microvascular complications of diabetes Flashcards
name the microvascular diabetic complications.
- diabetic retinopathy
- stroke
- cardiovascular disease
- peripheral vascular disease
- diabetic neuropathy
- diabetic nephropathy
what is meant by diabetic neuropathy?
neuropathy - nerve damage
diabetic neuropathy is nerve damage caused by diabetes
list the risk factors of diabetic neuropathy.
- hypertension
- smoking
- HbA1c
- change in HbA1c
- diabetes duration
- BMI
- triglycerides
treatment for diabetic neuropathy.
- Good glycaemic control
- Tricyclic antidepressants / SSRIs
- Anticonvulsants (carbamazepine, Gabapentin)
- Opiods (Tramadol, oxycodone)
- IV lignocaine
- Capsaicin
- Transcutaneous nerve stimulation / acupuncture / spinal cord stimulators
- Psychological interventions / hypnosis
name some causes of amputation by diabetic neuropathy
- diabetic foot ulceration
- diabetic foot disease
- sensory nerve damage
- motor nerve damage
- localised callus
- autonomic nerve damage
screening test for diabetic peripheral neuropathy.
Test sensation:
10 gm monofilament
neurotips
Vibration perception:
Tuning fork
biothesiometer
Ankle reflexes
peripheral vascular disease and causes of amputation
- Decreased perfusion due to macrovascular disease
- Sites: more distal
- 15-40 times more likely to have lower limb amputation
Peripheral vascular diseaseclinical presentation
Intermittent claudication
Rest pain
Signs of vascular disease
- Diminished or absent pedal pulses
- Coolness of the feet and toes
- Poor skin and nails
- Absence of hair on feet and legs
peripheral vasuclar disease diagnostic tests.
Methods
Doppler pressure studies (ABI)
duplex arterial imaging/MRA
Rationale
identify and confirm disease
predict healing or determine need for surgical intervention
Peripheral vascular disease treatment
Quit smoking
Walk through pain
Surgical intervention
whats the main cause of amputation and what interventions can be put into place to prevent this progression to amputation
neuropathy or vascular disease
trauma
ulcer
failure to heal
infection
amputation
- screening to identify risk
- educating and providing orthotic shoes
- ulcer - MDT foot clinic
- pressure releaving footwear and antibiotics
outline the relationship between rate of retinopathy progression and mean HbAc1
rate increases with HbAc1 levels
outline what is diabetic retinopathy
Diabetic retinopathy is a diabetes complication where high blood sugar damages the tiny blood vessels in the retina, leading to vision problems.
define diabetic neuropathy
Diabetic nephropathy is a serious complication of diabetes that affects the kidneys, leading to chronic kidney disease (CKD) and potentially kidney failure. It occurs due to prolonged high blood sugar and hypertension, which damage the kidneys’ filtering units (glomeruli).
