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Common Complications in Diabetes. March 9, 2011 Kevin Wang. Let’s Make a List!. DynaMed & UpToDate Have …. Macrovascular Coronary Artery Disease Cerebrovascular Disease Peripheral Arterial Disease Infection Depression Dysautonomia Erectile Dysfunction Microvascular Neuropathy

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common complications in diabetes

Common Complications in Diabetes

March 9, 2011

Kevin Wang

dynamed uptodate have
DynaMed & UpToDate Have …
  • Macrovascular
    • Coronary Artery Disease
    • Cerebrovascular Disease
    • Peripheral Arterial Disease
  • Infection
  • Depression
  • Dysautonomia
  • Erectile Dysfunction
  • Microvascular
    • Neuropathy
    • Nephropathy
    • Retinopathy
  • Hypoglycemia
  • DKA/HNK
  • Impaired Wound Healing
  • Periodontitis
objectives
Objectives
  • Discuss the common complications associated with diabetes
  • Discuss preventative measures to decrease the risk of developing these complications
macrovascular complications
Macrovascular Complications
  • Coronary Artery Disease
    • DM as a CAD Equivalent
macrovascular complications cont1
Macrovascular Complications (Cont.)
  • Peripheral Vascular Disease
risk reduction
Risk Reduction
  • Diet
  • Smoking
  • HTN
  • Dyslipidemia
  • Physical Inactivity
risk reduction cont
Risk Reduction (Cont.)
  • Aspirin
    • Primary Prevention (Grade C)
    • Secondary Prevention (Grade A)
glycemic control in cad cva
Glycemic Control in CAD/CVA
  • Intensive Therapy
    • ACCORD: Action to Control Cardiovascular Risk in DM
    • ADVANCE: Action in DM and Vascular Disease
    • VACSDM/VADT: Veterans Affairs Cooperative Study of DM
    • UKPDS: UK Prospective DM Study
screening for cad in dm patients
Screening for CAD in DM Patients
  • 2006 ADA Recommendations
  • 2002 ACC/AHA Recommendations
screening for pad
Screening for PAD
  • Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease
  • ACC/AHA
  • American College of Physicians
  • USPSTF
microvascular complications
Microvascular Complications
  • Diabetic Retinopathy
measures to reduce risk and progression of dr
Measures to Reduce Risk and Progression of DR
  • ACCORD Eye Trial
  • Glycemic Control
  • Antihypertensive Therapy
  • Lipid Lowering Therapy
  • Antiplatelet Agents
treatment of diabetic nephropathy
Treatment of Diabetic Nephropathy
  • Glycemic Control
  • BP Control
  • ACEI/ARB
  • CCB
  • Protein Restriction
screening for diabetic nephropathy
Screening for Diabetic Nephropathy
  • Urine Albumin Concentration
  • Urine Albumin-to-Creatinine Ratio
  • Timing
treatment of diabetic neuropathy
Treatment of Diabetic Neuropathy
  • First Line Treatment
  • Second Line Treatment
  • Third Line Treatment
  • Adjunct Treatment
  • Complementary Treatment
depression
Depression
  • Just a reminder …
  • www.meetup.com/seattle-social-diabetics
  • www.defeatdiabetes.org
prevention of dm
Prevention of DM
  • Moderate Weight Loss of At Least 7%
  • Regular Physical Activity – 150 min/week (Level B)
  • Medical Nutrition Therapy (Level B)
  • Increase Fiber Intake (14 gm/day)
  • Decrease Saturated Fat Intake < 7% of Total Calories (Level B)
  • Reduction in Trans Fat Intake (Level B)