Neuropathies are a potential complication of diabetes. Why do these occur?

Choice A reason: Cataract development is a common issue in people with diabetes due to the high blood sugar levels that affect the lens of the eye. However, it is not the primary cause of visual impairment. Cataracts cause the lens to become cloudy, leading to blurred vision, but the impact is generally less severe compared to the microvascular complications of diabetes.

Choice B reason: Exophthalmos, or bulging of the eye, is not typically associated with diabetes. It is more commonly seen in conditions like Graves' disease, an autoimmune disorder affecting the thyroid. Therefore, while it is important to be aware of various conditions that can impact eye health, exophthalmos is not a primary complication of diabetes.

Choice C reason: Abnormal metabolism in the lens can contribute to the formation of cataracts, but it is not the main reason for diabetic visual impairment. The primary issue in diabetes-related visual impairment is damage to the small blood vessels in the retina, not just changes in the lens metabolism.

Choice D reason: Microvascular changes in the eye, particularly diabetic retinopathy, are the primary cause of visual impairment in people with diabetes. High blood sugar levels can damage the blood vessels in the retina, leading to leakage, swelling, and the formation of new, abnormal blood vessels. This can result in significant vision loss and even blindness if not properly managed. Regular eye examinations and control of blood glucose levels are crucial in preventing and managing diabetic retinopathy.

Choice A reason: NGT (nasogastric tube) is used for enteral feeding, not parenteral nutrition. Enteral feeding involves delivering nutrients directly to the stomach or small intestine, bypassing the need for eating. This method is suitable for patients who have a functioning digestive system but cannot eat orally. Parenteral nutrition, on the other hand, involves delivering nutrients directly into the bloodstream.

Choice B reason: Oral administration of nutrition involves consuming food or nutrients by mouth. This method is suitable for individuals who can eat and digest food normally. Parenteral nutrition bypasses the digestive system altogether and delivers nutrients directly into the bloodstream, making oral administration inappropriate for TPN.

Choice C reason: Central Line is the correct answer because Total Parenteral Nutrition (TPN) requires delivery of nutrients directly into a central vein, typically the superior vena cava. This is because TPN solutions are highly concentrated and can irritate smaller veins, leading to complications such as phlebitis. A central line allows for the safe administration of TPN, ensuring that the high osmolarity solution is rapidly diluted by the large volume of blood in the central veins.

Choice D reason: Peripheral line administration is used for Peripheral Parenteral Nutrition (PPN), not TPN. PPN can be delivered through a peripheral vein because it is less concentrated than TPN. Using a peripheral line for TPN is not appropriate due to the risk of complications from the high osmolarity of the TPN solution.