DM- Type 1 Flashcards
What causes type 1 diabetes?
Autoimmune pancreas destruction:
- lymphocytic infiltration and destruction of the pancreatic islets of langerhans
- cannot produce insulin
What may predispose to type 1 diabetes?
- Coxsackie B virus
- Enterovirus
- Genetics
What happens as a result of the insulin deficiency?
Glucose cannot move into cells, and rely on ketogenesis.
What emergency are type 1 diabetics prone to?
DKA
What does insulin do in the body?
Reduces blood sugar:
1- Causes glucose uptake into cells
2- Promotes glycogenesis in the liver and muscles
How does ketogenesis work?
- Liver converts fatty acids to ketones
- In normal patients, their acidity is buffered. In diabetics, there are too many to buffer
Where is insulin made?
Beta cells
Islets of Langerhans
Where is Glucagon made?
Alpha cells
Islets of Langerhans
How does glucagon work?
Raises blood glucose:
- Promotes glycogenolysis
- Promotes gluconeogensis
What is the normal range for glucose?
4.4-6.1 mmol/L
How is T1 DM treated long term?
- SC insulin regimes
- Monitoring daily carbohydrates
- Frequent BMs
What is needed for successful management of T1DM?
Patient education, so that they may be fully involved in their care
What is a typical insulin regime?
- Background, long acting insulin
- Short term insulin around 30 minutes before eating
Why should you change insulin injection sites?
Lipodystrophy:
- SC fat hardens and patients do not absorb insulin through this
What are the short term complications of T1DM?
- Hypoglycaemia (from insulin)
- Hyperglycaemia and DKA
What are the symptoms of hypoglycaemia?
- Reduced consciousness
- Tremor
- Sweating
- Irritability
- Dizziness and pallor
How is mild and severe hypoglycaemia treated?
- Mild - Short and long acting glucose e.g. lucozade and toast
- Severe - Dextrose and IM Glucagon
What are the macrovascular complications of T1DM?
- Coronary artery disease
- Peripheral ischaemia e.g diabetic foot
- Stroke
- HTN
What are the microvascular complications of T1DM?
- Peripheral neuropathy
- Retinopathy
- Glomerulosclerosis
What infections do diabetics get?
- UTI
- Pneumonia
- Skin and soft tissue
- Fungal (candidiasis)
How is diabetes monitored?
- HbA1c
- Capillary glucose
What is HbA1c?
Glycated haemoglobin
What does HbA1c reflect?
Diabetic control over the last three months- as this is a RBC’s lifespan
How frequently should HbA1c be measured?
3-6 monthly