Diabetic complications Flashcards
What are some symptoms of hypoglycaemia
Shaking and trembling
Sweating
Difficulty concentrating
Confusion, unconsciousness and change of behaviour
Slurring of speech and convulsions
Overview of hypoglycaemia
In which case should we not give dissolved sugar sucrose
In patients taking acarbose as this prevents breakdown of sucrose to glucose
Should orange juice be avoided in hypo and why?
Yes as its high in potassium – not good in chronic kidney disease
Should chocolates be given in hypo?
No as have lower sugar content and high fat so delayed gastric emptying
After how long should hypo treatments be repeated?
After 15 mins. Max of three treatments
Who should avoid glucagon?
Glucagon mobilises glycogen in the liver so it is ineffective in patients who’s liver glycogen is depleted e.g. prolonged fasting, adrenal insufficiency, chronic hypoglycaemia
What can you give to alcoholic patients to reduce risk of Wernicke’s encephalopathy?
Thiamine
In diabetes and cardiovascular risk, what can be given alongside to reduce cardiovascular risk
Cardiovascular risk in patients with diabetes can be further reduced an ACE inhibitor (or an angiotensin-II receptor antagonist) and lipid-regulating drugs.
What can adding ACE inhibitors do to diabetic drugs
ACE inhibitors can potentiate the hypoglycaemic effect of insulin and oral antidiabetic drugs
What can be done to avoid diabetic nephropathy
Blood pressure should be reduced to the lowest achievable level to slow the rate of decline of glomerular filtration rate and reduce proteinuria.
Test urine for microalbuminuria – earliest sign of nephropathy
Also test serum creatinine
What is diabetic neuropathy
Painful diabetic neuropathy can occur in patients with type 1 diabetes who have a rapid improvement in blood-glucose control.
What is the treatment for diabetic neuropathy
Usually self limiting
Paracetamol or NSAID can be given
Duloxetine and venlafaxine can also be given
Pregabalin/Gabapentin if all else fails
DKA vs HHS
Sick day rules
SADMAN rules
