Diabetic Complications

Diabetic Amyotrophy

  • Motor neuropathy of Lower limbs in diabetics
  • Painful
  • Asymmetrical
  • Wasting of quadriceps
  • with areflexia
  • Sometimes extensor plantars
  • Usually period of very poor glycaemic control
  • Sometimes dramatic weight loss
  • Patients are usually middle age and older
  • Improves with better diabetic control
  • Resolves on its own given time

Thought to be due to occlusion of the vasa nevorum of the proximal lumbar plexus and/or femoral nerve

Autonomic Neuropathy

  • Postural Hypotension
  • Difficulty getting erections
  • Gastroperesis – causing diarrhoea and vomiting
  • Neuropathic bladder – painless urinary retention

Acute Painful Neuropathy

  • “Crawling Pains”
  • Legs
  • Worse at night
  • Unable to put sheets on legs
  • Treatement:
    • Good diabetic control
    • tricyclic antidepressants
    • gabapentin

Diabetic Eyes

Maculopathy

  • Macular odema is first feature
  • Which will result in permanent damage if not treated early
  • Perimacular haemorrhages and hard exudates signifies advanced disease

Background Retinopathy

  • Capillary microaneurysms
  • Blot haemorrhages
  • Not a threat to vision itself but may progress:
  • May progress to maculopathy or proliferative retinopathy