain in thighs one one side of body
what type of neuropathy affects nerves that regulate heart rate and blood pressure and those that control internal organs?
autonomic neuropathy
what is seen in autonomic neuropathy of the digestive system?
gastroparesis causing glucose levels to fluctuate
oesophageal nerve damage causing difficulty swallowing
there is persistent ________ and ________, bloating and loss of ________ in gastroparesis
there is persistent NAUSEA and VOMITING, bloating and loss of APPETITE in gastroparesis
gastroparesis drug treatment?
promotability drugs - metoclopramide, domperidone and erythromycin
anti-nausea - ondansetron
pain - NSAIDS, amitriptyline, gabapentin
botulinum toxin or gastric pacemaker
treatment of excessive sweat production sue to autonomic neuropathy?
topical glycopyrrolate
clonidine
botulinum toxin
name the 4 diagnostic tools for neuropathy
nerve conduction/electromyography
heart rate variability
ultrasound
gastric emptying studies
a progressive kidney disease caused by damage to the capillaries in the kidneys’ glomeruli - characterized by nephrotic syndrome and diffuse scarring of the glomeruli defines what?
diabetic neuropathy
diabetic neuropathy consequences?
hypertension
decline in renal function
GFR reduction
accelerated vascular disease
what is used to screen for diabetic kidney disease?
urinary albumin creatinine ratio (ACR)
nephropathy risk factors?
hypertension cholesterol smoking glycaemic control albuminuria
patients with microalbuminuria or proteinuria should be commenced on an ___ _________ or an ___
patients with microalbuminuria or proteinuria should be commenced on an ACE INHIBITOR or an ARB
state the most common cause of kidney disease/failure
diabetes
name the 4 eye pathologies as a result of diabetes
diabetic retinopathy
cataract
glaucoma
acute hyperglycaemia
name the 4 stages of retinopathy
mild non-proliferative - RI
moderate non-proliferattive - R2
severe non-proliferative - R3
proliferative - R4
optical coherence tomography is used to diagnose and stage what?
maculopathy
retinopathy treatment?
laser
vitrectomy
anti-VEGF injections
name the vascular and neuropathic cause of dysfunction seen in 50% of diabetic men
erectile dysfunction
ED risk factors?
diabetes renal failure hepatic failure multiple sclerosis severe depression
name the 2 anti-hypertensive drugs that cause ED
thiazides and beta blockers
do CNS drugs cause ED?
yes
