Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

High - Endocrine system > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is type 1 diabetes?

A
  • Cause: autoimmune destruction of pancreatic beta islet cells
  • Treatment: insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is type 2 diabetes?

A
  • Cause: unhealthy lifestyle (poor diet, high BO + cholesterol)
  • Treatment: anti-diabetics + insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the symptoms of diabetes?

A
  • Hyperglycaemia
  • Polyuria
  • Polydipsia
  • Poor wound healing
  • Fatigue
  • Weight loss
  • Blurry vision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the microvascular diabetic complications?

A

Diabetic retinopathy
- Treat HPT

Diabetic nephropathy
- Treat HPT
- Low dose ACEi/ARB

Peripheral neuropathy
- Neuropathic pain: analgesic, TCA + anti-epileptic
- Erectile dysfunction: sildenafil

Diabetic foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the macrovascular complications?

A
  • Stroke
  • Heart attack
  • Atherosclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When would you offer low dose statin (primary)?

A
  • 40+
  • Type 1 >10 years
  • Type 2 >20 years
  • Target organ damage
  • Significant elevated risk factor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the risk factors of diabetic ketoacidosis?

A
  • Stress
  • Severe dehydration
  • Not eating
  • Surgery
  • Intercurrent illness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the symptoms of diabetic ketoacidosis?

A
  • Inc ketones
  • Blood glucose >11mmol/L
  • Extreme thirst
  • Polyuria
  • Fruity breath
  • Rapid weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the management of diabetic ketoacidosis?

A

Fluids?
Shock:
- Yes: restore circulating volume
- No: rehydrate + maintain

Potassium
- Don’t give anuric

Soluble insulin
- Continue LA insulin
- Add glucose when <14mmol/L
- Continue:
- Blood ketones <3mmol/L
- Blood pH >7.3: eat and drink
- Stop: 1H post SC fast acting insulin + meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the treatment for type 2 diabetes?

A
  • First line: Metformin (GI disturbance: MR)
  • CV status: HF, CVD, QRISK >10%: Metformin AND SGLT
  • Additional therapy: SU, PIO, DPP
  • Switch a drug for GLP-1 agonist or Tirzepatide (dual glucose dependent insulin tropic polypeptide + GLP-1 agonist)

Triple therapy: insulin therapy
- Continue Metformin
- Review/stop other drugs

If CVD develops during treatment: add/replace a drug w SGLT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Type 2 diabetes + CKD: treatment

A

ACEi/ARB + SGLT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sick day rules: antidiabetic drugs

A

Temporarily stop -> AKI
- Metformin: INC risk of lactic acidosis
- SGLT inhibitor: volume depletion = dehydration is a significant risk factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Surgery (major procedure) + antidiabetic drugs

A
  • Sliding scale insulin
  • Stop antidiabetic (except GLP-1 agonist)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Surgery (minor procedure) + antidiabetic drugs

A

Omit antidiabetic dose
- SGLTi: diabetic ketoacidosis
- Sulphonylureas: hypoglycaemia in fasted state
- Metformin: renal impairment = lactic acidosis

Pioglitazone, DPPi, GLP-1 agonist: continue as normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pregnancy + diabetes: pregnancy planning

A
  • HbA1c level: <48mmol/mol (6.5%)
  • 5mg folic acid daily before conception until week 12
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pregnancy + diabetes: STOP

A
  • Oral antidiabetic drugs except metformin
  • ACEi/ARB, statin - STOP
17
Q

Pregnancy + diabetes: treatment

A

First line: NPH, continue LA analogues (glargine, determir)

SC infusion: multiple injections AND don’t achieve blood glucose control without causing significant disabling hypo

18
Q

What is the treatment for gestational diabetes?

A

stop after birth

<7mmol/L
- First line: diet + exercise
- Metformin
- Alt: insulin (AND metformin if not effective alone)

> 7mmol/L (6-6.9 w hydamnios, macrosomia)
- First line: insulin +/- metformin

19
Q

What medication is given when breastfeeding?

A
  • Insulin
  • Metformin
20
Q

What are the signs and symptoms of hypoglycaemia?

A
  • Slurred speech
  • Blood glucose <4mmol/L
  • Sweat + chills
  • Blurred vision
  • Tingling lips
  • Palpitations
  • Pale, clammy skin
  • Drowsy + confused
21
Q

Which medication masks symptoms of hypoglycaemia?

A

Beta blockers

22
Q

What is the treatment for hypoglycemia?

A

> 4mmol/L small carbohydrate snack or next meal

<4mmol/L
15-20g fast acting sugar
- Repeat after 15min, max 3 times
- 150-200ml pure fruit juice (avoid orange juice in low potassium diet in CKD)

Long acting carb
- Two biscuits, one sliced bread

Do not omit insulin if due

23
Q

How is diabetes diagnosed?

A

HBA1c blood test - Glycaemic control in last 2-3M
- Diabetes: >6.4% (48mmol/mol)
- Prediabetes: 5.7-6.4%
- Normal: <5.7%

For: type 2 diabetes

24
Q

When would you not use HBA1c for a diagnostic tool?

A
  • Type 1 diabetes
  • Pregnancy, <2M postpartum
  • Diabetes symptoms <2M
  • Acutely ill
  • Medication causes hyperglycaemia
  • HIV infection, end stage CKD
  • Acute pancreatitis damage
25
Q

When would you use oral glucose tolerance test to diagnose diabetes?

A
  • Pre-diabetes
  • Gestational diabetes
  • Not suitable if severe hyperglycaemia symptoms
26
Q

How often do you monitor blood glucose levels?

A

Type 1 diabetes: 4x day
- Before meals + before bed

Not routinely for type 2:
- Insulin or oral hypoglycaemic
- Intercurrent illness
- Medication changes
- Driving

27
Q

What are the correct levels when testing for blood glucose?

A
  • Waking (fasting) – 5-7
  • Pre-prandial – 4-7
  • Post-prandial (90min) – 5-9
  • Driving – at least 5
28
Q

What are the correct levels when monitoring HBA1c in diabetic patients?

A

Type 1 diabetes: 6.5% (48mmol/mol)

Type 2 diabetes:
- Diet controlled, monotherapy: 6.5% (48mmol/mol)
- Hypoglycaemic monotherapy + combination therapy: 7.0% (53mmol/mol)
- Intensify monotherapy if HbA1c: >7.5% (58mmol/mol)

29
Q

What are the targets in diabetic patients with hypertension?

A
  • Type 1: 140/90
  • Type 2 under 80: <140/90
  • Type 2 over 80: <150/90
30
Q

What are the targets in diabetic patients with high cholesterol?

A
  • Normal patients <5mmol/L
  • High risk patient <4mmol/L
31
Q

Diabetes + driving

A

Notify DVLA:
- Insulin

Hypoglycaemia
- 2+ severe episodes <12M
- Impaired awareness
- Disabling hypo while driving

Group 2 vehicle

Diabetic complication – retinopathy

32
Q

How often do you monitor blood glucose levels when driving?

A

Monitor 2H before + every 2H for long journey: insulin + group 2 vehicle
- <5mmol/L: eat carb snack
- <4mmol/L: do not drive

Hypoglycaemia: stop vehicle in safe place + switch engine off, treatment, wait 45 minutes

High - Endocrine system (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions