L14: Diabetes Diagnosis And Management Flashcards
What is diabetes
A state of altered glucose haemostasis that leads to hypeglycaemia (high glucose) when left untreated and results in micro and macro vascular damage
What is the oral glucose tolerance test
- You give patient a milk to drink
- Wait for 2 hours
- Take glucose
What happens in a normal glucose tolerance test
Blood glucose rises and then falls
What happens to the oral glucose tolerance test in diabetes
Blood glucose is significantly above the threshol and stays high
What is the renal threshold
When the glucose can become detected in the urine
What is type 1 diabetes
- An autoimmune condition when the beta cell in the pancreas are destoryed so they cannot release insulin
- Insulin cant convert glucose to glycogen to become stored in the liver
- There is high blood sugar as a result
What symptoms does type 1 diabetes present with
Thirst
Polyuria
Weight loss
Blurred vision
What is type 1 diabetes
When there is insulin but the body stops reacting to insulin so glucose cant be converted to glycogen to become stored
If a type 1 diabetic patient is symptomatic what test can be diagnostic
Random plasma glucose more than 11.1mmol/l
If a patient with type 2 diabetes is asymptomatic wgat is the diagnostic test we can carry out to diagnose
Fasting blood glucose above 7 Or 2hour post oral glucpse tolerance test more than 11.1 Or Hba1c greater than 48mmol/mol
What are the antibodies used in type 1 diabetes for diagnosis
Islet cell antibodies
Anitbodies to glutamic acid decarboxylase
In which type of diabetes is ketones likelt to be present
Type 1
How can we monitor diabetes
Capillary blood glucose testing
Urine testing
Hb1ac
Frucosamine
Why is urine testing not reliable
If there is renal glycosuria then the renal threshold for glucose is lower therefore there can be glucose in the urine when infact the patient has normal glycaemia
What is hb1ac
This is the glucose bound to the haemoglobin molcule non enzymeattically
What pharmacological therapy is used in diabetes
Aspiring for secondary prevention
Inuslin with/without metformin in type 1
Oral hyperglycaemic agents in type 2 before progressing to inuslin
Blood pressure using anti hypertensives
Lipid management
Eye screening
Foot care
What is the first line treatment for type 2 diabates
Metformin
What is the first line treatment in type 1
Insulin
How do we monitor patients
By doing 3 monthy hb1ac
What agent is given to type 2 paitents before insulin
oral hypoglycaemic agents
Who has to monitor with a capillary blood glucose test
All type 1 diabetes patients
And
Type 2 patients on insulin
What are the ways in which insulin can be administered (regimes)
Once daily or twice daily basal insulin- intermediate or long acting insulin
Once or twice daily pre mixed insulin
Pre meal rapid acting insulin with once daily basal insulin
Mealtime rapid acting insulin only- only in gestational diabetes
What are the types of insulin classed into
The duration of action
What are the types of insulin
Rapid acting insulin
Short acting insulin
Intermediate acting insulin
Long acting insulin
