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YEAR 3 REVISION > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is Diabetes?

A

High blood sugar levels

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2
Q

What is insulin?

A

Hormone made in the beta cells of the pancreas that allows glucose to enter cells

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3
Q

How are glucose levels regulated in someone without Diabetes?

A

The pancreas detects when glucose enters the blood and releases the correct amount of insulin to allow glucose to enter cells

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4
Q

What is Type I Diabetes?

A

Pancreas doesn’t make insulin or the beta cells of the pancreas are destroyed

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5
Q

What is Type II Diabetes?

A

Insulin is not effective or the pancreas doesn’t produce enough insulin to counteract the levels of glucose

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6
Q

What is Gestational Diabetes?

A

Placenta-induced insulin resistance with onset or first recognition during pregnancy

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7
Q

What are the common symptoms of Diabetes?

A
  • Increased urine output
  • Thirst
  • Lethargy
  • Weight loss/gain
  • Affects heart, eyes and kidneys
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8
Q

How does Diabetes affect the heart?

A

High BP and insulin resistance increase the risk of coronary heart disease

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9
Q

How does Diabetes affect the eyes?

A

Increased risk of retinopathy, cataracts and glaucoma

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10
Q

How does Diabetes affect the kidneys?

A

Increased risk of nephropathy

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11
Q

What are the neonatal risks associated with Diabetes in pregnancy?

A
  • Stillbirth
  • Neonatal death
  • Congenital abnormality
  • Prematurity
  • Macrosomia
  • Jaundice
  • Hypoglycaemia
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12
Q

What are the maternal risks associated with Diabetes in pregnancy?

A
  • Ketoacidosis
  • PET
  • Miscarriage
  • Polyhydramnios
  • Shoulder dystocia
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13
Q

Why is there an increased risk of macrosomia?

A

Lack of insulin results in excess glucose which is passed to the baby

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14
Q

What is a normal glucose level?

A

Before breakfast = <5.2

1 hour after each meal = <7.8

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15
Q

What is the glycaemic index?

A

How fast or slow food is digested

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16
Q

How can the glycaemic index be reduced?

A
  • Reduce sugar intake (e.g. artificial sweetener in tea, no chocolate or sweets)
  • Avoid saturated fats (e.g. cream, butter)
17
Q

Give a good breakfast meal for a Diabetic mother

A
  • Bran flakes
  • Muesli
  • Weetabix
  • Eggs, bacon, beans
18
Q

Give a good lunch meal for a Diabetic mother

A
  • Wholegrain bread
  • Olive-based spread
  • Fish/chicken salad
  • Fruit and yoghurt
19
Q

Give a good evening meal for a Diabetic mother

A
  • Spaghetti bolegnese

- Roast dinner

20
Q

Give a good snack for a Diabetic mother

A
  • Carrots and houmous
  • Fruit
  • Nuts
21
Q

What are the risk factors for GDM?

A
  • BMI >30
  • Previous baby >4.5kg
  • Previous GDM
  • FH of Diabetes
  • PCOS
22
Q

When does a Glucose Tolerance Test take place?

A

At booking and with 27/40 bloods (or if arises in pregnancy, just at 27/40 bloods)

23
Q

How does the GTT work?

A
  1. Fast for 12 hours
  2. Blood test on arrival
  3. Drink glucose solution
  4. Wait 2 hours
  5. Repeat blood test
24
Q

What values indicate GDM?

A

Fasting = >5.6

After glucose = >7.8

25
Q

What additional testing can be done?

A
  • HbA1c is glucose bound to Hb that has become glycosylated
  • Testing these levels show the average glucose level over the past 2-3 months
  • Results should be <48
26
Q

How is Diabetes in pregnancy managed?

A
  • Diabetic clinic
  • Blood sugar monitoring
  • USS every 4 weeks from 28/40
  • Dietary advice
  • Medication if required
  • Increased folic acid dose (5mg)
27
Q

How often should blood sugar be monitored?

A
  • Before breakfast

- 1 hour after every meal

28
Q

What medication may be used if diet control is not efficient?

A
  • Metformin

- Insulin

29
Q

What is the postnatal management for GDM?

A
  • Stop medication
  • 2-3 post-meal blood glucose readings
  • Advice re. diet and exercise
  • GTT with GP at 6 weeks
30
Q

What is the postnatal management for Type I Diabetes?

A
  • Return to pre-pregnancy dose
  • Decrease dose by 20% if BF
  • Need SC Insulin and something to eat before sliding scale taken down
31
Q

What is the postnatal management for Type II Diabetes?

A

Return to pre-pregnancy dose

32
Q

How should a hypo be treated if the patient is conscious?

A
  • If blood glucose <4, give 5x dextrose sweets or 200ml Lucozade
  • Once blood glucose >4 give starchy carbohydrate (e.g. digestive biscuits)
33
Q

How should a hypo be treated if the patient is unconscious?

A
  • No IV access = Glucagon 1mg SC or IM
  • IV access = Dextrose 100ml 20% or 200ml 10%
  • Do NOT omit the next insulin dose
34
Q

How does Metformin work?

A
  • Decreases amount of sugar produced

- Increases insulin sensitivity of cells

35
Q

What should Diabetic mothers be advised to do regarding feeding?

A

Colostrum harvesting

36
Q

What may be seen on USS that is an indicator for an SGTT?

A
  • Large foetal abdomen

- Polyhydramnios

37
Q

What foods should be avoided?

A
  • Fruit juice
  • Exotic fruits
  • Cereal
  • White rice/ pasta
38
Q

How can urinalysis be used to indicate an SGTT?

A

2x glucosuria in a row

YEAR 3 REVISION (49 decks)

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