Management of Diabetes C - Type 1 Diabetes Mellitus

Question 1

what health care specialist are involved in managing a patient with diabetes

Answer 1

DNS
practice nurse
dietitian 
podiatrist 
doctor

Question 2

what are the 4 things to check before injecting insulin

Answer 2

right insulin
right dose
right time
right way

Question 3

if blood ketones are less than 0.6mmol/l what should be done

Answer 3

repeat test after 2 hours to check levels arent rising

Question 4

if blood ketones are higher than 0.6 mmol/l what should be done

Answer 4

1. drink plenty of fluids
2. correction dose of insulin
3. retest blood sugar and ketones in 1-2 hours

Question 5

what is the most important thing to give when ketone levels are rising

Answer 5

give extra insulin

Question 6

why does insulin have to be given subcutaneously or via IV

Answer 6

as it is a polypeptide it is inactivate by the GI tract

Question 7

what is the insulin regime for injecting twice daily

Answer 7

RAI & IAI before breakfast and before evening meal

Question 8

what is the insulin regime for injecting three times daily

Answer 8

1. RAI & IAI before breakfast
2. RAI before evening meal
3. IAI at bedtime

Question 9

what is the insulin regime for injecting four times daily

Answer 9

SAI before breakfast, lunch, evening meal

IAI at bedtime

Question 10

what is hypoglycaemia

Answer 10

any episode of low blood glucose with or without symptoms usually occurs in patients taking insulin

Question 11

what are common reasons for hypoglycaemia

Answer 11

food
inactivity
insulin

Question 12

what are symptoms of hypoglycaemia

Answer 12

sweating
shaking
confusion
headache

Question 13

what is the treatment for hypoglycaemia

Answer 13

any of:

1. 200ml fruit juice
2. half lucozade
3. glucagon
4. IV glucose

Question 14

why is hypoglycaemia dangerous

Answer 14

can cause coma, hemiparesis, seizures (if hy[oglycaemia is prolonged neurological deficits may become permanent

Question 15

what levels do blood glucose have to be to drive

Answer 15

5 to drive

Question 16

what is the cause of diabetic ketoacidosis

Answer 16

too little insulin leading to fat breakdown associated with HIGH glucose levels (and type 1)

Question 17

what are the symptoms of DKA

Answer 17

thirst 
high urine output 
abdominal pain
tachy cardic / low BP
acetone on breath

Question 18

what are the ‘sick day rules’

Answer 18

NEVER stop taking insulin
frequent blood tests
check urine/blood ketones
maintain CHO intake

Question 19

what is the treatment if a patient has hogh blood glucose levels and ketones are present

Answer 19

give extra dose of insulin and then recheck

Question 20

in established DKA what investigations should be carried out initially

Answer 20

glucose
urinanalysis
blood ketones
venous blood gas

Question 21

what is the treatment of established DKA in hospital

Answer 21

IV saline
IV glucose
IV potssium

Question 22

what complications can DKA result in

Answer 22

hyper or hypokalaemia

hypoglycaemia