Lecture 9: Type 1 Diabetes Flashcards
What is the generic definition of Diabetes?
- A group of metabolic disorders characterised by hyperglycaemia resulting from defects in insulin secretion, action or both
What can chronic hyperglycaemia cause damage to?
- Nerves, Eyes, blood vessels, heart, kidneys
What are some types of Diabetes?
- Type 1
- Type 2
- Gestational
- LADA
- MODY
- Double Diabetes
- Type 3c Diabetes (Secondary)
- Steroid induced diabetes
What is Type 1 Diabetes?
- Autoimmune diseases - cell mediated destruction of pancreatic beta cells causing deficiency of endogenous insulin
- Loss of self tolerance so T cell target beta cell antigens
How does urine help with the diagnosis of diabetes?
- Glucose in urine - happens when plasma glucose concentration is above renal threshold (6-14mmol/L)
How does ketoacidosis occur?
- By the beta-oxidation of free fatty acids which leads to ketone bodies
- These deplete acid buffers and acidosis occurs
What are the 4Ts that diagnose type 1 diabetes and others?
- Thirst
- Tired
- Thinner
- Toilet
Other symptoms: thrush, cuts/wounds longer to heal, blurred vision, history of autoimmune diseases: addisons, graves, hashimoto - glucose in urine, nocturia, weight loss
What are the symptoms of diabetic ketoacidosis?
- Severe vomiting
- Abdominal pain
- Deep sighing respirations (kaussmaul respirations)
- Sweet smelling
- Reduced consciousness
What are the 8 types of acting insulin?
- Ultra rapid acting
- Rapid acting.
- Short acting.
- Intermediate acting
- Long acting
- Ultra long acting
- Human mixed insulins
- Analogue mixed insulins
What are some antigen/ autoantibody tests for type 1?
- GAD
- IA2
- ZnT8
When should you take ultra rapid acting insulin?
just before, with or up to 20min after food
when should you take a rapid acting insulin?
just before, with or just after food
when should you take a short acting insulin?
30min before food
when should you take intermediate acting insulin?
30min before food or bedtime
when should you take a long-acting insulin analogue?
once or twice a day
when should you take an ultra long-acting insulin analogue?
once a day
when should you take an analogue mixed insulin?
just before, with or just after food
when should you take human mixed insulin?
30 minutes before a meal
what 5 things does the dose of insulin injected depended on?
- Age
- Excercise
- Physical activity
- Stress
- Hormonal changes
Explain how basal bolus works?
- Basal: given 1/2 a day for baseline insulin concentration
- Bolus: given at each main meal
What is the honeymoon period
a remission when either no insulin or a much reduced dose is required to remain euglycaemic (normal level)
- Temp phase after diagnosis when the pancreas can produce some insulin leading to lower insulin needs and better control
- Usually begins within weeks of starting insulin gives illusion of getting better
At what angle must one inject insulin?
- 90 degrees
What are the 5 injection sites
- subcutaneous injection
- abdomen- faster
- back of arms- faster absorption
- thighs- slower absorption
- buttocks - slower
how often should a diabetic check their blood glucose whilst driving?
Every 2 hrs
