Conditions associated with Diabetes

Complications of Diabetes

a.       Renal Disease (rule of thumb, if not proteinuric unlikely to be immediately significant, almost all will have retinopathy)

b.      Autonomic Neuropathy, Gastrointestinal side effects – episodic D&V, Cardiac complications – resting tachycardia, long QT syndromes and higher arrhythmia risk associated with electrolyte abnormalities, dramatic postural hypotension (especially if dehydrated and usually requiring an anti-hypertensive when well) commonly anti-hypertensives need to be discontinued temporarily during illness

c.       Foot Ulceration – what’s under the bandage?

d.      Ischaemic Heart Disease – potentially ‘silent ischaemia’, potentially poor diastolic function and thus poor cardiovascular response to sepsis

e.      Atypical Infections secondary to relative immune suppression caused by hyperglycaemia

f. Thrombo-embolic disease – higher incidence than in non-diabetic patients

Associations of Diabetes

a.       Thyroid disease

b.      Addison’s Disease

c.       Autoimmune B12 deficiency (+/- folate potentially exacerbated by metformin use)

d.      Coeliac Disease

e.      Liver and Biliary-Pancreatic Disease (potentially causing secondary diabetes)