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#Phase 2.2: Paediatrics > Diabetes > Flashcards

Diabetes Flashcards

Not much in dis one cah is mostly da same as adult diabetes

1
Q

What is T1DM?

A

When pancreas unable to produce insulin

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2
Q

What are the CF of new T1DM children? (6 things)

A
  1. DKA (25-50% of pt)
  2. Polyuria
  3. Polydypsia
  4. Weight loss (bc dehydration)
  5. Secondary enuresis (bed wetting)
  6. Recurrent inf
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3
Q

What investigations should you do once a diagnosis of T1DM is established? (6 things)

A
  1. Baseline bloods: FBC, U&E, lab glucose
  2. Blood cultures
  3. HbA1c
  4. TFT + Thyroid Peroxidase Antibodies (TPO)
  5. anti-TTG
  6. Insulin antibodies, anti-GAD antibodies, Islet cell antibodies
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4
Q

What newly diagnosed T1DM patients should you do Blood cultures for?

A

If you suspect infection (e.g they have fever)

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5
Q

What is the use of a HbA1c for a newly diagnosed T1DM child?

A

To know how long they have been diabetic prior to presenting

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6
Q

What is the use of TFT and TPO newly diagnosed T1DM children?

A

To test for associated AI thyroid disease

(cah one AI condition means der might be more)

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7
Q

What is the use of anti-TTG antibodies in newly diagnosed T1DM children?

A

To test for associated Coeliac disease

(cah one AI condition means der might be more)

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8
Q

What is the use of Insulin antibodies, anti-GAD antibodies and Islet cell antibodies in newly diagnosed T1DM children?

A

To know which antibodies clarted the pancreas to cause DM to develop

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9
Q

What condition can happen if Insulin is injected into the same spot repeatedly?

A

Lipodystrophy

Subcut fat hardens –> X absorb anymore insulin

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10
Q

What is a new alternative to the normal basal bolus regime of insulin?

A

Insulin pump

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11
Q

What is an insulin pump?

A

Small device that continuously infuses insulin @ different rates to control BG

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12
Q

How do you prevent lipodystrophy from occurring with an insulin pump? (2 things)

A
  1. Replace cannula every 2-3 days
  2. Rotate insertion sites
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13
Q

Which children qualify for an insulin pump funded by NHS? (2 things)

A
  1. Over 12 years old
  2. Has difficulty controlling HbA1c

(both together)

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14
Q

What are the advantages of an insulin pump? (3 things)

A
  1. Better BG control
  2. More flexibility with eating
  3. Less injections
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15
Q

What are the disadvantages of an insulin pump? (3 things)

A
  1. Having it attached all the time
  2. Blockages
  3. Small risk of infection
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16
Q

What are the SHORT term complications of T1DM? (2 things)

A
  1. Hypoglycaemia
  2. Hyperglycaemia (and DKA)
17
Q

What causes Hypoglycaemia in T1DM? (2 things)

A
  1. Too much insulin
  2. Not enough carbs / not processing carbs properly
18
Q

What are examples of situations that can cause Hypos in T1DM? (9 things)

A
  1. Malabsorption
  2. Diarrhoea
  3. Vomiting
  4. Sepsis
  5. Hypothyroidism
  6. Glycogen storage disorders
  7. GH deficiency
  8. Cirrhosis
  9. Alcohol / FA oxidation defects
19
Q

What are the typical CF of Hypoglycaemia in T1DM? (6 things)

A
  1. Hunger
  2. Tremor
  3. Sweating
  4. Irritability
  5. Dizziness
  6. Pallor
20
Q

What are the CF of SEVERE Hypoglycaemia in T1DM? (3 things)

A
  1. Reduced consciousness
  2. Coma
  3. Death
21
Q

How should you treat Hypoglycaemia? (2 things)

A

Combination of:

  1. RAPID acting glucose (aka lucozade)
  2. SLOW acting carbs (aka biscuits / toast) to maintain BG level after RAG used up
22
Q

How can you treat SEVERE hypoglycaemia when oral glucose is not safe?

A
  1. IV dextrose
  2. IM glucagon
23
Q

When do diabetic children commonly get hypoglycaemia?

A

At night = Nocturnal hypoglycaemia

24
Q

What are the CF of Nocturnal hypoglycaemia? (2 things)

A
  1. Sweaty overnight
  2. Raised morning BG
25
Q

How do you diagnose Nocturnal hypoglycaemia?

A

Continuous glucose monitoring (CGM)

26
Q

How do you treat Nocturnal hypoglycaemia? (2 things)

A
  1. Alter bolus regimes
  2. Bedtime snacks
27
Q

What are the groups of LONG term complications of T1DM? (3 things)

A
  1. Macrovascular complications
  2. Microvascular complications
  3. Infection related complications
28
Q

What are the Macrovascular complications of T1DM? (4 things)

A
  1. CAD (major death cause in diabetics)
  2. Peripheral ischaemia –> Poor healing / Ulcers / Diabetic foot
  3. Stroke
  4. HTN
29
Q

What are the Microvascular complications of T1DM? (4 things)

A
  1. Neuropathy
  2. Retinopathy
  3. Nephropathy (esp glomerulosclerosis)
30
Q

What are the infection related complications of T1DM? (4 things)

A
  1. UTI
  2. Pneumonia
  3. Skin / soft tissue infections (esp feet)
  4. Fungal infections (esp oral / vaginal candidiasis)
31
Q

How do you monitor a child with T1DM? (3 things)

A
  1. HbA1c
  2. Capillary BG
  3. Continuous Glucose Monitoring (CGM)

#Phase 2.2: Paediatrics (18 decks)

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