n CME : Your SA Journal of CPD - Screening for microvascular complications of diabetes mellitus : missed opportunities : main topic

Volume 21, Issue 10
  • ISSN : 0256-2170



The overall prevalence of diabetic retinopathy and neuropathy exceeds 50%. <br>Preproliferative diabetic retinopathy includes venous beading, multiple cotton wool spots, IRMAs, and multiple haemorrhages. <br>Annual screening for diabetic retinopathy through dilated pupils should start immediately after diagnosis in patients with type 2 diabetes and after 5 years in patients with type 1 diabetes. <br>Diabetic nephropathy is the most common cause of end-stage renal failure in developed countries. <br>Diabetic nephropathy progresses from normoalbuminuria, through a stage of microalbuminuria to overt proteinuria and eventually to end-stage renal disease. <br>Annual screening for microalbuminuria and distal symmetrical diabetic neuropathy should commence immediately after the diagnosis of type 2 diabetes and 5 years after the diagnosis of type 1 diabetes. <br>Failure to detect pressure by a 5.07 U nylon monofilament at selected areas on the plantar aspects of the feet in a diabetic patient has a sensitivity of > 90% to predict ulceration. <br>Overt autonomic neuropathy carries a poor prognosis and patients may die from sudden cardiorespiratory arrest. <br>Optimal glycaemic (HbA1c &lt;u&gt;&lt;&lt;/u&gt; 7.0%) and blood pressure control (&lt;u&gt;&lt;&lt;/u&gt; 130/80 mmHg) significantly reduce the development of microvascular complications.

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