DIABETES MELLITUS-COMPLICATIONS

SUMMARY

1. Postprandial hyperglycemia has been associated with macrovascular complications: heart disease, stroke, PVD. Most common cause of death.

2. Retinopathy correlates with duration and control of DM. Early findings: dot hemorrhages (no treatment), but photocoagulation is needed if neovascularization occurs (a late finding). Universally precedes nephropathy.

3. Nephropathy is heralded by persistent microalbuminuria. Treating HTN with either ACEI or ARB decreases the rate of progression (by decreasing intraglomerular pressure) & reduced protein diet.

4. Neuropathy includes autonomic neuropathy, axonal (Schwann cell) degeneration, symmetric polyneuropathy, erectile dysfunction, and gastroparesis.

5. Diabetic mononeuropathy usually affects CN III & VI, the peroneal nerve (foot drop), and the radial nerve (wrist drop). Can be prevented by strict glycemic control.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].