Diabetes Flashcards
Not much in dis one cah is mostly da same as adult diabetes
What is T1DM?
When pancreas unable to produce insulin
What are the CF of new T1DM children? (6 things)
- DKA (25-50% of pt)
- Polyuria
- Polydypsia
- Weight loss (bc dehydration)
- Secondary enuresis (bed wetting)
- Recurrent inf
What investigations should you do once a diagnosis of T1DM is established? (6 things)
- Baseline bloods: FBC, U&E, lab glucose
- Blood cultures
- HbA1c
- TFT + Thyroid Peroxidase Antibodies (TPO)
- anti-TTG
- Insulin antibodies, anti-GAD antibodies, Islet cell antibodies
What newly diagnosed T1DM patients should you do Blood cultures for?
If you suspect infection (e.g they have fever)
What is the use of a HbA1c for a newly diagnosed T1DM child?
To know how long they have been diabetic prior to presenting
What is the use of TFT and TPO newly diagnosed T1DM children?
To test for associated AI thyroid disease
(cah one AI condition means der might be more)
What is the use of anti-TTG antibodies in newly diagnosed T1DM children?
To test for associated Coeliac disease
(cah one AI condition means der might be more)
What is the use of Insulin antibodies, anti-GAD antibodies and Islet cell antibodies in newly diagnosed T1DM children?
To know which antibodies clarted the pancreas to cause DM to develop
What condition can happen if Insulin is injected into the same spot repeatedly?
Lipodystrophy
Subcut fat hardens –> X absorb anymore insulin
What is a new alternative to the normal basal bolus regime of insulin?
Insulin pump
What is an insulin pump?
Small device that continuously infuses insulin @ different rates to control BG
How do you prevent lipodystrophy from occurring with an insulin pump? (2 things)
- Replace cannula every 2-3 days
- Rotate insertion sites
Which children qualify for an insulin pump funded by NHS? (2 things)
- Over 12 years old
- Has difficulty controlling HbA1c
(both together)
What are the advantages of an insulin pump? (3 things)
- Better BG control
- More flexibility with eating
- Less injections
What are the disadvantages of an insulin pump? (3 things)
- Having it attached all the time
- Blockages
- Small risk of infection
What are the SHORT term complications of T1DM? (2 things)
- Hypoglycaemia
- Hyperglycaemia (and DKA)
What causes Hypoglycaemia in T1DM? (2 things)
- Too much insulin
- Not enough carbs / not processing carbs properly
What are examples of situations that can cause Hypos in T1DM? (9 things)
- Malabsorption
- Diarrhoea
- Vomiting
- Sepsis
- Hypothyroidism
- Glycogen storage disorders
- GH deficiency
- Cirrhosis
- Alcohol / FA oxidation defects
What are the typical CF of Hypoglycaemia in T1DM? (6 things)
- Hunger
- Tremor
- Sweating
- Irritability
- Dizziness
- Pallor
What are the CF of SEVERE Hypoglycaemia in T1DM? (3 things)
- Reduced consciousness
- Coma
- Death
How should you treat Hypoglycaemia? (2 things)
Combination of:
- RAPID acting glucose (aka lucozade)
- SLOW acting carbs (aka biscuits / toast) to maintain BG level after RAG used up
How can you treat SEVERE hypoglycaemia when oral glucose is not safe?
- IV dextrose
- IM glucagon
When do diabetic children commonly get hypoglycaemia?
At night = Nocturnal hypoglycaemia
What are the CF of Nocturnal hypoglycaemia? (2 things)
- Sweaty overnight
- Raised morning BG
