General info Flashcards
Type 2
Reduced insulin secretion/peripheral resistance to insulin.
Treatment = diet, oral drugs or insulin
Type 1
Insulin deficiency
Pancreatic beta cells are destroyed.
Insufficient insulin
Treatment = insulin
Symptoms
Polyphagia (hunger)
Polydipsia (thirst)
Polyuria (urination)
Weight loss
Fatigue
Blurred vision
Poor wound healing
Long-term complications
Annual reviews
For children - begin screening after 12 or 5 years after diagnosis
Macrovascular
Microvascular
Macrovascular complications
Diabetes = risk factor for CVD
Statin give as primary prevention in:
- Type 1 diabates
- Type 2 diabetes with a 10 year CVD risk score of >10%
Low dose aspirin NOT recommended
ACEi = may have a role in preventing CVD
Microvascular complications
Eyes
Kidneys
Nerves
Eyes
Retinopathy
Treat hypertension - protects visual acuity
Kidneys
Nephropathy (proteinuria/microalbuminuria)
Treatment = ACEi/ARB
IMPORTANT to note that ACEi potentiate hypoglycaemic effects of antidiabetic drugs and insulin, especially in renal impairment
Nerves
Sensory, painful neuropathy (diabetic foot)
Autonomic neuropathy
Gustatory neuropathy
Neuropathic postural hypotension
Sensory, painful neuropathy (diabetic foot)
Analgesics = strong opioids (oxycodone/morphine); specialist use
Duloxetine/TCAs = amitriptyline, nortriptyline
Anti-epileptics = gabapentin, pregabalin, carbamazepine
1st line = amitriptyline, duloxetine, gabapentin or pregabalin
2nd line = try alternative
Autonomic neuropathy
Diabetic diarrhoea = codeine or tetracyclien
Gastroparesis = erythromycin
ED = sildenafil
Gustatory neuropathy
Sweating face, scalp, head and neck
- Antimuscarinic/antiperspirant
Neuropathic postural hypotension
Fludrocortisone + increased salt intake
