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DIABETES MELLITUS-COMPLICATIONS

Endocrinology

DIABETES MELLITUS-COMPLICATIONS

1. Postprandial hyperglycemia has been specifically associated with macrovascular complications.

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

3. Nephropathy is heralded by persistent microalbuminuria. Remember that 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).

6. Strict glycemic control decreases the risk of developing neuropathy and improves nerve conduction.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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