Diabetes complications Flashcards

1
Q

Effects of acute insulin deficiency (type 1)

A
Polyuria
Thirst
Weight loss 
Blurred vision
Tiredness
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2
Q

Effects of chronic insulin deficiency

A
Hyperglycaemia
Infections
Microvascular complications (retinopathy, nephropathy, neuropathy)
Hyperlipidaemia 
Macrovascular complications
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3
Q

Microvascular mechanism

A

Hyperglycaemia leads to formation of advanced glycation end-product (AGE)
Increased cytokines and adhesion molecules
Increased sorbitol and decreased myoninositol
Activation of protein kinase C
Results in change in blood flow, coagulation and vascular cell growth

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4
Q

Diabetic retinopathy

A

Most common cause of blindness in people aged 30-69

20% of type 2 patients have retinopathy at diagnosis

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5
Q

Diabetic nephropathy

A

Microabluminuria leading to proteinuria
Glomerular death, increased serum creatinine and low glomerular filtration rate
Results in renal failure

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6
Q

Diabetic neuropathy

A

Ulceration neuropathy
Loss of sensation in feet
Impaired healing
15% of diabetics develop foot ulcers and 5-15% of these need amputations

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7
Q

Capillary glucose testing

A

Finger prick glucose monitoring
Main monitoring method
Performed multiple times a day
Low cost

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8
Q

CGM

A

Continuous glucose monitoring
Sensors monitor interstitial glucose
Wirelessly transmits to insulin pump
Expensive

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9
Q

Flash glucose monitoring

A

Monitors interstitial glucose
Sensor worn on arm for up to 14 days
Shows current glucose and variation
Less expensive than CGM

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10
Q

HbA1C test

A

Glycosylation of haemoglobin beta chain HbA1 to form HbA1c
If more glucose is present, more haemoglobin is glycosylated
Can be automated

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11
Q

Insulin treatment

A

Reduce symptoms of hyperglycaemia
Restore glucose homeostasis
Prevent complications
Too much insulin may cause hypoglycaemia

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12
Q

Type 1 insulin treatment regimens

A

Most patients on “basal-bolus” regimes
Long acting insulin analogue and prandial rapid acting insulin (adjusted according to meal contents)
Rapid acting insulin can be administered by programmable pump

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13
Q

Insulin pump therapy

A
Used for type 1 diabetes
Varies insulin administration at different times of day
Insulin dose boosted at meal times
Can be integrated with CGM
MiniMed 508
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14
Q

Treating insulin resistance

A

Weight loss

Troglitazone may decrease risk

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