Diagnosis, hypoglycaemia and complications of diabetes

Question 1

What value is diagnosed as hypoglycaemia?

Answer 1

[4mmol/L]

Question 2

Symptoms of mild hypoglycaemia

Answer 2

palpitations, fatigue, blurred vision

Question 3

Symptoms of moderate hypoglycaemia

Answer 3

Behaviour change, slurred speech

Question 4

Symptoms of severe hypoglycaemia

Answer 4

Agitated, unresponsive, seizures/coma

Question 5

Treatments for mild hypoglycaemia

Answer 5

Sugary drink or 2 tablespoons of sugar followed by carbs

Question 6

Treatments of moderate hypoglycaemia

Answer 6

1.5-2 tubes of glucogel or IM glucagon (1mg)

Question 7

Treatments of severe hypoglycaemia

Answer 7

1mg of IM glucagon or IV glucose (150ml of 10% over 10-15mins)

Question 8

Symptoms of DKA (type 1)

Answer 8

weakness
Ketone breath
air hunger/ hyperventilation
dehydration
nausea
polydipsia
polyuria
blurred vision

Question 9

Why does DKA cause ketone breath?

Answer 9

increased ketone bodies, therefore metabolic acidosis
Excess Acetyl CoA

Question 10

Symptoms of HONK (type 2)

Answer 10

can cause candida infections
Nausea
Dehydration
polydipsia
polyuria
blurred vision
weakness

Question 11

Fasting diagnostic criteria for diabetes

Answer 11

less than 7.00mmol/L

Question 12

Random diagnostic criteria for diabetes

Answer 12

less than 11.1mmol/L

Question 13

What value can diagnose type 2 diabetes with a HbA1c test

Answer 13

48mmol/mol (6.5%) or below

Question 14

What are microvascular diseases in diabetes

Answer 14

Retinopathy
Nephropathy
Neuropathy
ED

Question 15

What are macrovascular diseases in diabetes

Answer 15

Hypertension
Hyperlipidaemia

Question 16

What do you give a patient with hypertension who has diabetes

Answer 16

ACEi and atorvastatin (20mg At Night)

Question 17

What is Diabetic eye disease and what are treatments for it

Answer 17

Blurred vision/ early cataracts/ resistant glaucoma
Good glycaemic control
Avoid rapid improvement in control
Regular screening
laser treatment
HT treatment

Question 18

What is Diabetic Kidney Disease and what are treatments for it

Answer 18

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

Question 19

What is Diabetic nerve disease and what are treatments for it

Answer 19

Numbness in legs or tingling
Decreases vibration sense
Can cause : ED or low BP when standing

Treatments: optimise blood sugar control

Question 20

what is Diabetic foot disease and what are treatments for it

Answer 20

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

Question 21

How can cardiovascular disease be reduced in diabetes type 2 patients?

Answer 21

Statins for over 40yr olds

Question 22

What symptoms cause someone under 40 with diabetes to be given statins?

Answer 22

If under 40 but have:
retinopathy,
nephropathy,
poor glycaemic control,
high BP,
relative with premature CVD
RECIEVE STATIN (atorvastatin)