Diabetes

Question 1

What is diabetes

Answer 1

-group metabolic disorders causing hyperglycaemia due to decrease in insulin or decrease in effectiveness of insulin

Question 2

Types diabetes

Answer 2

Type 1 or Type 2
Gestational/ secondary

Question 3

Pancreas

Answer 3

-leaf shaped organ
-endocrine and exocrine gland
-contains islets of langerhan that produce insulin and glucagon

Question 4

Glucagon-
Insulin-

Answer 4

-increases BG
-decreases BG

Question 5

BG control

Answer 5

-BG rises
-pancreas produces insulin
-insulin secreted
-insulin facilitates uptake glucose to cells
-BG decreases
-feedback mechanism stops pancreas secreting more insulin

Question 6

Type 1 diabetes
pathophysiology, symptoms

Answer 6

-dysfunction of insulin
-endocrine area of pancreas destroyed, not enough insulin produced
-autoimmune disease- genetic pre disposition
-younger onset
-body acts as if no glucose in blood stream so releases stored glucose to blood
Symptoms
-tiredness
-excess urination
-excess thirst

Question 7

Type 1 treatment

Answer 7

-advise routine monitoring, 4 times daily
-need insulin
-aim for fasting plasma glucose level of 5-7 mmol/litre on waking
-plasma glucose level of 4-7 mmol/litre before meals
-consider ketone monitoring

Question 8

Type 2
what is it, risk, causes

Answer 8

-most common
-‘insulin resistance’, cells desensitised
-longer development, later onset
Risk factors
-obesity
-gestational diabetes
-age
-ethnicity
-inactive lifestyle
-family Hx
Causes
-genetics
-hypertension
-age
-obesity
Treatment
-lifestyle changes
-then medication eg. metoformin to increase insulin release

Question 9

Gestational diabetes

Answer 9

-develops during pregnancy
-diagnosed 24-28wks
-normally resolves after birth
-if diagnosed in 1st trimester likely be pre existing diabetes
-pregnancy hormones affect way body uses insulin
-insulin resistance increases in 2nd trimester
-need to produce ore insulin to control BG, some can’t produce sufficient

Question 10

Hypoglycaemia

Answer 10

-low BG- under 4.0
-common in patients prescribed insulin
-caused- alcohol, insulin error, overdose
-may be abnormal neural signs
-could be cause of RTC

Question 11

Diabetic neuropathy

Answer 11

1. nerve damage occurs
   -nerves become inflamed due to hyperglycaemia
   -patients may be pre-disposed to genetic factors
   -smoking and alcohol abuse damages nerves and blood vessels
2. symptoms present
   -commonly affects legs and feet through altered sensation
   -cramps, sensitivity, numbness
   -can cause serious complications
3. if not controlled cause more damage
   -can damage urinary tract, GI, blood vessels
   -can cause hypoglycaemia unawareness if damage to ANS
   -can cause sudden pain or damage to face torso or leg