Presentation of T2DM and its complications Flashcards
Diabetes has an insidious onset. True or false.
True. T2DM patients may spend months to years not knwing they have diabetes at all.
What are the symptoms of TD2M due to.
Slowly rising glucose.
What are the symptoms of slowly rising glucose. (5)
Tiredness. Lethargy. Polyuria. Polydipsia. Often drinking lucozade (or coke) because of thirst.
What ion rises with T2DM.
Sodium.
Why does sodium rise with T2DM. (3)
The patients are very thirsty, and so drink a lot of (usually) sugary drinks.
There is consequent osmotic diuresis, which causes a loss of water and a rise in sodium.
Eventually, the sodium and the glucose are both very high.
How is osmolality calculated.
2(cations) + glucose + urea.
2(Na+K) + glucose + urea
How does T2DM affect the osmolality.
It causes a hyperosmolar state.
Give an example of the osmolar state of a patient with T2DM.
430mM
How many patients with T2DM do not actually know that they have it.
About 50%
What is the glycaemic state of patients with undiagnosed T2DM.
Hyperglycaemic.
Do patients with undiagnosed T2DM have acidosis.
No.
If patients ignore the first symptoms of polyuria, what might be the initial reason for presenting to the doctor. (T2DM)
With a complication.
What are the two broad categories of complications arising from T2DM.
Microvascular.
Macrovascular.
What is the cause of the microvascular complications of T2DM. (2)
Glycosylation of basement membrane proteins.
This leads to leaky capillaries.
What are the causes of the macrovascular complications of T2DM. (3)
Dyslipidaemia.
Hypertension.
Hypercholesterlaemia.
What are the potential microvascular complications of T2DM. (3)
Nephropathy.
Neuropathy.
Retinopathy.
What are the potential macrovascular complications of T2DM. (3)
Cerebrovascular events.
Ischaemic heart disease.
Peripheral gangrene.
What is seen in background diabetic retinopathy. (3)
Hard exudates.
Microaneurysms.
Blot haemorrhages.
What are hard exudates caused by.
Cholesterol deposits.
What do microaneurysms look like.
Small ‘dots’.
What is the treatment of choice for a patient with background diabetic retinopathy.
Improve blood glucose control.
Warn patients that there are warning signs.
What is seen in pre-proliferative diabetic retinopathy. (4)
Hard exudates.
Microaneurysms.
Blot haemorrhages.
Cotton wool spots.
What are cotton wool spots suggestive of.
Retinal ischaemia.
What can retinal ischaemia lead to.
New vessel growth.
Why is retinal ischaemia a problem.
Because the new vessels that grow are sensitive and may bleed.
What is the treatment for pre-proliferative diabetic retinopathy.
Pan retinal photocoagulation.
What is the treatment for proliferative diabetic retinopathy.
Pan retinal coagulation.
What is the main characteristic of pre proliferative retinopathy.
Cotton wool spots.
What is the main characteristic of proliferative retinopathy.
Visible new vessel growth.
