Management of Type 1 diabetes Flashcards
Type 1 diabetes symptoms/signs
weight loss
ketonuria
symptoms lasting weeks-days
possible FH
mostly preschool + teenage
can have severe symptoms
Type 2 diabetes signs/symptoms
usually no weight loss
no ketonuria
symptoms come on over months
generally presents after 20y
What is normal fasting glucose and normal glucose 2h after OGTT?
fasting <6.1
2h after OGTT <7.8
Fasting glucose and glucose 2h after OGTT in diabetes
fasting >7
2h after OGTT >11.1
Fasting glucose and glucose 2h after OGTT in impaired glucose tolerance
fasting <7
2h after OGTT 7.8<x<11.1
Fasting glucose in impaired fasting glucose
fasting 6.2<x<7
Normal HbA1c
<42mmol/mol
HbA1c in impaired glucose tolerance
43-47 mmol/mol
HbA1c in diabetes
> 48mmol/mol
What antibodies might be present in Type 1 diabetes?
GAD
IA-2
ZnT8
Diabetes aims of management
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
What do beta cells of the pancreas produce?
insulin
What do alpha cells of the pancreas produce?
glucagon
Insulin half life
6 minutes
What types of insulin are there?
rapid-acting analogue insulins
short-acting insulins
intermediate-acting insulins
long-acting insulins
mixed insulins - biphasic (eg. short and long acting together)
Describe the basal bolus regimen for diabetes management
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
Where can insulin be injected?
thighs
abdomen
arms
upper buttocks
Why do insulin injection sites need to be rotated?
no rotation can cause lipohypertrophy
What route is insulin administered by?
SC for normal use
IV for DKA/HHS
Where do libre devices measure glucose?
in subcutaneous tissue
