Module 1 Flashcards
what are the acute complications of diabetes mellitus
- hypoglycaemia
- hyperglycaemia in very unwell patients
- diabetic ketoacidosis - type 1 DM
- hyperosmolar hyperglycaemic state/syndrome - type 2 DM
complications of Type 1 and 2 DM
what is hypoglycaemia
- defined as a BGL <4mmoI/L
- can be fatal
causes - medication overdose
- not eating enough carbohydrates or skippin meals
- excess alcohol consumption
- excessive exercise
- malnutrition
clinical manifestations
hypoglycaemia
- BGL <4mmoI/L
- sweating
- pale
- hunger
- dizziness
- anxiety
- seizures
- coma
- death
- vision changes
hypoglycaemia - management
- if the person is unconciouss, drowsy - do not give them food
- medical emegrency
- check BGL <4mmoI/L
- eat 15-20g of fast acting carbohydrates
complications of hyperglycaemia
- acutely unwell
- stress mehcanism
- impaired insulin function
- hyperglycaemia
what is diabetic ketoacidosis (DKA)
- medical condition
- related to hyperglycaemia
- due to lack of insulin leading to glucose build up in blood
risk factors of DKA
- new diagnosis
- acute stress or illness
- omission of inuslin
- lack of access to medical care
DKA clinical manifestations
lab markers
* BGL >11mmoI/L
* ketones present in blood and urine
symptoms
* sunken eyes
* dry skin
* headache
* polyuria
* polydipsia
* abdo pain
DKA management
- correction of dehydration
- reverse ketosis
- acid base and electrolyte corrections
complications
hyperosmolar hyperglycaemic state (HHS)
- complications arising from T2D seen at initial presentation
- severe dehydration
- high serum osmality
- very unwell
risk factor/ causes of HHS
- elderly - reduced thirst or fluid intake
- poorly controlled t2d
- infection and illness
- drugs that reduce insulin action
clinical manifestations of HHS
lab markers
* BGL >30mmoI/L
* ketones can be present/ absent
symptoms
* polyuria +
* polydispia +
* sunken eyes
* coma
* seizures
* abdo pain
* weakness
* cramps
* dry skin
HHS management
- correction of dehydration
- reverse hyperglycaemia
- acid base and electrolyte corrections
whats the normal fasting BGL range
4-6 mmoI/L
what causes type 1 diabetes
- autoimmune destruction of the beta cells
- genetics
- envrionmental factors - drugs, viruses
- non immune mediated diabetes - secondary to other conditons (pancreas_
whats the pathophysiology of T1D
- genetic factors or viral infections cause
- immune response against beta cells which cause
- beta cell destruction
- lack of insulin released
- GLUT - 4s are not activated
- glucose unable to be taken up by cells leads to either
- hyperglycaemia which leads to T1D OR
- release of glucagon which leads to
- liver continuing to release glucose which leads to hyperglycaemia which leads to T1D
clinical manifestations of T1D
- 3 P’s (polyphagia, polyuria, polydispia)
- fatigue
- weight loss
- blurred vision
- confusion
- abdo pain
- nausea/ vomitting
- coma
treatment of T1D
- insulin is the only teatment option for T1DM
- protein based molecule
risk factors of T2D
- genetic factors/ family history
- overweight/ obese
- sedentary lifestyle
- age 35> + overweight
- history of gestational diabetes
pathophysiology of T2D
- characterised by insulin resistance
- decreased insulin production
- increased insulin resistance at the cell
- decrease beta cell responsiveness
what is the inflammatory response
- response is rapid
- limit the extent of injury
- destroy contaminating infectious microorganisms
- initate the immune response
- begin healing process
homeostaitic role in PGs, TXA2 and COX
- COX enzymes are required to produce the mediators thromboxanes and prostaglandins
- thromboxanes - involved in blood clotting function
- PGI2- initate platlet activation
what causes hypoglycaemia
- excess alcohol consumption
- exercise
- insulin overdose
what contributes to an increased insulin resistance and decreased production in T2D
- a reduction in the number of insulin binding sites
- a decrease in the amount of insulin binding to the receptors
- decreased insulin production in the pancreas
what can increase the risk of a person developing T2D
having both parents and a maternal grandmother diagnosed with T2D
what is the role of insulin?
- allows glucose uptake into the cells for ATP production
- stimulate protein syntheis
- inhibits liver production of glucose
the role of insulin is to what?
reduce blood glucose levels
after the consumption of carbohydrates, the pancreas releases what?
insulin
when required for energy the liver breakdowns stored glycogen ans converts it to what?
glucose
a BGL less than 4.0mmo/L is known as what ?
hypoglycaemia
it is important to maintain fasting BGL between what?
4 to 6 mmo/L to prevent disease
what can cause hypoglycaemia
- exercise
- insulin overdose
- excess alcohol consumption
the role of insulin includes what
- stimulates protein synthesis
- allows glucose uptake into the cells for ATP production
- inibits liver production of glucose
what is the first line treatment for type 2 diabetes
increasing physical activity
