Microvascular complications of Diabetes

Question 1

What are 2 macrovascular complications of diabetes?

Answer 1

IHD

Stroke

Question 2

What are 3 microvascular complications of diabetes?

Answer 2

Neuropathy
Nephropathy
Retinopathy

Question 3

What are 3 other chronic complications of diabetes?

Answer 3

Cognitive dysfunction/Dementia
Erectile dysfunction
Psychiatric

Question 4

What are the 4 types of neuropathy?

Answer 4

Peripheral
Autonomic
Proximal
Focal

Question 5

What is peripheral neuropathy?

Answer 5

Pain/loss of feeling in hands and feet

Question 6

What is autonomic neuropathy?

Answer 6

Changes in bowel/bladder function
Sexual response
Sweating
Heart rate
Blood pressure

Question 7

What is proximal neuropathy?

Answer 7

Pain in the thighs, hips or buttocks leading to weakness in the legs

Question 8

What is focal neuropathy?

Answer 8

Sudden weakness in one nerve or a group of nerves causing muscle weakness or pain

Question 9

What are the risk factors for neuropathy?

Answer 9

Increased length of diabetes
Poor glycaemic control
T1DM
High cholestrol
Smoking
Alcohol

Question 10

What are the symptoms of peripheral neuropathy?

Answer 10

Numbness/insensitivity
Tingling/burning
Sharp pains or cramps
Sensitivity to touch
Loss of balance and coordination

Question 11

What are the complications of peripheral neuropathy?

Answer 11

Charcot foot
Painless trauma
Foot ulcer

Question 12

What is the treatment for painful neuropathy?

Answer 12

Amitriptyline
Duloxetine
Gabapentin
Pregabalin
Topical capsaicin ream

Question 13

What are the symptoms of focal neuropathy?

Answer 13

Inability to focus eye
Double vision
Aching behind eye
Bell's palsy
Pain in thigh/chest/lower back
Pain on outside of foot

Question 14

Who is proximal neuropathy common in?

Answer 14

Elderly people

Question 15

What are 2 features of proximal neuropathy?

Answer 15

Proximal muscle weakness

Marked weight loss

Question 16

What does autonomic neuropathy affect?

Answer 16

The nerves regulating heart rate and blood pressure

Question 17

What GI effects does autonomic neuropathy have?

Answer 17

Gastric slowing/frequency
Constipation/Diarrhoea
Gastroparesis

Question 18

How can gastroparesis be treated?

Answer 18

Smaller food portions
Low fat
Low fibre
Pro-motility drugs
NSAIDs

Question 19

What are some diagnostic tests for neuropathy?

Answer 19

Nerve conduction studies or electromyography
Heart rate variability
Ultrasound
Gastric emptying studies

Question 20

What is diabetic nephropathy?

Answer 20

Progressive kidney disease caused by damage to the capillaries in the kidney glomeruli

Question 21

How is diabetic nephropathy typically characterised?

Answer 21

Nephrotic syndrome

Scarring of the glomeruli

Question 22

What are 2 other names for diabetic nephropathy?

Answer 22

Kimmelsteil-wilson syndrome

Glomerulosclerosis

Question 23

What can diabetic nephropathy lead to the development of?

Answer 23

Hypertension
Decline in renal function
Accelerated vascular disease

Question 24

What can be used to screen for diabetic kidney disease?

Answer 24

Urinary albumin creatinine ratio (ACR)

Question 25

What are 5 risk factors for nephrotic progression?

Answer 25

``` Hypertension Cholesterol Smoking Glycaemic control Albuminuria ```

Question 26

What treatment should be given to patients with microalbuminuria or proteinuria?

Answer 26

ACE inhibitor | ARB

Question 27

What 3 eye conditions are people with diabetes at risk of?

Answer 27

Diabetic retinopathy Cataracts Glaucoma

Question 28

How many stages of diabetic retinopathy are there?

Answer 28

Mild non-proliferative Moderate non-proliferative Severe non-proliferative Proliferative

Question 29

What occurs in mild non-proliferative retinopathy?

Answer 29

Haemorrhages | Microaneurysms

Question 30

What occurs in moderate non-prolierative retinopathy?

Answer 30

Microaneurysms Hard exudates Haemorrhages

Question 31

What occurs in severe non-proliferative retinopathy?

Answer 31

IRMA Venous bleeding Haemorrhages

Question 32

What occurs in proliferative retinopathy?

Answer 32

New vessel formation

Question 33

What are cotton wool spots?

Answer 33

Ischaemic areas

Question 34

What are hard exudates?

Answer 34

Lipid breakdown products

Question 35

What is IRMA?

Answer 35

Intra-retinal microvascular abnormalities

Question 36

What does bleeding of eye vessels lead to?

Answer 36

Floaters and sudden changes in vision

Question 37

What are the 3 treatments of retinopathy?

Answer 37

Laser Vitrectomy Anti-VEGF

Question 38

What % of diabetic men have erectile dysfunction?

Answer 38

50%

Question 39

What causes erectile dysfunction?

Answer 39

Vascular problems | Neuropathy

Question 40

What can also cause erectile dysfunction?

Answer 40

``` Spinal cord injuries Pelvic and urogenital surgery Radiation Substance abuse Alcohol Smoking Medications ```

Question 41

What medications can cause erectile dysfunction?

Answer 41

``` Anti-hypertensives: -All capable -Thiazides and Beta blockers common CNS drugs: -Anti-depressants -Tranquilizers -Sedatives -Analgesics ```