Diabetes Flashcards
What is metabolic syndrome?
A collection of conditions or risk factors for heart disease, diabetes and stroke known also as syndrome X or insulin resistance syndrome
For a diagnosis of metabolic syndrome what conditions ought to be present?
- an increase in abdominal fat (waist circumference of 88cm or more in women and 102cm for men)
- a high blood level of triglycerides
- a low high-density lipoprotein cholesterol (HDL-C) level or ‘good’ cholesterol
- High blood pressure of 130/85 mmhg
- High fasting blood glucose level of 2.8 mmol/L or above
From a worldwide perspective an increase in what factors are responsible for the development of metabolic syndrome?
Calorie intake and sedentary lifestyles
Which type of diabetes shows the strongest link with diabetes?
Type 2 diabetes mellitus also known as insulin resistant diabetes
True or false: the longer an individual remains obese the higher the person risk level of developing type 2 diabetes mellitus
True
In the treatment of schizophrenia which medications and most likely to increase the patients change of type 2 diabetes mellitus?
Clozapine and olanzapine
In the treatment of depression which medications and most likely to cause metabolic abnormalities?
Antidepressants with noradrenergic activity
What is pre-diabetes?
Before an individual develops diabetes
Which key organ is the site of glucose metabolism
The pancreas
what is hyperinsulinaemia?
When there is too much insulin in the blood due to insulin resistance. This causes weight gain, high blood pressure, high triglycerides and low HDL-C
What are the signs and symptoms of diabetes?
Frequent urination, excessive thirst, weight loss, tiredness, tingling sensation or numbness in extremities, blurred vision, frequent infections, increased hunger, slow-healing wounds, lack of interest and concentration and vomiting and stomach pain.
What are the two main methods for screening type 2 diabetes
Fasting blood sugar and oral glucose tolerance test (OGTT)
What is Hypoglycaemia?
A condition where the blood glucose level is too low and it is a medical emergency
When a person with type 2 diabetes mellitus experiences frequent hunger without other symptom what does this indicate?
That the blood glucose level is too low
Would we give a patient chocolate to raise their blood glucose level to normal?
No as it does not work quickly enough due to its high fat content
What is hyperglycaemia?
Excessively high glucose levels of 11mmol/L or above
What is the cause of hyperglycaemia?
Due to low insulin levels and or resistance to insulin
What is Diabetic ketoacidosis (DKA)?
A serious condition that can lead to a diabetic coma or death in extreme cases. It is when hyperglycaemia is due to a lack of insulin
What is hyperosmolar hyperglycaemic state? HHS
Where pancreatic insulin is not effective in controlling blood glucose and therefore blood glucose levels rise, to correct this the body excretes through the urine leading to excessive urination therefore excessive dehydration causing complications
What are hypoglycaemic medicines?
drugs that are used only in the treatment of type 2 diabetes
What is tertiary prevention?
A level of preventative care that deals with the rehabilitation and return of a patient to a status of maximum usefulness with a minimum risk of recurrence of the disorder. (This involves a degree of self-care)
What does successful management of diabetes usually include?
A combination of pharmacological, and lifestyle change interventions.
With regards to pharmacological interventions what are the common medications for managing diabetes?
Sulphonylureas, meglitinides, biguanides, thiazolidinediones and alpha-glucosidase inhibitors
What are some non-pharmacological interventions for diabetes?
Dietary advice and exercise + the empowerment of the patient and carer
Which psychotropic medications are LESS LIKELY to cause diabetes?
Aripiprazole, asenapine, iloperiodone, fluoxetine, and citalopram
What triggers type 1 diabetes?
The vast majority of type 1 cases are triggered by an autoimmune destruction of the pancreatic beta cells causing an inability to produce insulin
What does it mean by autoimmune destruction with Type 1 diabetes?
Where the immune system mistakenly identifies the pancreatic beta cells as foreign and attacks and destroys them
Why does autoimmune destruction occur?
This is mostly unknown although it is thought this is due to genetic susceptibility then at some point in their life an environmental trigger (such as a virus or toxin) activates this susceptibility to bring on the immune response.
What causes hyperglycaemia?
Insufficient insulin or oral diabetes medication, not injecting insulin properly or using expired insulin, diet, being inactive, illness or infection, certain medications (steroids ect), injury or surgery, and lastly experiencing emotional stress such as family conflict or workplace challenges
Does hyperglycaemia or hypoglycaemia require immediate treatment?
Hypoglycaemia, this is always a medical emergency due to risk of coma and death
How do we prevent hypoglycaemia?
BSL monitoring, monitor and encourage food intake, anticipate changes in insulin requirements, give dextrose with insulin infusions (HOSPITAL), educate about symptoms and encourage to report these promptly, and lastly ask patients on insulin about their awareness of hypoglycaemia.
What are the different types of insulin?
short acting, intermediate acting, long acting, fast acting, and pre-mixed
How do we manage type 2 diabetes?
With a healthy diet, exercise, weight loss, oral hypoglycaemic, and BP/Lipid monitoring.
What do Biganides do?
Reduce glucose produce in liver
What do Sulphonylureas do?
Stimulates the pancreas to release more insulin
What so alpha-glucosidase inhibitors do?
Slows the digestion and absorption of carbohydrates
What do thiazolidnediones do?
Increase body tissues sensitivity to insulin
Fat blocks insulins ability to what?
Work effectively and efficiently
High levels of insulin that cannot be utilised effectively is called what?
Insulinaemia
Can we prevent or cure Type 1 diabetes?
There is no known prevention or cure
Can we prevent or cure Type 2 diabetes?
Evidence weight loss may prevent it
When does onset usually occur for people with type 1 diabetes?
During childhood and adolescence
When does onset usually occur for people with type 2 diabetes?
During adulthood but can be diagnosed in children under 15 years
what is involved in self-management for those with type 1 diabetes?
Daily and often multiple insulin injections or a continuous delivery of insulin with a pump, meticulous attention to blood glucose levels, and a healthy lifestyle to contribute to effective management (routine).
what is involved in self-management for those with type 2 diabetes?
Good weight control, nutrition, and monitoring of blood glucose levels + potentially the management of oral medication and insulin therapy
