Diabetes Type 1 Flashcards
What is Diabetes Mellitus?
Diabetes mellitus is a group of metabolic disorders characterized by persistent hyperglycaemia due to deficient insulin secretion or insulin resistance, leading to abnormalities in carbohydrate, fat, and protein metabolism.
What can alcohol do to someone with diabetes?
Alcohol can mask the symptoms of hypoglycaemia and cause delayed hypoglycaemia. Diabetics are advised to drink alcohol in moderation and always with food.
What should a diabetic driver notify the DVLA about?
Diabetic drivers who are treated with insulin or have diabetic complications must inform the DVLA, depending on their type of treatment, license, and complications.
What is required for a driver treated with insulin?
A driver treated with insulin must always carry a capillary blood-glucose meter and test strips, even if using a continuous glucose monitoring (CGM) system.
What is the required blood-glucose level for driving?
The blood-glucose level must be at least 5 mmol/litre to drive. It should be checked no more than 2 hours before driving and every 2 hours while driving.
What should a diabetic driver do if their blood-glucose level drops below 4 mmol/litre?
If blood-glucose drops below 4 mmol/litre or hypoglycaemia symptoms occur, the driver should not drive. If already driving, they should stop the vehicle in a safe place, wait until their blood-glucose level is normal (≥5 mmol/litre), and wait 45 minutes before continuing the journey.
What is an oral glucose tolerance test (OGTT)?
An OGTT is a test used to diagnose impaired glucose tolerance and gestational diabetes, but it is not necessary for routine diagnostic use when severe hyperglycaemia symptoms are present.
What forms glycated haemoglobin (HbA1c)?
Glycated haemoglobin (HbA1c) forms when red blood cells are exposed to glucose in the plasma.
What does the HbA1c test reflect?
The HbA1c test reflects average plasma glucose over the previous 2 to 3 months and provides a good indicator of glycaemic control.
What conditions should HbA1c not be used for diagnosis?
HbA1c should not be used for diagnosis in those with suspected type 1 diabetes, in children, during pregnancy, or in women who are up to two months postpartum.
What is the main cause of Type 1 diabetes?
Type 1 diabetes is caused by an absolute insulin deficiency, usually due to autoimmune destruction of insulin-producing beta cells in the pancreas.
What is the target HbA1c level for patients with Type 1 diabetes?
The target HbA1c level should be 48 mmol/mol (6.5%) or lower in patients with Type 1 diabetes.
What are the main complications of Type 1 diabetes?
Complications include microvascular (retinopathy, nephropathy, neuropathy), macrovascular (myocardial infarction, stroke), metabolic (DKA, hypoglycaemia), psychological issues (anxiety, depression), and autoimmune conditions (thyroid disease, coeliac disease).
What is the primary treatment approach for Type 1 diabetes?
The primary treatment is insulin therapy, with the goal of achieving optimal blood-glucose control while minimizing the risk of complications.
What is the first-line insulin regimen for Type 1 diabetes?
The first-line choice for insulin therapy is a multiple daily injection basal-bolus regimen.
What should patients with Type 1 diabetes aim for in terms of fasting blood glucose?
They should aim for a fasting blood-glucose concentration of 5–7 mmol/litre on waking.
What is the primary cause of hypoglycaemia in Type 1 diabetes?
Hypoglycaemia occurs due to insulin therapy, insufficient carbohydrate intake, physical activity, alcohol consumption, or missed meals.
What should patients do if they suspect Diabetic Ketoacidosis (DKA)?
If DKA is suspected, patients should be tested for ketones and seek immediate medical advice if ketone levels are above 2+ in urine or 3 mmol/L in blood.
What are the key symptoms of hypoglycaemia in Type 1 diabetes?
Symptoms include hunger, anxiety, irritability, sweating, tingling lips, palpitations, and tremor. Severe hypoglycaemia may result in convulsions, loss of consciousness, or coma.
How should insulin be managed during illness (sick-day rules)?
Insulin should never be omitted, blood glucose should be checked frequently, ketones should be monitored, and fluids should be maintained. Seek medical advice if unable to keep fluids down or blood glucose remains uncontrolled.
What is the main treatment for lipid modification in people with Type 1 diabetes?
For primary prevention of cardiovascular disease (CVD), statin treatment with atorvastatin 20 mg is recommended for patients aged over 40 years, those with diabetes for more than 10 years, nephropathy, or other CVD risk factors.
