Management of Type 1 Diabetes

Question 1

what are the different insulin action durations that exist?

Answer 1

> rapid acting
> short acting
> intermediate acting
> long acting
> continuous sub cutaneous insulin infusion

Question 2

where is insulin injected into?

Answer 2

the subcutaneous fat, the needle site is rotated

Question 3

true or false:

rapid short acting insulin cover carbohydrates in meals with 1 unit covering 10g

Answer 3

true

Question 4

what lifestyle adjustments might have to be considered?

Answer 4

> exercise
> driving
> alcohol
> conception
> drugs
> holidays
> employment

Question 5

what could cause hypoglycaemia?

Answer 5

> food (too little/wrong type)
activity
insulin (dose/injection technique)
alcohol

Question 6

who is at risk of hypoglycaemia?

Answer 6

> tight glycaemic control
> impaired awareness/cognition
> malabsorption
> hypoadrenalism
> coeliac disease
> renal/hepatic impairement
> pancreatectomy

Question 7

what are some autonomic symptoms of hypo?

Answer 7

> sweating
palpitations
shaking
hunger

Question 8

what are some neurological symptoms of hypo?

Answer 8

> confusion
> drowsiness
> odd behaviour
> speech difficulty
> incoordination

Question 9

what are symptoms of DKA?

Answer 9

> nausea/vomiting
> abdominal pain
> sweet smelling breath
> drowsiness
> deep respiration
> coma
> tachycardia
> low BP

Question 10

when may there be loss of warning signs of a hypo?

Answer 10

> recurrent severe hypoglycaemia

> long disease duration

Question 11

how is hypoglycaemia treated?

Answer 11

> 15-20g simple CHO
out of hospital 1mg IM glucose
in hospital 75-80ml 20%/10% glucose
follow up with long acting CHO

Question 12

what are the sick day rules in insulin treated patients?

Answer 12

> NEVER stop insulin
adjust the dose according to the blood glucose
perform frequent checks
check blood/urine for ketones
if unable to tolerate food must maintained CHO intake with fluids