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PY6030 > Pathophysiology & Insulin Therapy > Flashcards

Pathophysiology & Insulin Therapy Flashcards

1
Q

Which tests should be performed if a person is presenting with symptoms of diabetes?

A
  1. OGTT
  2. Random BG test
  3. Fasting BG test
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2
Q

What does the c-peptide link in an insulin molecule?

A

It links the alpha & beta chains of the insulin molecule.

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3
Q

What can c peptide measurements in the urine tell us?

A

How much insulin secretion there is in the body.

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4
Q

What are the steps of treatment for a type 2 diabetic?

A
  1. Diet & exercise
  2. Oral monotherapy
  3. Oral combination
  4. Insulin + oral agents
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5
Q

What happens when a diabetic patient goes into ketosis, on a cellular level?

A

When they have a lack of insulin, adipose tissue breaks down, as glucose cannot be up-taken by cells.
This produces fatty acids which break down into ketones, leaving the blood more acidic.

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6
Q

What are insulin analogues?

A

They are altered amino acid sequences of normal insulin.

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7
Q

What is the benefit of using an insulin analogue?

A

You can change the duration of action for each analogue (rapid, intermediate, slow)

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8
Q

What is an example of a short-acting insulin?

A

Actrapid.

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9
Q

What are some examples of medium-long acting insulins?

A

Insulatard
Ultratard
Humulin I

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10
Q

What are some examples of mixed insulins?

A

Mixtard 30/70

Humulin M3

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11
Q

What are some examples of rapid-acting analogues?

A

Novorapid
Humalog
Apidra

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12
Q

What are some examples of long-acting analogue mixtures?

A

Lantus
Levemir
Tresiba

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13
Q

What are some examples of analogue mixtures (biphasic)?

A

Humalog mix 25, or mix 30

Novomix 30

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14
Q

What type of therapy is used for type 1 diabetics?

A

Basal-bolus therapy

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15
Q

Why are stronger concentrations of insulin sometimes used?

A

To inject a small volume.

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16
Q

When are rapid-acting analogues given?

A

5-15mins before a meal

17
Q

When are basal or intermediate insulins given?

A

A set time everyday.

18
Q

Which layer of the skin do smaller needles penetrate into?

A

The subcutaneous layer

19
Q

What is lipohypertrophy?

A

Lumps of fat or scar tissue formed due to the patient not rotating their sites of injection.

20
Q

How do insulin (CSII) pumps work?

A

CSII: continuous subcutaneous insulin infusion
A pump reservoir holds 2-3 days worth of insulin inside it.
A cannula is inserted into the skin to deliver this insulin.
The pump then delivers either a basal or set rate of insulin.

21
Q

What are the benefits of using a BG sensor?

A
  1. Allows continuous BG monitoring
  2. Alarms can be set to avoid hypos/hypers
  3. BG can be measured any minute
  4. Health care professional can access sensor information & see any patterns
22
Q

How is DKA treated?

A
  1. IV fluids to restore dehydration
  2. Set insulin infusion rate to restore BG (only for type 1, not type 2)
  3. K+ supplement
23
Q

In what 2 bodily fluids can ketones be measured in?

A

Blood & urine.

24
Q

What are the potential differential diagnosis for DKA?

A
  1. Alcohol abuse
  2. Starvation
  3. Chronic renal failure
  4. Lactic acidosis
  5. Drug toxicity
25
Q

What 2 treatments do hypos occur in more?

A
  1. Insulin therapy

2. Sulphonylureas

26
Q

What is hypo-unawareness?

A

When the patient is asymptomatic of their hypoglycaemia (can be dangerous)

27
Q

What are some common causes of developing a hypo?

A
  1. Missed/delayed meals
  2. Overdose/misestimating insulin dose
  3. Weight loss
  4. Poor injection technique
  5. Renal/hepatic impairment
  6. Increased physical activity
28
Q

What are some symptoms of hypoglycaemia?

A
  1. Shaking
  2. Sweating
  3. Hunger
  4. Weakness/fatigue
  5. Impaired vision
29
Q

How do you treat a hypo?

A

Give a sugary drink + a long-acting carbohydrate

PY6030 (23 decks)

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