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Long-Term Complications of Diabetes Mellitus PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Long-Term Complications of Diabetes Mellitus" by DR. SHEETAL JAIN.

This medical PowerPoint presentation talks about diabetes mellitus, a chronic metabolic disorder that affects how the body processes blood sugar (glucose). When left uncontrolled or poorly managed, it can lead to various long-term complications. Some of the most common long-term complications of diabetes include Cardiovascular disease, Nephropathy, Neuropathy, Retinopathy, Foot complications, Skin complications, Hearing impairment, Gastroparesis, and Dental problems, etc.

Tags : diabetes mellitus, metabolic disorder, Cardiovascular disease, Nephropathy, Neuropathy, Retinopathy, Foot complications, Skin complications, Hearing impairment, Gastroparesis, Dental problems, endocrinology, endocrinology PowerPoint presentation

Published on : Apr 18, 2023 | Views : 1493 | Downloads : 3

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Slide 1-

Long-Term Complications of Diabetes Mellitus Marion Technical College NUR 1020
Slide 2-

Chronic complications of diabetes Categories of longterm diabetic complications macrovascular disease microvascular disease Neuropathy Hypertension -major contributing factor especially in macrovascular and microvascular disease
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Long-term complications of diabetes mellitus
Slide 4-

Chronic hyperglycemia damage to cells & tissues possibly by: 1. Accumulation of damaging by-products of glucose metabolism-sorbitol a. Associated with damage to nerve cells 2. Formation of abnormal glucose molecules in the basement membrane of small blood vessels - eye and kidney 3. Derangement in red blood cell function leads to ↓in oxygenation to tissues
Slide 5-

Macrovascular Macrovascular complications Diseases of the large and medium-size blood vessels Occur with greater frequency and earlier onset in people with diabetes Macrovascular diseases Cerebrovascular, coronary artery, and peripheral vascular disease.
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Macrovascular Changes Atherosclerotic changes Blood vessels thicken, sclerose & become thickened by plaque→adheres to vessel wall Eventual blockage of blood vessel Changes occur at an earlier age and more often in the diabetic
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Macroangiopathies Cerebrovascular Effects Glucose – stiffens the RBC’s, making platelet aggregation easier Leads to TIA’s and causes CVA’s People with diabetes- 2x risk of cerebrovascular disease Recovery from stroke impaired if blood glucose ↑at time of event
Slide 8-

Macroangiopathy Coronary artery disease (CAD) MI- 2x as common in men & 3x as common in women with diabetes ↑ likelihood of second MI Ischemic symptoms may be absent May be secondary to autonomic neuropathy Silent MI common in DM
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Macroangiopathy Occlusive Peripheral Arterial Diseases Occurs 2-3x more frequently in diabetics Signs & symptoms Decreased pulses Intermittent claudication (pain in buttock, thigh or calf when walking) Gangrene & amputation – result from severe form of arterial occlusion
Slide 10-

Interventions for occlusive peripheral arterial disease Good BS control- medication compliance Protect feet from heat and cold Foot care: Wash daily in warm water, dry well, inspect feet daily (use mirror to √ bottoms) Keep skin soft; gently smooth corns & calluses Trim toenails straight- emery board to edges Wear closed toe well-fitting shoes & socks – avoid any irritation of foot No smoking (causes vasospasm) Check DP and PT pulses; examine feet daily
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Reduction of risk factors for Macroangiopathies Medical nutrition therapy & exercise Reduces obesity, HTN & hyperlipidemia Obesity increases insulin resistance BP control – meds and lifestyle changes Tight BS control ↓triglyceride concentrations ↓ complications No smoking
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Microvascular Complications Result from thickening of the vessel membranes in the capillaries and arterioles from chronic hyperglycemia Areas most affected Eyes (retinopathy) Kidneys (nephropathy
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Microvascular changes Present in some patients with type 2 diabetes at time of diagnosis Clinical manifestations usually do not appear until 10 to 20 years after the onset of diabetes
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Diabetic Retinopathy Most common cause of new cases of blindness in people ages 20 to 74 years Occurs in Type 1 & Type 2 diabetes Deterioration of small blood vessels that nourish the retina Maintenance of blood glucose to near normal in type 1 - decrease risk by 74%
Slide 15-

Diabetic Retinopathy Stages: nonproliferative stage- results in microaneruysms → capillary fluid leakage→ retinal edema proliferative-most severe form- retinal capillaries become occluded New fragile capillaries form- hemorrhage easily and cloud the vitreous→ loss of vision Scar tissue also forms→ retinal detachment Blurred vision secondary to macular edema often occurs
Slide 16-

Management of Retinopathy Annual eye exam- screen for retinopathy Laser photocoagulation Destroys ischemic areas of the retina that produce growth factors that encourage neovascularization This prevents further visual loss - reduces the rate of progression to blindness Done as outpatient- can return to normal ADL Control BS levels Control hypertension Cessation of smoking
Slide 17-

Other eye problems in diabetes Glaucoma -results from occlusion of the outflow channels secondary to neovascularization This type of glaucoma is difficult to treat and often results in blindness Cataracts develop at an earlier age and progress more rapidly in people with diabetes
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Diabetic Nephropathy A microvascular complication Damage to small blood vessels that supply the glomeruli of the kidney Leading cause of end-stage renal disease (ESRD) in the United States Risk of nephropathy is about the same in patients with either type 1 or type 2 diabetes Symptoms occur 10-20 yrs after diagnosis of diabetes
Slide 19-

Pathophysiology of nephropathy Consistent elevation of blood glucose for a significant period of time Proteins leak into urine d/t stress on filtration mechanism Pressure in the blood vessels in kidneys increases Stimulates development of nephropathy
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Management of Nephropathy Monitor urine for microalbuminuria, BUN, creatinine annually Blood glucose control to prevent & delay development of nephropathy Use of ace-inhibitor drugs – delay progression of nephropathy Aggressive control of BP- to slow progression of nephropathy
Slide 21-

Other interventions for nephropathy Decrease protein intake if indicated (renal diet) Low sodium diet Avoid nephrotoxic substances Dialysis or transplant
Slide 22-

Diabetic Neuropathies Nerve damage d/t metabolic derangements from diabetes Demyelination of nerves from hyperglycemia Most common types: sensory or peripheral neuropathy autonomic neuropathy
Slide 23-

Peripheral Neuropathy May involve all extremities – usually lower Symmetrical and bilateral Sx: Burning pain (night) Paresthesia & unable to feel where feet are Decreased sensation of pain and temp - ↑ risks of injury to feet Foot & hand deformities r/t atrophy of small muscles of the hands and feet
Slide 24-

Neuropathy: neurotrophic ulceration
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Management -Peripheral Neuropathy Control of blood glucose -only treatment for diabetic neuropathy Medications: Analgesics, antidepressants, Neurontin Capsaicin- topical cream from chili peppers- depletes the accumulation of pain-mediating chemicals in the peripheral sensory neurons TENS units
Slide 26-

Autonomic Neuropathies Can affect all body systems Three systems often involved Cardiac Gastrointestinal Renal
Slide 27-

Autonomic - Cardiovascular Fixed tachycardia Orthostatic hypotension Change from a lying or sitting position slowly to avoid fainting & injury Painless MI
Slide 28-

Autonomic GI Tract Neuropathy Gastroparesis Delayed stomach emptying and decreased peristalsis Anorexia, bloating, GERD, n & v Can delay absorption of food and result in wide swings in blood sugar Medication: Reglan ↑motility of GI tract Low fat diet
Slide 29-

Autonomic – Urinary Tract Neuropathy Neurogenic bladder with urinary retention Inner wall of bladder loses ability to sense pressure Bladder empties incompletely Increases risk of UTI
Slide 30-

Treatment of Urinary Tract Neuropathy Urecholine- cholinergic agonist Acts on nerves that innervate bladder Antibiotics for UTI Manual pressure q 2 hr – Crede’ Learn self-catheterization
Slide 31-

Reproductive System Neuropathy 50% of males affected- erectile dysfunction May have retrograde ejaculation Fertility counseling if attempting conception ↓ libido & ↑ in vaginal infections in women Treatment: Meds, surgery
Slide 32-

Increased Susceptibility to Infections Related to high BS levels Impairs phagocytosis by neutrophils and monocytes Loss of sensation (neuropathy) may delay the detection of an infection Treatment of infections must be prompt and vigorous
Slide 33-

Implications with Infection & Diabetes Healing is slow Related to impaired vascular supply Not enough oxygen to tissue, nutrients, antibodies d/t poor circulation Infections increase the need for insulin Often insulin is needed in the hospitalized diabetic, even if they do not take it at home
Slide 34-

Nursing Role Assess for complications in the diabetic patient r/t the cardiac, vascular and nervous systems Educate the patient and caregiver about prevention and management r/t chronic complications of diabetes