Diabetes

Question 1

What is type 1 diabetes

Answer 1

o insulin deficient caused by the loss/destruction of beta cells of the pancreas.
o Destruction of insulin secreting islet cells is related to genetic susceptibility, environmental factors and autoimmunity (autoimmune T-cell mediated disease).

Question 2

symptoms oftype 1 diabetes

Answer 2

o Polyuria: increased urine production
o Polyphagia: increased hunger
o Polydipsia: increased thirst
o Fatigue

Question 3

Type 1 diagnosis

Answer 3

o CT scan of pancreas
o vision test to look for cataracts
o renal functions.

Question 4

Normal blood glucose levels

Answer 4

• normal = 4-7mmol
• fasting = 4.0–5.4 mmol/L
  o HbA1 = under 40mmol/L

Question 5

Type 1 diabtes treatment

Answer 5

o maintain BGL
o regular testing
o insulin therapy
o diet/exercise
o fluids/electrolytes.

Question 6

What is type 2 diabetes

Answer 6

o results from body not creating enough insulin to keep BGL within normal range (Insulin resistant)

o Pancreas produces insulin, target cells no longer respond normally.

Question 7

Risks of developing type 2 diabetes

Answer 7

o obesity
o pancreatitis
o cancer
o increasing age
o infection

Question 8

treatment for type 2 diabetes

Answer 8

o dietary changes
o weight loss
o exercise
o oral medications for control (Gliclazide – stimulate secretion of insulin by pancreas. Metformin – reduces high cholesterol, decreases liver glucogenesis).

Question 9

What is hypoglycemia

Answer 9

Low blood sugar due to excessive insulin taken, too much exercise for insulin dose or inadequate food/insulin dose.

Question 10

symptoms of type 2 diabetes

Answer 10

o tachycardia
o palpations
o Tremor
o Headache
o fatigue

Question 11

What is diabetic ketaoacidosis

Answer 11

o Insulin in body is low.
o Prevents glucose from getting to cells to be used as fuel.
o When ketones are produced too quickly and build up in the blood and urine, they can be toxic, making the blood too acidic (metabolic acidosis).

Question 12

symptoms of diabetic ketoacidosis

Answer 12

o Excessive thirst
o Urination
o appetite
o high BGL
o high ketones in urine
o nausea
o confusion

Question 13

treatment for type 2 diabetes

Answer 13

Fluid resuscitation, insulin therapy (until BGL is safe), electrolyte replacement.

Question 14

Example of Ultra-short acting insuline name and onset/peak time

Answer 14

o Onset of 15 minutes, peak 1 hour, duration 3 hours.
o (Humalog/novorapid)

Question 15

Example of short acting insulin name and onset/peak time

Answer 15

o Onset 30 minutes, peak 2 hours, duration 8 hours
o (Actrapid, Humulin)

Question 16

Example of intermediate acting insulin name and onset/peak time

Answer 16

o Onset 2 hours, peak 8 hours, duration 16 hours.
o (Humulin NPH, Protophane)

Question 17

Example of long acting insulin name and onset/peak time

Answer 17

o Onset 2 hours, peak none, duration 24 hours.
o (Lantus)

Question 18

Microvascular complications with diabetes

Answer 18

o Diabetic retinopathy – results from retinal ischemia due to capillary damage.
o Renal damage – glomeruli damaged, increased permeability, decreased flow/filtration rate.

Question 19

Macrovascular complications

Answer 19

o Hyperglycemia causes neuron damage due to increased glucose entering neurons = nerve degeneration = neuropathy.
o Peripheral neuropathy – damage to peripheral sensory nerves (hands, feet).
o Autonomic – damage to nerves involved in autonomic regulation (sweat).