Diabetes Flashcards
What are the two types of blood glucose test
capillary blood test
venous plasma blood glucose
What is the limit of plasma glucose in a random test
11.1 mmol/l
below 200mg / dl
What is fasting limit glucose at normal level
below
5.5 mmo/l
100 mg/dl
What is fasting limit glucose at prediabetic level
below 6.9
100 - 125mg / dl
What is fasting limit glucose at diabetic level
7 mmol / l >
126>
What is the normal level of a 2 hour post prandial test
<7.8
below 140
What is prediabetic level of a 2 hour post prandial
7.8 - 11 mmo/l
140 - 199 mg/dl
What is the diabetic level of a 2 hour post prandial
11.1 mmol/l or more
200mg / dl
main cause of diabetes type 1
Polygenic autoimmune disorder which leads to destruction of the β cells in the Islets of Langerhans of the pancreas, resulting in insulin deficiency
Main cause of type 2 diabetes
A polygenic disorder which leads to a decrease in the mass of β cells in the islets of langerhans, leading to a reduced secretion of insulin and insulin resistance
what are the main test we can use to diagnose diabetes
Urine dipstick
Rand venous plasma glucose test
Fasting venous plasma glucose test
oral glucose tolerance test
glycogen haemoglobulin levels
what is the gold standard test
oral glucose tolerance test
how is an oral glucose tolerance test carried out
fasting blood sugar
drink sweet drink
take blood samples every 30 minutes or 1 blood after 2 hours
Short term complications of diabetes
Hypoglycaemia
Ketoacidosis
Hyperosmolar hyperglycaemic state
long term complications of diabetes
cardiovascular disease
diabetic retinopathy
diabetic nephropathy
diabetic neuropathy
what is the blood glucose level that indicates hypoglycaemia
<4mmol
9 symptoms of hypoglycaemia
Physical
Shaky
Sweaty
Fast Heart beat
Impaired vision
Feeling
Headache
Hungry
Fatigued
Irritable
Anxious
Name 6 causes of hypoglycaemia
too much insulin prescribed
insulin absorbed more rapidly than normal
lipohypertrophy at injection site
reduced clearance of insulin owing to renal failure
decreased insulin requirement due to missed or delayed meals
failure to recognize symptoms
Treatment of hypoglycaemia (Conscious then unconscious)
Glucose suplements if conscious
- drink
- tablet
- gel
if unconscious
- im or sc glucagon to break down the glycogen stored in the liver
Define nocturnal hypoglycaemia
hypogylcaemia caused by
- skipping meals
- accidental overdose
- alcohol or exercising in the evening
what is diabetic ketoacidosis
severe emergency where dont have enough insulin to allow blood sugar into your cells for use as energy. Instead, your liver breaks down fat for fuel
What are the Ketoacidosis causes
loose appetite and stop taking insulin as to prevent hypoglycaemia
infections need insulin so body can fight the infection
non compliance
What are the symptoms of ketoacidosis
Polyurea
Polydipsia
Polyphagia
Fatigue
Blurred vision
Ketone breath
Labourered breathing
What is the treatment of diabetic ketoacidosis
iv rehydration
insulin infusion
careful correction of electrolyte balance
what is diabetic neuropathy
nerve damage caused by daibetes and poor glycaemic control
what are 3 types of neuropathy
sensory
autonomic
motor
(think the different neurones)
what is sensory neuropathy
lack of feeling or numbness in extremities
what is autonomic neuropathy
can be things such as
ED
Incontinence
Irregular heart rate
Abnormal sweating
Gastroparesis
what is motor neuropathy
muscle weakness
twitching
cramp
Treatment for diabetic neuropathy
Tricyclic antidepressents
Duloxetine
VGCC ligands
if not tollerated try switching
How can we minimise risk of diabetic complications in eye
annual eye screening to montor retina
keep blood glucose within normal range
maintain normal blood pressure
seek advise if blurred vision
Treatment for retinopathy
laser surgery to improve circulation
anti vascular endothelial growth factor intro ocular injection to prevent inappropriate growth of blood vessels
intra ocular corticosteroid implant to inhibit inflammation and VEGF
