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Chapter-023 Microvascular Complications in Diabetes

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Dhanwal Dinesh Kumar
2. Pandit Sanjay
ISBN
9789351526476
DOI
10.5005/jp/books/12535_30
Edition
2/e
Publishing Year
2015
Pages
8
Author Affiliations
1. NMC Speciality Hospital, Abu Dhabi, UAE; Maulana Azad Medical College, New Delhi, India
2. Maulana Azad Medical College, New Delhi, India
Chapter keywords
Hyperglycemia, diabetic nephropathy, proteinuria, diabetic neuropathy, diabetic retinopathy, macular edema, ophthalmoscopy, vitreoretinal surgery

Abstract

The hyperglycemic effects are the major source of morbidity and mortality in both type 1 and type 2 diabetes mellitus (DM). The microvascular complications associated with diabetes are diabetic nephropathy, neuropathy and retinopathy. Diabetic nephropathy is the major cause of chronic renal failure and end stage renal disease. This can be diagnosed with four clinical features such as hyperglycemia, nephropathy, hypertension and proteinuria. A combination of both ACE inhibitors and angiotension receptor blocker (ARBs) helps to treat diabetic nephropathy by controlling the blood pressure. Diabetic neuropathy (DN) refers to the peripheral nerve dysfunction in diabetics and it can be diagnosed by certain electrophysiological testing. The drugs such as amitriptyline, duloxetine, carbamazepine, gabapentin and pregabalin are used to treat symptomatic DN. The common complication of diabetes is diabetic retinopathy (DR) which causes serious threat to vision. Generally, retinopathy is classified into nonproliferative and proliferative diabetic retinopathy. The clinical features of both retinopathies are elaborately discussed with their clinical investigation and treatment methods.

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