Posters- complications of diabetes Flashcards
Define microvascular disease
Atherosclerotic plaques build up in the small vessels. This leads to nerves not getting enough oxygen so they become damaged and die off.
Give examples of microvascular disease
Retinopathy
Neuropathy
Nephropathy
Give examples of macrovascular disease
Ischaemic heart disease (IHD)
Stroke
Erectile dysfunction
Psychiatric
Peripheral neuropathy is an example of
Microvascular disease
Symptoms of peripheral neuropathy
Pain/loss of sensation in the hands and feet Could present with: Tingling/burning sensation Extreme coldness Numbness/loss of sensitivity Sensitive to touch (allodynia) Sharp pains/ cramps Loss of balance and co-ordination
What complications can arise from peripheral neuropathy
Infections/ulcers
Deformities- Charcot foot, Hammer toes, collapse of mid foot
What is Charcot foot?
Bone protrudes downwards due to many micro fractures in a foot with neuropathy
Treatment of peripheral neuropathy
Simple analgesia such as paracetamol Stronger opioids such as tramadol and oxycodone TCA's- amitriptilline Gabapentin Topical capsaicin cream
What does autonomic neuropathy present as?
Change in bowel habit (gastroparesis) change in bladder function HR and blood pressure changes (postural hypotension) eye changes sweating sexual response Hypoglycaemic unawareness
Describe gastroparesis in further detail and outline why it may be dangerous in diabetics
Gastroparesis is basically slow gastric emptying. Diabetics who have taken their insulin may experience hypos due to the mismatch in the time they take their insulin and emptying of the food into their small intestine.
Why does autonomic neuropathy affect sweating
The autonomic system controls sweat glands and it prevents them from working properly meaning body temperature cannot be regulated. People may experience excessive sweating during eating and at night.
How are the eyes affected in autonomic neuropathy
Less responsive to changes in light. Difficulty driving in the dark.
Treatment of gastroparesis
Start with metoclopramide, domperidone or erythromycin.
Last resort is a gastric pacemaker.
What is proximal neuropathy?
Pain in the thigh, buttocks and hips leading to weakness in the legs (amyotrophy).
Can lead to muscle wasting in the legs.
What is focal neuropathy?
Sudden weakness in one group of nerves causing muscle weakness or pain e.g. carpal tunnel syndrome, bells palsy ect.
