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Complication Perkeni WDF
Complication Perkeni WDF
OF
DIABETES MELLITUS
R. BOWO PRAMONO
ENDOCRINOLOGY SUBDIVISION
INTERNAL MEDICINE DEPARTEMENT
GADJAH MADA UNIVERSITY
Twenty
Researchers
Blood
Controlled
COMPLICATIONS of DM
ACUTE
1.Diabetic ketoacidosis (DKA)
2.Hyperglycemic hyperosmolar state (HHS)
3.Hypoglycemia 4. Lactic acidosis
CHRONIC
1.Microangiopathy (retinopathy, nephropathy,
neuropathy, Cardiomyopathy, Diabetic foot, etc)
2.Macroangiopathy (Heart attack/IMA, Stroke,
PAD)
Acute complications
Medical
laktic acid
DKA
Occurs
rapid breathing
Sweet, fruity smell on breath
Loss of appetite
Nausea
Fatigue
Vomiting
Weakness
Fever
Confusion
Drowsiness
Stomach pain
Weight loss
Clinical presentation
Lost
Treatment
Replenishing
HHS
Blood
thirst
Increased urination
Weakness
Leg cramps
Confusion
Rapid pulse
Convulsions
Coma
Hypoglycemia
Blood
Hypoglycemia unawareness
Some
TERIMA KASIH
Alhamdullillah
Thank you for
your attention
CHRONIC
COMPLICATION
Of
DIABETES
MELLITUS
Chronic complications
Development
of other diseases
Long-term DM complications are those
that develop gradually and that may
become disabling or live-threatening. They
include nerve, kidney, eye, heart and
blood vessel disease
CHRONIC COMPLICATIONS
MICROVASCULAR
RETINOPATHY
NEPHROPATHY
CARDIOMYOPATHY
NEUROPATHY
AUTONOMIC
CARDIAC
GASTRIC
UROGENITAL
CHRONIC COMPLICATION
MACROVASCULAR
CHD
RISK
24x
DEATH 60 %
CEREBROVASCULAR
STROKE
: 4x
PERIPHERAL VD
40 50 % NON-TRAUMATIC AMPUTATION
Retinopathy
Retina
Nonproliferatif
Mild & most common
Blood vessel in retina become weak &
swell or bulges or fatty deposits
Doesnt affect in the vision unless
Responsible for sharpest vision
Proliferatif
Tiny blood vessel are damage, bleed or
close off
New & fragile of blood vessel in retina may
bleed
If
early
Laser procedure to seal weak blood vessel
In most cases only one eye is treated at a time
may several treatments pain
Bleedin in the middle eye need surgical
procedure to remove the blood an replace with
clear fluid
Detached (ablatio) retina by scar tissue requires
surgery to position the retina in place
Nephropathy
Inside
Neuropathy
Have
arm
Tingling feeling, numbness, pain or combination
these sensation
Burning pain comes and goes
Discomfort as a crawling sensation
Begin in tips of toe or finger or both and gradualy
spread upward
Damage nerve in toe, if untreated can lose of all
sensation high risk for injury without realizing
How it is treated?
Many
Risk of infection
High
How it is treated?
Antibiotic
to kill bacteria
A foot injury: procedure to clean the
injured area and remove infected tissue
Reduce risk of gum disease by brushing
and flossing the teeth regularly
Reduce risk of bladder infection by going
the bathroom regularly and making sure to
empty the bladder
IMPOTENCE in DM
Refers:
MEDICATION of IMPOTENCE
I. Sildenafil (Viagra, Androz, Edegra,Silagra) isnt effective
for everyone
1hour before activity effective 4 hours
II. Alprostadil (synthetic of prostaglandin E-1)
not a pill self intraurethral (a grain rice)
or self injection therapy (5-20 minutes before and 1 hour
erection)
III. Vacuum device
IV. Penile implant
a. semirigid, benabled rod (permanent erection)
b. inflantable (with pump in scrotum produce an erection
only when you want)
V. Counseling (if psychologycal factors)
Preventing complication
Tight
SELF CARE:
Reducing risk of complication
Have
THANK YOU