part 13

Question 1

• damage to small blood vessels that supply the glomeruli of the kidney
• leading cause of end stage renal disease

Answer 1

diabetic nephropathy

Question 2

What are the risk factors for diabetic nephropathy?

Answer 2

hypertension
genetics
smoking
chronic hyperglycemia

Question 3

When pt’s are screened anually for diabetic nephropathy what are we looking for and how do we treat it?

Answer 3

-if albuminuria is present we treat with
-ACE inhibitors
-Angiotensin II receptor antagonists
(controlling hypertension and glucose is imperative)

Question 4

Nerve damage due to metabolic derangements of diabetes.

• reduced nerve conduction and demyelinization
• sensory or autonomic

Answer 4

diabetic neuropathy

-60-70% of pt’s with diabetes have some degree of neuropathy

Question 5

loss of protective sensation in lower extremities

Answer 5

sensory neuropathy

Question 6

What is a major risk of sensory neuropathy?

Answer 6

amputation

Question 7

What is the most common form of sensory neuropathy?

Answer 7

distal symmetric polyneuropathy

Question 8

• affects hands and/or feet bilaterally

- loss of sensation, abnormal sensations, pain, and paresthesias

Answer 8

distal symmetric polyneuropathy a type of sensory neuropathy

Question 9

How do you treat sensory neuropathy?

Answer 9

• manage blood glucose
• Drug therapy: topical creams, tricyclic antidepressants, SSRI’s, norepinephrine reuptake inhibitors, antiseizure meds (gabapentin/neurontin)

Question 10

This can affect nearly all body systems and lead to hypoglycemia unawareness, bowel incontinence, diarrhea, and urinary retention.

Answer 10

diabetic neuropathy autonomic neuropathy