Diabetes- type 1 Flashcards

1
Q

Presentation

A

Signs and symptoms in new diangosis are typically in DKA

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2
Q

Features of DKA

A

Abdo pain

Polyuria/ polydipsia/ dehydration

Kussmaul respiration

Acetone-smelling breath

Hyperglycaemia

Potassium imbalance

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3
Q

Investigations for diabetes

A

Urine dip for glucose and ketones

Fasting glucoe and random glucose

HbA1c no useful as may not reflect recent rapid rise in serum glucose

C-peptide levels low in T1DM

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4
Q

Diagnosis

A

Symptomatic

Fasting glucose >7.0mmol/L

Random glucose>11.0mmol/L

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5
Q

HbA1c monitoring

A

Every 3-6 months

Target <48mmol

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6
Q

Self-monitoring of blood glucose

A

Recommend testing at least 4 times a day (before each meal and before bed)

More frequent monitoring if frequent hypoglycaemia, period of illness, before/during/after sport, when planning pregnancy, during pregnancy, breastfeeding

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7
Q

Blood glucose targets

A

5-7mmol/L on waking

4-7mmol/L before meals and other times of the day

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8
Q

Type of insulin

A

Multiple injection basal-bolus insulin regimens for all adults

Twice dailt insulin detemir is regime of choice

Rapid acting insulin analogues before meals

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9
Q

Short term complications

A

Hypoglycaemia (tremor, sweating, irritable, dizzy, pallor, LOC, coma, death)

Hyperglycaemia (lead to DKA)

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10
Q

Macrovascular complications

A

Coronary artery disease is major cause of death

Peripheral ischaemia causing poor healing, ulcers, diabetic foot

Stroke

HTN

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11
Q

Microvascular complications

A

Peripheral neuropathy

Retinopathy

Kidney disease (glomerulosclerosis)

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12
Q

Infection related complications

A

UTI

Pneumonia

Skin and soft tissue infections

Fungal infections (candidiasis)

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