Paeds endocrinology Flashcards
- Describe type 1 diabetes pathophysiology briefly
Ketogenesis occurs when
- Type 1 diabetes presentation
When a new diagnosis of type 1 diabetes is established the following bloods should be taken to exclude other associated pathology and get a baseline idea of the child’s overall health:
- Long term management of diabetes involves:
Insulin is usually prescribed as a combination of
Injecting insulin into the same spot repeatedly can cause a condition called
Insulin regimes are initiated by a specialist in diabetes. Patients are usually initiated on a… regime.
Insulin regimes are initiated by a specialist in diabetes. Patients are usually initiated on a basal-bolus regime.
what is a basal bolus insulin regime
- What are insulin pumps and how do they work?
To qualify for an insulin pump funded by the NHS the child needs to
To qualify for an insulin pump funded by the NHS the child needs to be over 12 and have difficulty controlling their HbA1c. Local criteria may vary.
- Advantages and disadvantages of an insulin pump
- There are two types of insulin pump:
Short term complications relate to immediate insulin and blood glucose management:
Hypoglycaemia
Hyperglycaemia (and DKA)
In diabetes, hypoglycaemia is caused by:….symptoms of hypoglaecemia are:
Hypoglycaemia needs to be treated with
Other causes of hypoglycaemia include
hypothyroidism
glycogen storage disorders
growth hormone deficiency
liver cirrhosis
alcohol and fatty acid oxidation defects (such as MCADD).
- Nocturnal hypoglycaemia is..it’s treated by
- How to treat patients with hyperglycaemia
- Long term complications of hyperglycaemia
- How is blood glucose monitored in diabetes
- How often is HbA1c measured in diabetes
every 3 to 6 months
Ketogenesis normally occurs when
- Ketone levels can be measured how?
Ketone levels can be measured in the urine using a** urine dipstick** and in the **blood **using a ketone meter.
- People in ketosis have a characteristic
People in ketosis have a characteristic acetone smell to their breath.
hen underlying pathology (i.e. type 1 diabetes) causes extreme hyperglycaemic ketosis, this results in
- Pathophysiology of DKA
Presentation of DKA
…should be monitored very closely (e.g. hourly) to look for signs of cerebral oedema. Signs include:
Children with DKA are at high risk of developing
Management options for cerebral oedema
Management options for cerebral oedema are slowing IV fluids, IV mannitol and IV hypertonic saline. These should be guided by an experienced paediatrician.
Diagnosing DKA
most common cause of hypothyrodism in children in the UK
