diabetes and addison's disease Flashcards
What happens when blood sugar is low in a non-diabetic person?
-Glucagon is released by alpha cells
-it stimulates the liver to concert glycogen stores into glucose, which is then released into the blood stream
-promotes the production of energy source from amino acids
-reduces glucose storage in the liver
-acts on adipose tissue to break it down into ketone bodies
What is the role of insulin in a non-diabetic person?
-Allows glucose across the cell membranes to be used as energy
-stops the use of fat as an energy source by inhibiting the release of glucagon
-stimulates the liver to store excess glucose as glycogen
What is the cause of type 1 diabetes mellitus?
-its an autoimmune condition, exact cause is unknown
-often becomes present in the teenage years
-immune system attacks insulin-producing beta cells
What happens when someone with diabetes mellitus eats food?
-body still breaks down food, but there is no insulin to allow glucose into cells
-glucose builds up in the blood stream
-blood pH becomes more acidic
-cells are starved of glucose, start to anaerobically respire, lactic acid makes blood even more acidic
What are the signs and symptoms of type 1 diabetes?
-increased thirst and urination
-fatigue
-loss of muscle bulk/weight loss
-BM alteration
What is the cause/process of type 2 diabetes?
-lifestyle induced
-pancreas-produced insulin doesn’t work or isn’t enough, as there is partial beta cell destruction, and/or cells become insulin resistant where receptors on the cell membrane become damaged so insulin cannot work to allow glucose in.
What are the signs and symptoms of type 2 diabetes?
-fatigue (after meals)
-feeling hungry after eating
-nausea
-blurred vision
-BM alterations
What are the signs and symptoms of hypoglycaemia?
Mild:
-tremors
-sweating
-tachycardia
-agitation
-pallor
Severe:
-confusion/reduced gcs/impaired judgement
-headache
-speech changes
-gait problems
-seizures/coma
What is the treatment for a hypoglycaemic patient with a gcs of 14 or more?
-CABCDE
-Baseline BM
-10g oral glucose, wait 10 minutes, retake BM
-repeat if needed
-complex carbohydrate to stabilise blood sugar levels
-non-diabetic go to hospital, diabetic left at home if stable/supervised
What is the treatment for a hypoglycaemic patient with a gcs of 13 or less?
-1mg IM glucose, 15 minutes to be effective. can only be given once
or
-100ml IV glucose, wait 5 minutes, re-take BM, with a second dose if necessary. If no improvement, transport and 3rd dose. (get as big a cannula in as possible as glucose is syrupy)
-non-diabetic going to hospital, diabetic can stay at home if stable and supervised. Consider community referrals if its frequent.
What are the signs and symptoms of hyperglycaemia?
-feeling tired/weak
-blurred vision
-very thirsty/urinating a lot
-pear drop breath smell
What is the treatment of hyperglycaemia?
Measure blood ketone levels with patient’s own monitor if possible
-normal level is <0.6mmol
-if >0.6mmol, ‘SICK DAY’ rules
->0.6 but <3.0 with illness, take to hospital
->0.6 but <3.0 able to readily eat and drink and administer fast-acting insulin, can stay in the community
->3.0 indication of DKA
-Assess for dehydration (?treat for shock)
-ECG
-consider pre-alert
What are the main signs/symptoms of diabetes insipidus?
-extreme thirst
-frequent urination, up to 20l per day
What causes diabetes insipidus?
A deficit of ADH OR the kidneys don’t respond to ADH means too much water is lost from the body.
