1 / 24

Understanding Long-Term Complications and Co-Morbid Conditions in Diabetes Management

This presentation provides an overview of long-term complications arising from diabetes, emphasizing their development over years and the importance of early glucose control and screening programs. Key complications include retinopathy, nephropathy, neuropathy, and peripheral vascular disease, which can lead to blindness, kidney failure, and heart issues. The role of co-morbid conditions such as thyroid dysfunction and coeliac disease in diabetic patients, alongside necessary screening methods, is also discussed to aid in effective management and prevention strategies.

dominica
Télécharger la présentation

Understanding Long-Term Complications and Co-Morbid Conditions in Diabetes Management

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chronic Care Plan

  2. Programme Long-term complications 1 2 Co-morbid conditions

  3. Long-term complications

  4. Slide no 4 Complications • Eyes (retinopathy)  blindness • Also cataracts • Kidneys (nephropathy)  kidney failure • Nerves (neuropathy)  decreased pain perception • Blood vessels • Limbs  peripheral vascular disease • Heart  heart attacks • Brain  strokes Amputations

  5. Slide no 5 Long-term complications • Take years to develop • May occur in childhood • Glucose control (HbA1c) related to risk of complications • Early control in childhood important (metabolic memory) • Complications due to injury to blood vessels • Cause of mortality

  6. Screening programmes Limited joint mobility (LJM)

  7. Slide no 7 Neuropathy • Peripheral neuropathy • Painful neuritis • ‘Glove and sticking’ distribution • Loss of sensation • Reduced reflexes • Autonomic neuropathy • Alteration in gastric function (gastroparesis) • Bloating, decreased appetite, constipation, diarrhoea • Palpitations • Urinary retention

  8. Slide no 8 Neuropathy screening • Symptoms • Neurological examination

  9. Slide no 9 Nephropathy • Increase protein excretion • Small increase early  microalbuminuria • Treatment can slow progression • Large amount of protein excretion  macroalbuminuria or proteinuria • Can cause increased blood pressure • Kidney failure • Treatment is dialysis or transplant

  10. Slide no 10 Nephropathy screening • Annual microalbumin tests • Start 5 years after diagnosis or at start of puberty • Monitor blood pressure • Treat microalbuminuria proteinuria and/or high blood pressure with medication • Improve control (i.e. decrease HbA1c)

  11. Slide no 11 Retinopathy • Bleeding and new blood vessels in the eye • 5-10% chance of blindness • Rapid improvement of poor control can cause retinopathy to get worse • Screen from 5 years after diagnosis or at start of puberty • Eye examination • Retinoscopy • Fundus photography is better if available

  12. Cataract / Retinal hemorrhage Slide no 12 Cataract Retinal hemorrhage

  13. Retinal Microvascular Complications Proliferative retinopathy Normal retina

  14. Nonproliferative diabetic retinopathy (NPDR)

  15. Proliferative diabetic retinopathy (PDR)

  16. Post Laser/Severe PDR Treatments

  17. Co-morbid conditions

  18. Slide no 18 Co-morbid conditions (1) • Not caused by diabetes • More common in children & adolescents with diabetes • Common genetic predisposition • Auto-immune disease • Often no clinical symptoms • Need laboratory screening

  19. Slide no 19 Co-morbid conditions (2) • Thyroid dysfunction • Goitre, hypothyroidism, hyperthyroidism • Thyroid function tests, thyroid antibodies • Coeliac disease • Sensitivity to gluten  bowel dysfunction • Often asymptomatic positive transglutaminase or endomysial or gliadin antibodies • Addisons disease • Unexplained decrease in insulin doses, hypoglycaemia, slow growth, fatigue, increased skin pigmentation • Refer for management

  20. Slide no 20 Other issues • Osteopenia • Necrobiosis lipoidica diabeticorum • Itchy/painful hardened skin patches • Lipohypertrophy (if injection sites are not rotated correctly) • Lipoatrophy

  21. Necrobiosis lipoidica diabeticorum

  22. Skin complications of insulin injections Lipohypertrophy Lipoatrophy

  23. Questions

  24. Changing Diabetes® and the Apis bull logo are registered trademarks of Novo Nordisk A/S

More Related