Endocrinology Book

Approach

Disease Complications

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Management

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Diabetes Mellitus Complications

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  1. Prevention
    1. Better glycemic control yields lower complication risk
    2. Most patients with diabetes die of cardiovascular disease complications
      1. Hypertension control has greater benefit in reducing stroke risk
      2. Hyperlipidemia control has greater benefit in reducing coronary disease risk
    3. Complications reduced 60% if Hemoglobin A1C <7.2%
      1. (1995) N Engl J Med 332:1251
  2. Complications: Macrovascular
    1. Atherosclerotic Heart Disease
    2. Myocardial Infarction and Sudden Death
    3. Peripheral Vascular Disease
    4. Cerebrovascular Disease
    5. Renal Artery Stenosis
  3. Complications: Microvascular
    1. Diabetic Retinopathy
    2. Diabetic Nephropathy
      1. Occurs in 40% of Type I Diabetes Mellitus
      2. Occurs in 20% of Type II Diabetes Mellitus
    3. Peripheral Neuropathy
      1. See Diabetic Neuropathy
      2. See also Peripheral Neuropathy Testing
      3. See Charcot Foot
      4. See Foot Ulcer and Diabetic Foot Care
      5. See Suspected Osteomyelitis in Diabetes Mellitus
    4. Autonomic Neuropathy
    5. Gastroparesis
    6. Impotence

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