Complications Flashcards

A patient with type 2 diabetes reports numbness and tingling in both feet that worsens at night. Which complication is most likely?

Answer: Distal symmetric polyneuropathy

Distal symmetric polyneuropathy is the most common form of diabetic neuropathy, causing bilateral numbness and tingling that typically worsens at night.

Which finding on a monofilament foot exam indicates loss of protective sensation?

Answer: Unable to feel the 10-g monofilament at one or more sites

Inability to feel the 10-g Semmes-Weinstein monofilament at one or more plantar sites indicates loss of protective sensation and high ulcer risk.

A diabetic patient develops a painless, swollen, deformed ankle joint. X-ray shows fragmented bone and joint disorganization. What condition is this?

Answer: Charcot neuroarthropathy

Charcot neuroarthropathy (Charcot foot) presents as a painless, hot, swollen joint with bony destruction due to loss of protective sensation.

Which HbA1c target is associated with the greatest reduction in microvascular complications in type 1 diabetes, per the DCCT trial?

Answer: Less than 7%

The DCCT trial demonstrated that intensive therapy targeting HbA1c below 7% reduced microvascular complications by approximately 50–76%.

Autonomic neuropathy affecting the cardiovascular system in diabetes can manifest as which finding?

Answer: Resting tachycardia and orthostatic hypotension

Cardiovascular autonomic neuropathy typically presents as resting tachycardia, reduced heart rate variability, and orthostatic hypotension.

A patient with diabetes has gastroparesis. Which glucose management challenge does this create?

Answer: Unpredictable glucose excursions due to delayed gastric emptying

Gastroparesis causes delayed and erratic gastric emptying, making glucose absorption unpredictable and insulin timing difficult.

Which class of antihypertensive is preferred for patients with diabetes and microalbuminuria to slow progression of diabetic kidney disease?

Answer: ACE inhibitors or ARBs

ACE inhibitors and ARBs reduce intraglomerular pressure and have proven renoprotective effects in patients with diabetic nephropathy and microalbuminuria.