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Cardiovascular:
1- diabetic patients are at increased risk for hypertension,
coronary artery disease,congestive heart failure, diastolic
dysfunction, cereberovascular, renovascular and peripheral
vascular disease.
2-these patient may have clinically silent myocardial
ischemia or infarction.
3- DM considered one of the risk factors when determining
preoperative cardiac testing
4--adrenergic blockers
Renal:
-avoid nephrotoxic drugs, maintain
normovolumia, control of hyperglycemia
and/or hypertension and preservation of renal
blood flow
Neuropathy:
Peripheral and automonic
-autonomic neuropathy
may blunt the compensatory cardiovascular
response to hypotension so predisposing to
haemodynamic liability.
May cause gastroparesis so presdisposing to
pulmonary aspiration
Autonomic Neuropathy
Orthostatic hypotension
Resting tachycardia
Gastroparesis(vomiting,diarrhea)
Impotence
Cardiac dysrhythmias
Asymptomatic hypoglycemia
Sudden death syndrome
Non enzymatic glycosylation of proteins and
abnormal cross linking of collagen :
-leading to decreased joint mobility
-if affecting tempromandubilar joint and/or
cervical spine will cause difficult airway
Stiff joint syndrome
Obesity
Stiff Joint Syndrome
-Long-standing type I diabetics are at risk for this syndrome, which is
Manifested by: joint rigidity (most significantly affecting joints involving
the airway such as the temporomandibular, atlantooccipital, and cervical
spine joints), short stature, and tight, waxy skin.