Diabetes

Question 1

Define diabetes

Answer 1

A syndrome of DISORDERED GLUCOSE METABOLISM and inappropriate hyperglycaemia that results in absolute deficiency in insulin secretion, the reduction in the biological effectiveness of insulin or both

Question 2

Discuss TYPE 1 and TYPE 2 diabetes

Answer 2

Type 1
■ Results from the autoimmune destruction of the B cells of the pancreas
■ Severe insulin deficiency thus exogenous insulin is required

Type 2
■ Characterized by insulin resistance that prevents the BETA cells from producing sufficient insulin for glucose control
■ Associated with obesity, old age, genetics, physical inactivity

Question 3

List 5 signs of hyperglycemia and the ways in which it can be managed?

Answer 3

Signs and symptoms
■Hot, dry skin
■Tachycardia
■Low blood pressure
■Smell of acetone, fruity and sweet
■Blood glucose level>11 mmol/L

Management
■Fluid-Ringer’s lactate (avoid normal saline)
■Insulin (10 U IV)
■Transfer patient to hospital

Question 4

List 5 clinical signs of hypoglycemia and ways in which it can be managed.

Answer 4

Polyuria
Polydipsia
cold, wet skin
Irritability
Piloerection

Management
■Oral glucose
■IV bolus of 50ml of 50% glucose until reading is at 5-10 mmol/L
■ Followed by continuous IV infusion of dextrose until the next meal