Microvascular Diabetes Complications Flashcards
What are the 4 main types of microvascular complications
Neuropathy, Nephropathy, retinopathy, erectile dysfunction
What is peripheral neuropathy?
Pain/loss of sensation in feet/hands
Commonly nocturnal
Complications of peripheral neuropathy (3)
Painless trauma, ulcers, charcot foot
Treatment for peripheral neuropathy pain
Amitriptyline, gabapentin, prcegabalin
What is focal neuropathy?
Damage to a single nerve causing pain or weakness, rare
Example of focal neuropathy (4)
Carpal tunnel, foot drop, bells palsy, cranial nerve palsy
Common places for focal neuropathy? (3)
Head, torso, legs
What is proximal neuropathy?
Pain in thighs, hip, buttocks. Weakness in leg. Muscle waisting
Who gets proximal neuropathy?
Older, T2DM
What nerves are affected in autonomic neuropathy?
Nerves relating to HR, BP, digestive system, sweat glands, eyes
Symptoms of autonomic neuropathy?
Recurrent postural hypotension, loss of hypo warning signs, eye problems, gastroparesis, diarrhoea, constipation and sweating after meal
Diagnostic tools for neuropathy
Nerve conduction studies, gastric emptying studies, USS of bladder to see if emptying, screening for foot disease
What is nephropathy?
Progressive kidney disease due to capillary damage because of high sugar.
Diffuse scarring of glomeruli
Consequences of nephropathy (3)
Hypertension, even more renal impairment because of hypertension, accelerated vascular disease
Screening tools for nephropathy (4)
Urinary albumin creatinine ratio (ACR)
Dipstick to check for infection
U&Es
eGFR
Treatment for nephropathy
BP should be maintained <130/90 using ACEI or ARB
Common presentation of retinopathy
Floaters, distortion, blurred vision
Treatment for retinopathy (4)
Improve diabetic control and BP
Laser to minimise leakage and loss of visual field
Vitrectomy (remove jelly inside eye)
Anti-VEGF injections will reverse damage
Risk factors for ED
Smoking, spinal injury, alcohol, antihypertensive and CNS drugs
Treatment for ED
PDE inhibitors, refer to clinic
Stages of retinopathy
Haemorrhages and micro aneurysms
+ hard exudates
+ microvascular abnormalities and venous bleeding
+ lots of new blood vessel formation that leak and are friable
