Random 9 Flashcards
When do patients with T2DM start having home monitoring?
- When they are started on insulin
- When they are started on hypoglycemic medication like gliclazide.
When do you have to inform the DVLA about a patient with T2DM?
If they are on insulin
Or they are on a hypoglycemic med for more than 3 months
What HBA1c level is considered diabetic?
> 48mmol/L
What is DAFNE?
Focus: DAFNE is primarily a program for adults with type 1 diabetes. It emphasizes flexible insulin dosing to match food intake, allowing individuals to lead a more normal life, including the flexibility to eat a varied diet.
What is DESMOND?
Focus: DESMOND is designed for individuals with type 2 diabetes, both newly diagnosed and those who have been living with the condition for some time. It focuses on lifestyle changes, including diet, physical activity, and emotional well-being.
What egfr level should you stop Metformin at?
35
Orlistat
Inhibits lipase which prevents the absorption of dietary fats in the body.
What are some risks of obesity that are independent of T2DM?
- Sleep apnoea
- Osteoarthritis
- Sudden death
- NAFLD
- GORD
What are DPP-4 inhibitors like sitagliptin and saxagliptin best for?
When you want to decrease HBA1c but not drop blood glucose too much.
What diabetic medication is best for weight loss?
GLP-1 inhibitors, semaglutide, liraglutide.
What diabetic medication is best for kidney protection?
SGLT-2 inhibitors.
What factors could precipitate DKA?
- Failure to take insulin
- Illness
- Trauma, emotional
- Hypovolaemia
How do patients with DKA present?
- Polyuria, polydipsia
- Dehydration
- Abdominal pain
- Fruity breath
- Combative, drunk, coma
What is the biochemical criteria for DKA?
Glucose >11mmol/L
Ketones >3mmol/L
Anion gap acidosis. pH <7.3, <15mmol/L, anion gap >12
What are treatment targets for DKA?
Reducing ketones by 0.5/h
Increasing HCO3 by 3/hr
Reducing glucose by 3/hr
Maintaining K at 4.5-5.5mmol/L
Biochemically, what does DKA resolution look like?
Ketones <0.3
Bicarbonate >15
pH >7.3
How does mannitol help with cerebral oedema?
Increased osmotic force in the bloodstream
Water is drawn into the bloodstream
This movement of water reduces the swelling in the brain tissue, alleviating cerebral edema.
What are complications of DKA?
- Shock
- Vascular thrombosis
- Pulmonary edema
- Cerebral edema
With hypoglycemia, what do you do if the patient is conscious, orientated and able to swallow.
Give any of the following
- Glass of lucozade
- Orange juice
- 3 dextrosol tablets
- Tube of glucose gel
- fortijuice for enteral feeding
With hypoglycemia, what do you do if the patient is conscious but confused, uncooperative or disorientated and unable to tolerate oral treatment
1mg of glucagon and given IM