Diabetes Flashcards
Diagnosis of diabetes mellitus
- Symptomatic with random plasma glucose >11 mmol
- Fasting plasma glucose >7 mmol and
2hr post OGTT plasma glucose >11 mmol.
If fit these criteria but no evidence of insulin deficiency need to check antibodies to rule out type 2.
Presentation of diabetes mellitus in children
Polyuria Polydipsia Failure to thrive Thrush DKA PCOS (type 2)
Management of suspected type 1 diabetes in children e.g ketonuria
Urgent admission to paediatric team
Progression of type 1 diabetes
Genetic predisposition
Precipitating event
Progressive loss of insulin due to beta islet cell destruction
Symptomatic when lost >80% beta islet cells
Criteria for DKA
pH <7.3
Ketones >3
Glucose >11
What is MODY and LADA
Maturity onset diabetes of the young (genetic type 2)
Late autoimmune diabetes of adults (type 1)
Symptoms of DKA
Tachypnoea Tachycardia Abdo pain Polyuria Polydipsia Vomiting Drowsy/impaired consciousness
Treatment of DKA
IV fluids
IV insulin infusion - sliding scale
Warning signs for cerebral oedema in DKA treatment
Headache Changing neurological status Cranial nerve palsy HR drop BP increase Abnormal resp pattern Low O2 sats
Differences between type 1 and 2
Type 1: sudden onset, ketones, insulin deficiency, absent C peptide, autoimmunity markers present
Type 2: gradual onset, obese, insulin resistance, C peptide present, no autoimmunity markers present
Glucose monitors
Insulin pumps
Glucose sensors
Non continuous
Relation between HbA1c and microvascular complications
Exponential increase in risk with increasing HbA1c
VERY IMPORTANT TO KEEP LOW
Management of diabetes in children
MDT care Insulin regime Encourage to keep blood glucose diary Follow up clinics to monitor HbA1c Counselling Education Offer patient choice to improve compliance
