Vascular: Diabetic Arteriopathy and other complications Flashcards
risk factors for amputations
- diabetes
- obesity
- longer life expectancy
risk of diabetic foot problems
- compromised blood supply
- diabetic neuropathy
3 types of diabetic neuropathy
- sensory
- motor
- autonomic
what does sensory neuropathy do?
diabetic do not feel trauma to their legs and this might allow for further damage, leading to ulceration and haematomas
what does motor neuropathy do?
- clawing of the toes
- disbalance between the flexors and extensors of the foot
- formation of callosities
what does autonomic neuropathy do?
- loss of thermoregulation to the foot
- less production of sebum which moistureses the foot
- causes drying of the skin on the foot
treatment of diabetic foot problems
- offloader shoes
- regular podiatry checks
how often should diabetics go to the podiatrist?
- low-risk: 1yr
- medium-risk: 6m
- high-risk: 3m
- severe: more regularly
which vessels does diabetes affect?
smaller, distal vessels (which are more difficult to treat)
biomechanical aspects of diabetic foot disease
- trauma
- elevated plantar pressure
- callus
- alteration in foot shape
- limited joint mobility
clinical presentation of peripheral artery disease
- intermittent claudication
- rest pain (these might be silent due to neuropathy)
- ulceration
- gangrene
how would you examine the patient?
- cardio
- resp
- exercise tolerance
- pulses
- sensation
- ulceration
- waveforms/ABPI
what does the value of ABPI indicate?
0.9-1.3: normal
<0.9: stenosis of the vessles
>1.3: calcification of the vessels
treatment of ischaemia in the limb
revascularisation (open or EVAR or bypass)
types of amputation
- above-knee: transfemoral
- below-knee: transtibial
- minor
