Management of Type 1 Diabetes Flashcards
List some of the rapid acting analogue forms of insulin.
Humalog
Novorapid
Apidra
Where do most people inject their insulin?
Tummy
Thighs
Sometimes bottom
If it better to take insulin before or after eating?
Before
-> remember when E used to go down to the office before lunchtime
What is the name given to the device which allows for continuous glucose monitoring using a phone?
Dexcom
What are the symptoms of DKA?
Nausea and vomiting
Abdominal pain
Sweet smelling, ketonic breath
Drowsiness
Rapid, deep sighing respiration
Coma
Which type of diabetes predominantly leads to DKA?
Type 1 but not always the case
What is the initial management for DKA which must be carried out asap?
Normal saline and IV fluids
Start actrapid
What are some of the potential complications of hypoglycaemia?
Rebound ketosis
Arrhythmias
Acute brain injury
What can happen as a result of trying to increase fluids of a child with type 1 diabetes?
Cerebral oedema
What BG level means a hypo?
<4mmol/L
-> less than four, on the floor
What are some of the symptoms of a hypo?
Tachycardia
Shaking
Sweating
Dizziness
Hunger
Hypos can be mild or severe. What is the difference?
Mild- patients know how to treat themselves
Severe- require assistance, in hospital
What are some of the causes of a hypo?
Too much insulin
Inappropriate timing of insulin
Injection site problems
Inadequate food carbs
Exercise
Alcohol
Which groups are more at risk of a hypo?
-Tight glycaemic control
-Impaired awareness
-Cognitive impairment
-Malabsorption
-Pancreatectomy
-Renal/hepatic impairment
Management of a hypo?
Fast acting glucose
-> Dextrosol tablets, Glucotabs, Glucojuice- pure fruit juice
What is CSII?
Continuous subcutaneous insulin infusion
-> given by a pump
List some examples of short-acting insulin.
Actrapid
Humulim
Insuman Rapid
Which type of insulin is taken before meals?
Rapid-acting insulin if immediately before eating
Short acting insulin if 30mind before
How long does rapid acting insulin take to act and how long does it last?
5-10 mins
Lasts 2-5hrs
How long does short acting insulin take to work and how long does it last?
30mins-1hr
Lasts up to 8hrs
How long does intermediate acting insulin take to work and how long does it last?
2hrs
Lasts 8-14hrs
How long does long acting insulin take to work and how long does it last?
2hrs
Lasts 18-24hrs
Give some examples of intermediate-acting insulin.
Isophane insulin- insuman, Insulatard, Humulin
Give some examples of long-acting insulin.
Insulin detemir- Levemir
Insulin glargine- Lantus, Abasaglar
If using an insulin pump, which insulin is used alongside the pump?
Long-acting insulin
Benefits of insulin pump?
-Reduction of hypos
-Return of hypo awareness
-Improved control and flexibility
-No daily injections
-More accurate insulin delivery
Which type of insulin does the insulin pump use to control glucose levels?
Rapid-acting insulin
When may an insulin pump be considered for a patient?
If they have hypoglycaemia unawareness
If they would benefit from the flexibility a pump provides
If they experience Dawn Phenomenon- reasonable glucose levels overnight w dramatic rise upon waking
If trying for pregnancy
Inadequate control of diabetes
What are some of the challenges of an insulin pump?
-Risk of site infection
-Pump may malfunction
-Infusion set change required every 2-3 days
-Must have good knowledge of carbohydrate counting
-Pump must be worn all day, everyday
