diabetes part 2 Flashcards
what could cause hypoglycaemia?
- Not eating enough food
- Not eating enough carbs
- Missing or delaying meals
- Missing snacks if they are apart of a food plan
- Introducing exercise without changing diabetes tablet doses
- Taking too much insulin or too many sulphonyurea tablets
- Losing weight without reducing meds
- Drinking excess alcohol
what are 3 steps used to manage the hypo’s?
Step one; eat or drink on serving of quick acting carbohydrate eg jellybeans or dextro energy tablets
Step two: after 10 mins test blood glucose if still under 4mmol/l eat another serving
Step three: once blood sugar is above 4mmol/l follow up with a more substantial carbohydrate
what is gestational diabetes?
- characterised by hyperglycaemia with values above normal but below the diagnostic of diabetes, occurring during pregnancy
what risks are associated with gestational diabetes?
- increased risk of complications during pregnancy and at delivery
- increased risk of developing type 2 diabetes in the future
what are the treatment objectives for diabetes?
- alleviate symptoms of hyperglycaemia
- control blood glucose
- achieve HbA1c of 53 mmol/mol
- prevent onset of micro and macro - vascular complication
- maintain health and prolong life
- reduce impact and burden on others
Type 1 diabetes relies on the injection of subcutaneous insulin to lower blood glucose levels. What is types are often used and give an example?
- Lantus - basal insulin
- intermediate insulin (protaphane or Humulin N)
- Rapid acting ( NovoRapid, Humalog, Apidra)
what is the onset, peak and duration of rapid acting insulin
Rapid acting
- Subcutaneous
- 30 min onset
- 1-3 hours peak
- 8 hour duration
what is the onset, peak and duration of short acting insulin
Short acting
- Subcutaneous
- 10-20 min onset
- 1-3 hour peak
- 3-5 hour duration
what is the onset, peak and duration of intermediate acting insulin
Intermediate acting
- Subcutaneous
- 1-1.5 hour onset
- 4-12 hour peak
- 12-24 hour duration
what is the onset, peak and duration of long acting insulin
Long acting (detemir)
- Subcutaneous
- 1-2hoursonset
- 3-4 hours peak or some can have no peak
- Duration upto 24 hours or longer
People with type two diabetes may require insulin what are the common types used for them?
- basal bolus; lantus + rapid acting
- Premixed insuline ; Novomix30 or Humalog mix
- intermediate; protaphane or Humulin NPH
the oral medication Metformin is a biguanide which is also used in association with type 2 diabetes what does this do?
helps to stop the liver producing new glucose & helps to overcome insulin resistance by making insulin carry glucose into muscle cell more effectively
the oral medication Glipizide/Gliclazide are sulphonylureas and often used apart of type 2 diabetic treatment. What do they do?
stimulate the cells in the pancreas to make more insulin or mediate factors that are preventing beta cell response to glucose levels
the oral medication Pioglitazone is commonly used with type 2 diabetics what does this drug do?
they are insulin sensitising drugs and reduce insulin resistance
the oral medication DPP-4inhibitors are used with type 2 diabetics what do these drugs do?
work by blocking the action of DPP-4, an enzyme which destroys the hormone incretin- Sitagliptin
