Diagnosis, hypoglycaemia and complications of diabetes Flashcards
What value is diagnosed as hypoglycaemia?
[4mmol/L]
Symptoms of mild hypoglycaemia
palpitations, fatigue, blurred vision
Symptoms of moderate hypoglycaemia
Behaviour change, slurred speech
Symptoms of severe hypoglycaemia
Agitated, unresponsive, seizures/coma
Treatments for mild hypoglycaemia
Sugary drink or 2 tablespoons of sugar followed by carbs
Treatments of moderate hypoglycaemia
1.5-2 tubes of glucogel or IM glucagon (1mg)
Treatments of severe hypoglycaemia
1mg of IM glucagon or IV glucose (150ml of 10% over 10-15mins)
Symptoms of DKA (type 1)
weakness
Ketone breath
air hunger/ hyperventilation
dehydration
nausea
polydipsia
polyuria
blurred vision
Why does DKA cause ketone breath?
increased ketone bodies, therefore metabolic acidosis
Excess Acetyl CoA
Symptoms of HONK (type 2)
can cause candida infections
Nausea
Dehydration
polydipsia
polyuria
blurred vision
weakness
Fasting diagnostic criteria for diabetes
less than 7.00mmol/L
Random diagnostic criteria for diabetes
less than 11.1mmol/L
What value can diagnose type 2 diabetes with a HbA1c test
48mmol/mol (6.5%) or below
What are microvascular diseases in diabetes
Retinopathy
Nephropathy
Neuropathy
ED
What are macrovascular diseases in diabetes
Hypertension
Hyperlipidaemia
What do you give a patient with hypertension who has diabetes
ACEi and atorvastatin (20mg At Night)
What is Diabetic eye disease and what are treatments for it
Blurred vision/ early cataracts/ resistant glaucoma
Good glycaemic control
Avoid rapid improvement in control
Regular screening
laser treatment
HT treatment
What is Diabetic Kidney Disease and what are treatments for it
Proteinuria (presence of albumin in urine)
Men more than 2.5mg/mmol
Women more than 3.5mg/mmol
Aim for HbA1c of less than 7%
Type 1 HT= 130/80 Type 2 HT= 140/90
Start with ACE-I (renoprotective)
If need CCB - amlodipine or felodipine
Restrict sodium in diet
What is Diabetic nerve disease and what are treatments for it
Numbness in legs or tingling
Decreases vibration sense
Can cause : ED or low BP when standing
Treatments: optimise blood sugar control
what is Diabetic foot disease and what are treatments for it
Poor circulation of lower limbs - problems w infections and healing
Risks are: deformities/callus’, poor footwear, poor mobility
Prevent via education
Manage by treating wounds and check blood flow
Needs amputations
How can cardiovascular disease be reduced in diabetes type 2 patients?
Statins for over 40yr olds
What symptoms cause someone under 40 with diabetes to be given statins?
If under 40 but have:
retinopathy,
nephropathy,
poor glycaemic control,
high BP,
relative with premature CVD
RECIEVE STATIN (atorvastatin)
