49-Year-old woman presents with foot paresthesia

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(No Transcript)
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49-Year-old woman presents with foot paresthesia
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49-Year-old woman Physical exam
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49-Year-old woman Laboratory results
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49-Year-old woman Diagnosis
American Diabetes Association (ADA).
www.diabetes.org
England JD et al. Neurology.
200972177-84.
National
Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK). www.niddk.nih.gov
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Diabetic neuropathy and gender The EURODIAB
study
Tesfaye S et al. N Engl J Med. 2005352341-50.
European Diabetes Prospective Complications Study
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Diabetic neuropathy
Maser RE et al. J Clin Endocrinol Metab.
2005905896-903. Schönauer M et
al. Diabetes Vasc Dis Res. 20085336-44.
Vinik AI et al. Diabetologia.
200043957-73.
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Diabetic neuropathy
Centers for Disease Control Prevention (CDC).
www.cdc.gov/diabetes
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Tesfaye S et al. N Engl J Med. 2005352341-50.
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Pathogenesis of diabetic neuropathy
Schönauer M et al. Diabetes Vasc Dis Res.
20085336-44. Vincent AM et al.
Endocr Rev. 200425612-28.
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Cumulative incidence of neuropathy in type 1 DM
is related to
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EURODIAB Glycemia is not the only risk factor
for distal symmetric neuropathy in type 1 diabetes
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Risk factors associated with the development of
peripheral sensory neuropathy in T2DM at 5 years
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DCCT Effect of intensive vs conventional
glycemic control on neuropathy in type 1 diabetes
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Effect of long-term intensive insulin vs
conventional control on peripheral neuropathy in
T2DM FBG A1C
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Effect of long-term intensive insulin vs
conventional control on peripheral neuropathy in
T2DM (cont)
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Diabetic neuropathy in long-standing T2DM may be
irreversible despite improvements in glycemic
control
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Diabetic neuropathy in long-standing T2DM may be
irreversible despite improvements in Total-C and
TG
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Systolic BP significantly increased in neuropathy
group despite treatment
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Prevalence of asymptomatic CAD in diabetes
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The female diabetic and CAD
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Gender-specific differences in CAD risk factors
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Gender-specific differences in CAD interventions
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LV systolic function abnormalities in diabetic
patients with neuropathy Effects of ARI
treatment
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Effect of long-term intensive vs conventional
glycemic control on autonomic neuropathy in T2DM
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49-Year-old woman Management decision
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49-Year-old woman 3-Month follow-up
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49-Year-old woman Clinical pearls