diabetes Flashcards
what causes T1DM?
autoimmune destruction of beta cells
what causes T2DM?
insulin resistance or relative insulin lack
4 main symptoms of diabetes?
- polyuria
- polydipsia
- weight loss
- blurred vision
increased risk of infections
diabetes is diagnosed at what level of HbA1c?
> 48mmol/mol
which 4 hormones increase glucose levels?
- glucagon
- adrenaline
- GH
- cortisol
3 acute complications of diabetes
- ketoacidosis
- hypoglycaemia
- hyperosomolar hyperglycaemia state - type 2
2 main type of chronic complications of diabetes?
microvascular - retinopathy, neuropathy, nephropathy
macrovascular
what level of blood glucose is hypoglycaemic?
<4mmol/l
when would IM glucagon not work?
in starved pt or pt with liver disease
it tunes glycogen in liver into glucose
would need IV glucose
what causes diabetic ketoacidosis?
hyperglycaemia - caused by insulin lack in T1DM
dehydration of cells due to water moving out
loss of K from cells then urine
loss of Na in urine
accumulation of acid in blood + urine = ketone bodies made from breakdown of fat
what do ketone bodies smell like?
nail varnish remover
clinical features of ketoacidosis
onset over 12-24hrs thirst, polyuria dehydration - dry mouth, low BP confusion deep breathing
how to prevent DKA?
never omit insulin in T1DM
how to treat DKA?
IV insulin infusion
IV rehydration + electrolyte replacement
treat underlying cause i.e. infection, MI
what is hyperosmolar non-kerotic coma?
similar to DKA but without ketoacids
only T2DM
usually onset over days
