T1DM Flashcards
What is T1DM?
Occurs when the pancreas does not produce insulin
Inability to convert glucose (sugar) into energy
Less sensitive to the effect of insulin (insulin resistance)
What are the two forms of T1DM?
Immune mediated: beta cells destroyed by autoimmune process
Idiopathic: cause of beta cell function loss
What are the sign and symptoms of T1DM?
Polyuria
Polydipsia
Fatigue
Wound healing
Weight loss
What is DKA?
Diabetic ketoacidosis:
Produce ketones to use for energy
Increase the bloods acidity
Loss of body salt & fluids
Immediate medical attention required
What are the complications of T1DM?
Heart disease (CVD)
Kidneys- Diabetic Kidney Disease (DKD)
Feet (Diabetic Neuropathy)
Eyes (Diabetic Retinopathy)
What are the ways to diagnose T1DM?
Fasting plasma glucose (FPG)
Random plasma glucose (any time of the day)
Oral glucose tolerance test (OGTT)
Fasting: 5.5–6.9
Random: 5.5–11.0 mmol/L
HbA1c
≤7%.
Geno testing
What are the symptoms of Hyperglycaemia >15mmol/L ?
Thirst++ Fatigue++ Blurred vision Urination++ Lack of concentration Irritable
What are the symptoms of Hypoglycaemia <4mmol/L ?
Shaking, trembling or weakness Sweating Light headed / headache Paleness Slurred speech Unconsciousness Confusion
When should you monitor your BGL’s?
Before breakfast (fasting)
Before lunch/dinner
Two hours after a meal
Before bed
Before rigorous exercise
When feeling unwell
What is the role of a Dietitian when working with a T1DM Patient?
Carbohydrate (CHO) awareness
CHO and GI
CHO distribution
Small, frequent meals
Monitor and change, monitor and change, monitor and change!
What is a possible PESS statement for a patient with T1DM?
(1) : Nutrition knowledge deficit related to new Dx T1DM as evidenced by HbA1c 11.8%, Wt loss 30kg (30%) LOW and diet Hx containing high GI foods.
(2) : Mild-Moderate malnutrition related to unintentional weight loss on b/g new Dx T1DM as evidenced by 30kg (30%) LOW and mild-moderate muscle wastage & subcutaneous fat loss, SGA B., HbA1c 11.8%.
What is a T1DM Patient Energy, Protein and Fluid Requirements?
EER: (100 - 125kJ/kg/d)
EPR: (0.8 - 1.2g/kg/d)
EFR: (30-35mL/kg/d)
What is the Intervention plan for a T1DM Patient?
Change to Diabetic diet & High Protein
Daily testing: fasting, pre BF/L/D & 2hrs post BF/L/D
Referral to Diabetes educator (DE)
NEMO FEEDS: Dietitian to provide education once stable.
Education provided on: Understanding 15g Carbohydrate (CHO) CHO counting Low glycemic (GI) diet CHO and exercise Protein prioritisation Provide hospital CHO ready reckoner