Module 8- Diabetes and Vascular Disease Flashcards
____% of people with DM have wounds
15
14-24% of those with diabetic ulcers will ultimately have an_____
amputation
Mortality following amputation increases with level of amputation and range from 50-85% at ____ Years
5
hyper-______ can lead to stiffer blood vessels and reduced tissue oxygenation
hyperglycemia
Type 1 DM- after 20 years of disease duration at least 20% have ____
diabetic peripheral neuropathy
Type 2 DM- after 10 years of disease duration at least 50 % have ____
diabetic peripheral neuropathy
with diabetic peripheral neuropathy loss of sensation manifests as a decrease in what
decreased sensation, vibration, proprioception, loss of reflexes
Neuropathic pain
diabetic peripheral neuropathy how does motor change
progressive weakness and atrophy
What autonomic changes occur in diabetic peripheral neuropathy
decreased sweat and oil production—> leads to dry inelastic skin
orthostasis
Silent MI
____ is the most common complication of DM type I and II
diabetic peripheral neuropathy
when completing a monofilament test for DM what sensation are you testing
protective sensation
progressive degeneration of weight-bearing joints
-increase risk of skin breakdown
Charcot disease
What are 3 common foot deformities in charcot disease
- claw toe deformity
- bunion and overlapping toes
- rocker-bottom deformity secondary to charcot arthopathy
What are 4 complications of vascular and neuropathic changes
- ulceration- often painless
- neuropathic edema
- charcot arthropathy
- callus formation
up to 50% of patients with type 2 DM are at an _____ risk of developing skin infections
increased
how does the skin change with diabetes
loss of elasticity
commonly a shiny appearance
thick skin
most common in hands and fingers
Where is the most common spot for diabetic yellow skin
palms of hands, soles of feet and distal nail plate
what is the most common cutaneous change present in 30-60% of pts with DM
usually seen in men >50 years old
diabetic dermopathy
Explain the presentation of diabetic dermopathy
round/oval atrophic
hyperpigmented raised lesions
usually on the pretibial are of LE
can occur on the forarms
initially small, dull red, scaly papules and small plaques
Xerosis is dryness of the skin with fissures/cracks most commonly found on heels and feet this is an area at risk of ____
infection
development of dark, thick, velvety skin in body folds and creases
most common in axilla, groin, posterior neck
acanthosis nigricans
acquired perforating dermatosis presentation
large papules with central keratin plugs
usually on limbs of adults, usually LEs
Describe the two cutaneous reactions to insulin
lipotrophy- occurs within 6-24 months of starting treatment
most common in children and women
Liphypertrophy- resembles lipoma
