Complications Of Diabetes Pennington Biomedical Research Center.ppt

pbrc2009 1 complicationsofdiabetes penningtonbiomedicalresearchcenterdivisionofeducation pbrc2009 2of39 heartdiseasekidneydisease kidneytransplantationeyecomplicationsdiabeticneuropathyandnervedamage footcomplicationsskincomplicationsgastroparesisanddiabetesdepression commonpotentialcomplicationsofdiabetes pbrc2009 3of39 heartdisease causedbyanarrowingorblockingofthebloodvesselstoyourheart thevesselscarryoxygenandnutrientstoyourheart vesselscanbecomepartiallyortotallyblockedbyfattydeposits aheartattack whenthebloodsupplytoyourheartisreducedorcutoff pbrc2009 4of39 diabetesincreasestheriskforcoronaryarterydisease aheartattackorstroke takepreventivestepsnow keepyourabcsofdiabetesontarget heartdiseaseanddiabetes pbrc2009 5of39 theabcs pbrc2009 6of39 kidneyfunction kidneysactasfilters kidneysremovewasteproductsfromtheblood wecreatewasteproductsfromdigestion normally wasteproductsareeliminatedinurinefromthebody proteinandredbloodcellsaretoobigtopassthroughthefilterandremainintheblood pbrc2009 7of39 kidneydisease highlevelsofbloodsugarcanputextrastressonthekidneys afteryearsofdamage thekidneysstarttoleak usefulproteinsarelostintheurine getaconditionknownasmicroalbuminuria thereareseveraltreatmentsatthispointthatmaykeepthekidneydiseasefromgettingworse whenkidneydiseaseisdiagnosedlater duringmacroalbuminuria end stagerenaldisease esrd usuallyfollows pbrc2009 8of39 kidneydisease kidneyslosetheirfilteringability wasteproductsbegintobuildupintheblood finally thekidneysfail esrdkidneytransplantorregularvisitstoadialysisclinic pbrc2009 9of39 whogetskidneydisease factorsthatinfluencekidneydiseasedevelopmentinclude geneticsbloodpressurebloodsugarcontrolcontrollingbloodsugarandbloodpressureareveryimportantinreducingthechancesofdevelopingkidneydisease pbrc2009 10of39 factsaboutdiabetesandkidneydisease nephropathy 10 21 ofdiabetescases 43 ofnewcasesofesrdareattributedtodiabetes 12timeshigherinpeoplewithtype1diabetes4timeshigherinafricanamericans 4to6timeshigherinmexicanamericans6timeshigherinnativeamericansthaninthegeneralpopulationofdiabetespatients pbrc2009 11of39 eyecomplications higherriskofblindness manyhaveminoreyedisorders earlytreatmentscritical pbrc2009 12of39 glaucoma pressurebuild upintheeye pinchesthebloodvessels damagesnerves visionisgraduallylost 40 morelikelytosufferfromglaucoma riskincreaseswithageanddurationofdiabetes pbrc2009 13of39 cataracts theeye sclearlensclouds blockinglight wearsunglassesuseglare controllensesineyeglasses damagedlens remove transplant pbrc2009 14of39 individualswithdiabetesare 60 morelikelytodevelopcataractsatayoungeragefasterprogressionhaveproblemsifremovalofthelensisnecessaryduetothebeginningstagesofglaucoma cataracts pbrc2009 15of39 retinopathy diabeticretinopathyisageneraltermforalldisordersoftheretinacausedbydiabetes thereare2majortypesofretinopathy nonproliferative thisisthecommon mildform proliferative thisformismuchmoreserious pbrc2009 16of39 thereareseveralfactorsthatinfluencewhetheryougetretinopathy bloodsugarcontrolbloodpressurelevelshowlongyouhavehaddiabetesgeneticsalmosteveryonewithtype1diabeteswilleventuallydevelopnonproliferativeretinopathy retinopathy pbrc2009 17of39 diabeticneuropathy nervedamage 50 havesomeformofnervedamage it smorecommoninthosewhohavehadthediseaseformanyyears bloodglucosecontrolcanhelppreventordelaynervedamage pbrc2009 18of39 2commontypesofnervedamage sensorimotorneuropathy alsoknownas peripheralneuropathy cancausetingling pain numbness orweaknessinhandsandfeet autonomicneuropathy canleadtodigestiveproblemssuchasfeelingfull nauseavomiting diarrhea orconstipationproblemswithhowwellthebladderworksproblemshavingsexdizzinessorfaintnesslossofthetypicalwarningsignsofaheartattacklossofwarningsignsoflowbloodglucoseincreasedordecreasedsweatingchangesinhowyoureyesreacttolightanddark pbrc2009 19of39 keepyourbloodglucoselevelsinyourtargetrange itisimportantto reportallpossiblesignsofdiabeticneuropathygettreatmentrightawayifyouhaveproblems takegoodcareofyourfeet checkingthemeveryday protectyourfeet wearshoesandsocksthatfitwellandwearthemallthetime purchasespecialshoes iftheyareneeded becarefulwithexercising someactivitiesarenotsafeforindividualswithneuropathy pbrc2009 20of39 footcomplications skinchangescallusesfootulcerspoorcirculationamputation pbrc2009 21of39 skinchangesandcalluses skinchanges dryskinandfeet sealremainingmoistureinwithplainpetroleumjelly unscentedhandcream orasimilarproduct itisimportantnottoputoilsorcreamsbetweentoes callusesoccurmoreoftenandbuildupfaster mayneedtherapeuticshoesandinserts callusescanleadtoulcers opensores nevertrytocutcallusesyourself thiscanleadtoinfection letyourhealthcareprovidercutthem pbrc2009 22of39 footulcersandpoorcirculation footulcerseveryulcershouldbeseenbyyourhealthcareproviderimmediately canresultininfections potentiallyleadingtolossofalimb itisimportanttokeepoffofyourfeet poorcirculationcanleadtoinfectionanddelayhealing toimprovepoorcirculation stopsmokingandkeepbloodpressureandcholesterolincheckexerciseimprovescirculation itincreasesbloodflow exerciseisagoodideaforindividualswhocurrentlydonothaveanyopensoresonthefoot propershoesareessential pbrc2009 23of39 amputation highlylikelyindiabetes duetoarterydisease whichreducesbloodflowtothefeetandnervedamage whichreducessensation thesecanleadtoulcersandinfectionsthatmayleadtoamputation amputationsarepreventable pbrc2009 24of39 amputation prevention takegoodcareofyourfeet alwaysfollowyourhealthcareprovider sadvicewhencaringforfootproblems stopsmoking smokingdecreasesbloodflowtothefeet pbrc2009 25of39 skincomplications bacterialinfectionsfungalinfectionsitchingdiabeticdermopathynecrobiosislipoidicadiabeticorumatherosclerosisallergicreactions diabeticblisterseruptivexanthomatosisdigitalsclerosisdisseminatedgranulomaannulareacanthosisnigricans pbrc2009 26of39 bacterialandfungalinfections bacterialinfectionsmanykinds styes boils carbuncles inflamedtissuesareusuallyhot swollen red andpainful treatedbyantibiotics fungalinfectionscandidaalbicansisayeast likefungus leadstocommonfungalinfections canbetreatedbymedication stye athlete sfoot pbrc2009 27of39 itchinganddiabeticdermopathy itchinglocalized canbecausedbyayeastinfection dryskin orpoorcirculation occursofteninthelowerpartsofthelegs usemildsoapwithmoisturizer andapplyskincreamafterbathingtohelpresolvetheissue diabeticdermopathychangesinthesmallbloodvessels lookslikelightbrown scalypatches thedisordermostoftenoccursonthefrontofbothlegs thepatchesdonothurt openup oritch dermopathyisharmlessanddoesnotrequiretreatment pbrc2009 28of39 atherosclerosisandallergicreactions atherosclerosisthickeningofthearteriesoccursatyoungerages canleadtoskinchanges skinbecomeshairless thin cool andshiny affectedlegshealslowlywhentheskinisinjured allergicreactionsinresponsetomedications suchasinsulinordiabetespills ifyouthinkyouarehavingareactiontoamedication contactyourdoctorimmediately reportanyrashes depressions orbumpsaroundtheinsulininjectionsitesimmediately pbrc2009 29of39 diabeticblistersanderuptivexanthomatosis diabeticblistersoccursrarelyinindividualswithdiabetestheycanoccuronthebacksoffingers hands toes feet andonlegsorforearms theyaresometimeslargeandresembleburnblisters painlessandwithnorednessaroundthem theyoftenhealthemselveswithin3weeks theonlytreatmentistobringbloodsugarlevelsundercontrol eruptivexanthomatosisthisisaconditioncausedbydiabetesthatisoutofcontrol consistsoffirm yellow pea likeenlargementsintheskin thedisorderusuallyoccursinyoungmenwithtype1diabetes likediabeticblisters thesebumpsdisappearwhendiabetescontrolisrestored pbrc2009 30of39 digitalsclerosisanddisseminatedgranulomaannulare digitalsclerosisconsistsoftight thick waxyskinonthebackofthehands thefingerjointsbecomestiffandcannolongermovethewaytheyshould rarely knees ankles orelbowsalsogetstiff happenstoabout1 3ofpeoplewithtype1diabetestheonlytreatmentistobringbloodsugarlevelsundercontrol disseminatedgranulomaannulareconsistsofsharplydefinedring shapedorarc shapedraisedareasontheskin rashesmostoftenoccuronpartsofthebodyfarfromthetrunk i e earsorfingers butsometimestheraisedareasoccuronthetrunk contactyourdoctorwhenrashappears certaindrugscanhelpclearupthecondition pbrc2009 31of39 acanthosisnigricans acanthosisnigricansthisisaconditioninwhichtanorbrownraisedareasappearonthesidesoftheneck armpits andgroin usuallystrikespeoplewhoareoverweight thebesttreatmentistoloseweight somecreamscanhelpthespotslookbetter pbrc2009 32of39 gastroparesisanddiabetes duetonervedamagethatcontrolthestomach leadstopoormusclecontrolofthestomachandintestines movementoffoodisslowedorstopped signsandsymptoms heartburnnauseavomitingofundigestedfoodanearlyfeelingoffullnesswheneatingweightlossabdominalbloatingerraticbloodglucose sugar levelslackofappetitegastroesophagealrefluxspasmsofthestomachwall thesesymptomsmaybemildorsevere dependingontheperson pbrc2009 33of39 complicationsofgastroparesis gastroparesismakesithardertomanagebloodglucose slowerdigestioncanresultin bacterialovergrowthduetofermentationfoodcanhardenintosolidmassescalledbezoarsthatmaycausenausea vomiting andobstructionofthestomachbezoarscanbedangerousiftheyblockthepassageoffoodintothesmallintestine pbrc2009 34of39 treatmentofgastroparesis themostimportanttreatmentgoalfordiabetes relatedgastroparesisistomanageyourbloodglucoselevelsaswellthroughtheusageof pbrc2009 35of39 depression consultyourdoctortoeliminateanyphysicalcauseforyourdepression poorlycontrolleddiabetescancausedepressionlikesymptoms highorlowbloodsugarduringthedaycanmakeyoufeeltiredoranxiouslowbloodsugarlevelscanalsoleadtohungerandeatingtoomuchlowbloodsugarnthenightcoulddisturbsleephighbloodsugarinthenightcanleadtofrequenturinatingandthenfeelingtiredthroughoutthenextday pbrc2009 36of39 conclusions therearemanypotentialcomplicationsofdiabetes complicationscanbeminimizedwithgoodbloodglucosecontrol discussanydevelopmentswiththephysicianimmediately pbrc2009 37 divisionofeducation reviewedby bethkalickiedited 10 2009 divisionofeducationphillipbrantley phd directorpenningtonbiomedicalresearchcenterclaudebouchard phd executivedirectorhelij roy phd rd pbrc2009 38of39 thepenningtonbiomedicalresearchcenterisaworld renowne