Diabetes Type 1 Management Flashcards
DM1 presents with?
weight loss
polyuria
polydipsia
ketoacidosis
short acting insulin GLARGINE is short or long acting?
long acting
Detemir replaces B30 and replaced with?
fatty acid
Typical insulin regime?
- Basal Bolus before bed
2. short acting prior to each meal
Insulin pumps deliver?
continuously at back ground rate
What is artificial pancreas?
closed loop system
what is artificial pancreas good for?
prevention of nocturnal hypoglycaemia
2 issues with islet transplantation?
- availability
2. life-long immunosuppression
3 tissues particularly vulnerable to DM1 complications?
Retinopathy
Nephropathy
Neuropathy
What should you aim for in glycaemic control?
7 for HB-A1C
what is non-enzymatic glycosylation?
binds to RBC proteins irreversibly covalent bonds
Why measure HB-A1C?
gives an indirect measure of average levels of blood glucose for past 3 months
Why measure fructosamine?
if they have high red cell turn over as they will have low HB-A1C
how to measure kidney function in DM1?
urinary microalbumin
creatinine to albumin ratio
How test neuropathy in DM1?
sensation testing
what is low blood glucose value?
<4mmol/L
2 types of hypoglycaemia symptoms?
- rapid fall: sympathetic discharge
2. absolute low: brain malfunction/coma, death
what hormone seems to be the one important factor to get out of hypoglycaemia?
glucagon
How to treat conscious hypoglycaemia?
oral glucose then meal
how to treat diminished conscious hypoglycaemia?
intravenous glucose or
glucagon
if DM1 has no insulin for a day, what happens?
ketoacidosis: hospitalization
1 reason for ketoacidosis in DM1?
infection
why give potassium replacement in ketoacidosis?
Insulin pushes K+ into cells > hypokalaemia > arrythmia > death
important thing to do if keto in a known diabetic?
reasons behind it
