Management of Type 1 diabetes

Question 1

Type 1 diabetes symptoms/signs

Answer 1

weight loss
ketonuria
symptoms lasting weeks-days
possible FH
mostly preschool + teenage
can have severe symptoms

Question 2

Type 2 diabetes signs/symptoms

Answer 2

usually no weight loss
no ketonuria
symptoms come on over months
generally presents after 20y

Question 3

What is normal fasting glucose and normal glucose 2h after OGTT?

Answer 3

fasting <6.1
2h after OGTT <7.8

Question 4

Fasting glucose and glucose 2h after OGTT in diabetes

Answer 4

fasting >7
2h after OGTT >11.1

Question 5

Fasting glucose and glucose 2h after OGTT in impaired glucose tolerance

Answer 5

fasting <7
2h after OGTT 7.8<x<11.1

Question 6

Fasting glucose in impaired fasting glucose

Answer 6

fasting 6.2<x<7

Question 7

Normal HbA1c

Answer 7

<42mmol/mol

Question 8

HbA1c in impaired glucose tolerance

Answer 8

43-47 mmol/mol

Question 9

HbA1c in diabetes

Answer 9

> 48mmol/mol

Question 10

What antibodies might be present in Type 1 diabetes?

Answer 10

GAD
IA-2
ZnT8

Question 11

Diabetes aims of management

Answer 11

to achieve near normal glycaemia

short term - prevent symptoms of hyper and hypo

long term - to prevent complications

good quality of life, near normal life expectancy

Question 12

What do beta cells of the pancreas produce?

Answer 12

insulin

Question 13

What do alpha cells of the pancreas produce?

Answer 13

glucagon

Question 14

Insulin half life

Answer 14

6 minutes

Question 15

What types of insulin are there?

Answer 15

rapid-acting analogue insulins
short-acting insulins
intermediate-acting insulins
long-acting insulins
mixed insulins - biphasic (eg. short and long acting together)

Question 16

Describe the basal bolus regimen for diabetes management

Answer 16

once or twice daily basal insulin is given to balance hepatic glucose output

bolus insulin should be taken 10-15min premeal to cover carbohydrate intake and/pr to correct raised glucose levels

Question 17

Where can insulin be injected?

Answer 17

thighs
abdomen
arms
upper buttocks

Question 18

Why do insulin injection sites need to be rotated?

Answer 18

no rotation can cause lipohypertrophy

Question 19

What route is insulin administered by?

Answer 19

SC for normal use
IV for DKA/HHS

Question 20

Where do libre devices measure glucose?

Answer 20

in subcutaneous tissue