Presentation
Abstract Vascular disease, exceedingly common in persons with long-term diabetes and affecting both large and small blood vessels, presents the greatest problem and challenge in diabetes today. [diabetes.diabetesjournals.org]
Comatose or precomatose status are present. 32. [slideshare.net]
Presentation[edit] Complications[edit] Diabetes mellitus is the most common cause of adult kidney failure worldwide. [en.wikipedia.org]
Entire Body System
- Gangrene
E11.52 - Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene. ICD-10-CM. [unboundmedicine.com]
Short description: Type 2 diabetes w diabetic peripheral angiopath w/o gangrene The 2020 edition of ICD-10-CM E11.51 became effective on October 1, 2019. [icd10data.com]
ALMAG is used as required part of the complex therapy of angiopathy in the pre-gangrene period. [almagia.com]
So if patient has atherosclerotic PAD (ASPAD) with gangrene, it is assumed the patient also has an ulcer. Do not assign codes 440.23 and 440.24 on the same record. [fortherecordmag.com]
It also the most common cause of amputation in the US, usually toes and feet, often as a result of gangrene, and almost always as a result of peripheral artery disease. [en.wikipedia.org]
- Disability
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Cardiovascular
- Hypertension
Apart from the best possible metabolic regulation, early treatment with antihypertensive drugs has been shown to be beneficial in hypertensive adolescents but may also be renoprotective in normotensive adolescents with permanent microalbuminuria. [onlinelibrary.wiley.com]
[…] angiopathies and during insulin therapy]. 61 54 Rud'ko IA...Kubatiev AA 7863440 1994 23 Antioxidants in the serum of children with insulin-dependent diabetes mellitus. 54 61 Asayama K...Nakazawa S 8138185 1993 24 [Cost of the treatments of arterial hypertension [malacards.org]
• - persistent proteinurea (>500 mg/day); • - normal or decreased GFR; • - persistent blood hypertension. • V. Chronic renal failure or uremia. - decreased GFR; - blood hypertension; - increased serum creatinine (CRF) - signs of intoxication. 48. [slideshare.net]
In many cases, DPA is difficult to cure especially in patients with other medical conditions, such as hypertension. Thus, the preferred approach is to prevent it from occurring. [docdoc.com.sg]
Cardio Diabetes 2020 (Thailand) Hypertension and Stroke - Diabetes Meet 2020 (Netherlands) Insulin Analogues and Glucose Sensors - Global Diabetes 2020 (Switzerland) Insulin and Beta Cell Targeting - Diabetes and Metabolism 2020 (Japan) Insulin Devices [diabetes.conferenceseries.com]
Eyes
- Visual Impairment
Global data on visual impairments 2010. Geneva, World Health Organization, 2012. [cardiorrenal.es]
- Visual Impairment
Global data on visual impairments 2010. Geneva, World Health Organization, 2012. [cardiorrenal.es]
Skin
- Skin Ulcer
[…] complications E11.620 Type 2 diabetes mellitus with diabetic dermatitis E11.621 Type 2 diabetes mellitus with foot ulcer E11.622 Type 2 diabetes mellitus with other skin ulcer Reimbursement claims with a date of service on or after October 1, 2015 require [icd10data.com]
If the patient also has gangrene, then code 440.24 is assigned, but it is still appropriate to list code 707.1x as a secondary diagnosis to identify the skin ulcer type and site. [fortherecordmag.com]
Neurologic
- Stroke
Microvascular disease causes blindness, renal failure, and neuropathy, and diabetes-accelerated macrovascular disease causes excessive risk for myocardial infarction, stroke, and lower limb amputation. [ncbi.nlm.nih.gov]
In part because diabetes increases atherosclerosis-related inflammation, diabetic patients are twice as likely to have a heart attack or stroke. [sciencedaily.com]
Macroangiopathy may cause other complications, such as ischemic heart disease, stroke and peripheral vascular disease which contributes to the diabetic foot ulcers and the risk of amputation. [en.wikipedia.org]
Thus, it increases the risk of heart attack and stroke. Microangiopathy, on the other hand, affects the smaller blood vessels. The condition makes them thick and weak. As a result, the flow of blood throughout the body is slowed down. [docdoc.com.sg]
Cardio Diabetes 2020 (Thailand) Obesity & Stroke - Diabetes & Heart Experts Meet 2020 (Japan) Obesity and Bariatric Surgery - Metabolic Diseases Meet 2020 (UAE) Obesity and Diet - Diabesity Europe 2020 (Italy) Obesity and Metabolic Disorders - Diabetes [diabetes.conferenceseries.com]
- Tingling
Other features which occur in some (but not all) patients are: Altered sensation and tingling in the thigh, hip or buttock, which tends to be mild in comparison to the pain and weakness. [patient.info]
Some references would use 5 P’s, with the addition • Pruritus and • Paresthesia which is “a sensation of tingling, burning, pricking, or numbness of a skin. [slideshare.net]
- Paresthesia
Some references would use 5 P’s, with the addition • Pruritus and • Paresthesia which is “a sensation of tingling, burning, pricking, or numbness of a skin. [slideshare.net]
Workup
Serum
- Hyperglycemia
Abstract The sequelae of chronic hyperglycemia in diabetes of all phenotypes are divided into microvascular and macrovascular complications. [ncbi.nlm.nih.gov]
Pathophysiology[edit] As insulin is required for glucose uptake, hyperglycemia in diabetes mellitus does not result in a net increase in intracellular glucose in most cells. [en.wikipedia.org]
Insulin lack may impair transport of AA if the latter is an insulin-dependent process, or hyperglycemia, of whatever cause, might impair transport of AA if the two sugars compete for a common carrier. [muse.jhu.edu]
Treatment
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[…] and Prevention of Diabetes - Diabetes Expo Asia Pacific 2020 (Japan) Advance Treatment in Diabetes: - Endocrinology Congress 2020 (Thailand) Advance Treatments and Diagnosis - Diabetes and Metabolism 2020 (Japan) Advanced Technologies & Treatments for [diabetes.conferenceseries.com]
During the treatment the control of blood glucose and lipids, as well as the consultation with Endocrinologist – are required! [almagia.com]
Treatment with irbesartan can substantially improve the activity and production of these enzymes in skin fibroblasts. From the journal Diabetes care ISSN : 0149-5992 [agris.fao.org]
Treatment of DPA focuses on preventing the condition from progressing and complications from developing. [docdoc.com.sg]
Prognosis
(October 2017) Prognosis[edit] Prognosis is generally poor for all forms of diabetic angiopathy, as symptomatology is tied to the advancement of the underlying pathology i.e. the early-stage patient displays either non-specific symptoms or none at all [en.wikipedia.org]
Nevertheless, the early detection of risk factors and the implementation of appropriate intervention strategies are necessary to improve the long‐term prognosis for children with diabetes. © 1997 John Wiley & Sons, Ltd. [onlinelibrary.wiley.com]
The prognosis is extremely poor. 5 years after recognition of this complication 50 % of the patients are blind. 51. Diabetic angiopathy of lower extremities. [slideshare.net]
Etiology
Etiologic classification of DM (1999) I. Type 1 of DM (destruction of β-cells which mostly leads to absolute insulin insufficiency): • autoimmune; • idiopathic. II. [slideshare.net]
Epidemiology
The prevalence, detection, and epidemiological correlates of peripheral vascular disease: a comparison of diabetic and non-diabetic subjects in an English community. Diabet Med. 1992; 9(8): 710-715. 26. [aaem.pl]
Published on Dec 11, 2016 Pathophysiology, Epidemiology and Classification of Diabetes By Dr Shahjada Selim 1. [slideshare.net]
(Canada) Metabolomics in Cancer and Oncology - Metabolomics Summit 2020 (Canada) Metabolomics in Cardiovascular Disease - Metabolomics Summit 2020 (Canada) Metabolomics in Nervous System - Metabolomics Summit 2020 (Canada) Metabolomics in Nutrition: Epidemiology [diabetes.conferenceseries.com]
Pathophysiology
Pathophysiology[edit] As insulin is required for glucose uptake, hyperglycemia in diabetes mellitus does not result in a net increase in intracellular glucose in most cells. [en.wikipedia.org]
While not exclusive, the two most common forms are Diabetic retinopathy and Diabetic nephropathy, whose pathophysiologies are largely identical. [stemcellreference.com]
A contemporary appraisal of these issues is essential for all those interested in the pathophysiology and management of diabetic vascular disease. [amazon.co.uk]
Prevention
Treatment of DPA focuses on preventing the condition from progressing and complications from developing. [docdoc.com.sg]
[…] the impact of therapeutic and nutraceutic options in preventing diabetes and its vascular complications. · To evaluate the autonomic gastrointestinal dysfunction in animal models of metabolic diseases. [uc.pt]
Pathways to diabetic limb amputation: basis for prevention. Diabetes Care. 1990; 13(5): 513-521. 3. Prompers L, Schaper N, Apelqvist J, Edmonds M, Jude E, Mauricio D, et al. [aaem.pl]
Abdominal pain - Diabetes 2020 (Spain) Adolescent Gynaecology - Global Diabetes Expo 2020 (Australia) Adrenal and Thyroid Disorders - Endocrinology 2020 (Austria) Adrenal and Thyroid Disorders - Endocrinology Meet 2020 (Finland) Advance Treatment and Prevention [diabetes.conferenceseries.com]
Since treatment of fully developed complications is unsatisfactory, exploration of ways of prevention offers the best hope for the future. [diabetes.diabetesjournals.org]