Diabetes Flashcards
What are the complications of Chronic Hyperglycemia to the Retinopathy (eyes)?
- Macular edema
- capillary nonperfusion
- angiogenesis
- Hemorrhage
- Glaucoma
What are the complications of Chronic Hyperglycemia to the Nephropathy (kidneys)?
- Damaged glomeruli
- Hyperfiltration
- Renal damage
What are the complications of Chronic Hyperglycemia to the Peripheral Neuropathy?
- Nerve damage
- Ulceration
- Necrosis
What are the complications of Chronic Hyperglycemia to the Autonomic Neuropathy?
- Nerve damage
- Gastrointestinal dysfunction
- genitourinary dysfunction
What are the complications of Chronic Hyperglycemia to the Heart?
Heart disease
- Atherosclerosis
- Endothelial dysfunction
- Hypertension
- Dyslipidemia
- Antifibrinolitic state
- Procoagulant state
- Vascular inflammation
What are the complications of Chronic Hyperglycemia to the Brain?
stroke
What is diabetes?
Diabetes involves inability to produce or use insulin. when there is a lack of insulin, the glucose cannot be taken out of the blood by the body cells therefore blood glucose levels rise.
What are the types of diabetes?
Type 1
Type 2
EXTRA: Gestational diabetes (pregnancy)
What are the underlying causes of type 1 diabetes?
- Genetics
- environmental trigger, possibly a virus or toxin
- The immune system mistakenly identifying the beta cells in the pancreas for a virus or something foreign causing autoimmune destruction of the pancreatic beta cells.
What triggers type 1 diabetes?
The vast majority of type 1 cases are caused by the autoimmune destruction of the pancreatic beta cells, which results in the inability to produce insulin.
The immune system mistakenly identifies these cells as foreign and attacks and destroys them
The precise cause of this error in immune function is unknown, but experts think that some are born with a genetic susceptibility to it.
Then, at some point in their life, an environmental trigger such as a virus or a toxin activates this genetic susceptibility to bring on the immune response that produces type 1 diabetes.
What is Hyperglycaemia?
High blood glucose levels
What are the symptoms of Hyperglycaemia?
polydipsia - Increased thirst polyuria - Increased urination Blurry vision Fatigue/tiredness Slow healing of cuts or wounds More frequent infections Weight loss Nausea and vomiting
What are the causing of Hyperglycaemia?
Many factors can contribute to hyperglycaemia, including:
- Insufficient insulin or oral diabetes medication
- Not injecting insulin properly or using expired insulin
- Diet
- Being inactive
- Illness or infection
- Certain medications, eg steroids, beta blockers
- Injury or surgery
- Experiencing emotional stress, such as family conflict or workplace challenges
What is Hypoglycaemia?
Low blood glucose levels
What are the warning signs of Hypoglycaemia?
Perspiration, Pale, Shaking hands and/or legs, Headache, Blurred vision, Palpitations, Dizziness, Drowsiness, Nervousness, Irritability, Hunger, Pins and needles in mouth/tongue, Confusion, loss of concentration
What are some consequences of Hypoglycaemia?
Sympathetic arousal, collapse, confusion, seizure, coma, death.
Does hypoglycaemia need immediate treatment?
yes
How can you prevent hypoglycaemia?
Frequent BSL monitoring
Monitor and encourage food intake
Anticipate changes in insulin requirements eg. fasting, changes in activity level
Give dextrose with insulin infusions* (Hospital)
Educate about symptoms of hypoglycaemia and encourage them to report these promptly.
Ask patients on insulin about their experience of hypoglycaemia and awareness threshold.
How do you manage hypoglycaemia?
Patient conscious, and able to swallow safely
- Give 15-20g quick acting carbohydrate
- Test BSL after 10min
- If still <3.5mmol/L, repeat up to 3 times
- If still low, call for help, consider IV glucose or IM glucagon.
- Once BSL>3.5 give a snack or next meal if available
eg:
3-4 glucose tablets
5 jelly beans
1/2cup of ordinary soft drink
What are the different types of insulin?
The types of insulin include:
Short acting e.g., Neutral (Actrapid, Humulin R)
Intermediate acting e.g., Isophane (Humulin NPH, Protaphane)
Long acting e.g., Glargine (Lantus)
Fast acting e.g., Aspart (NovoRapid), Lispro (Humalog)
Pre-mixed
What is common with type 2 diabetes?
Usually aged over 40
Family history
Gradual onset
Maybe no symptoms
Inefficient insulin
Overweight (95-99.9%%)
Lean (up to 5%)
Other conditions present
Metabolic syndrome is defined as…?
3 or more of the following:
Abdominal or visceral obesity(>102cm M, >88cm F)
High triglycerides(ugly cholesterol)
Low HDL(good) cholesterol
High BP >130/80 (EPA SMI without DM 140/90)
High fasting blood glucose
Presence of MS another way to identify ↑ CVD risk and ↑ DM risk
Prevalence greater for people with SMI 2-3 fold or 50%
How can you manage type 2 diabetes?
Healthy diet
Exercise
Weight loss
Oral hypoglycaemics
BP and lipid monitoring
What are the two most common medications for treating diabetes?
METFORMIN and GLIPIZIDE
What medications can treat diabetes and what is their category?
Answer in this format
Category:
Medication
Biguanides:
Metformin
Sulphonylureas:
Glipizide, glibenclamide, gliclazide
Alpha-glucosidase inhibitors:
Acarbose
Thiazolidnediones:
Pioglitazone
What do Biguanides do?
Reduce glucose production in liver
What do Sulphonylureas do?
Stimulate pancreas to release more insulin
What do Alpha-glucosidase inhibitors do?
Slow digestion and absorption of carbohydrates
What do Thiazolidnediones do?
Increase body tissue sensitivity to insulin
What is insulin resistance?
A term used to describe the detrimental effect fat has on blocking available insulin’s ability to work properly.
fat blocks insulin’s ability to work effectively and efficiently
High levels of insulin (that can not be utilised effectively) called insulinaemia
Multi faceted, complicated mechanism/s and is a feature of the ‘metabolic syndrome’
