T1DM Flashcards

1
Q

ideal BG conc.

A

4.4-6.1mmol/l

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2
Q

insulin reduces blood sugar by -

A
  1. causes cells in body to absorb Glc and use it for fuel

2. causes muscel and liver to absorb Glc and store it as glycogen

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3
Q

how does glucagon increase BG

A
  1. tells liver to breakdown glycogen into glucose - glycogenolysis
  2. tells liver to convert proteins and fats into glucose - gluconeogenesis
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4
Q

when does ketogenesis occur

A

when there is insufficient glucose supply and glycogen stores are exhausted

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5
Q

ketogenesis

A

liver takes fatty acids and converts them to ketons –> water soluble fatty acids which can be used as fuel

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6
Q

how can ketone levels be measure

A

urine dipstix

blood ketone meter

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7
Q

T1DM

A

pancreas unable to produce insulin

–> cells cannot take up Glc –> think theyre being fasted and Glc levels continue to rise in blood

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8
Q

DKA

A

occurs when body doesn’t have enough insulin to use and produce glucose

–> ketoacidosis, dehyrdation, potassium imbalance

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9
Q

pathophys of DKA: ketoacidosis

A

cells in body have no fuel and think theyre starving to initiate ketogenesis

–> higher and higher glc and ketone levels

ketone acids use up bicarb produced by kindeys and blood becomes acidotic –> ketoacidosis

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10
Q

pathophys of DKA: dehydration

A

hyperglycemia overwhelmes kidneys and glc starts being filtered into urine

causes osmotic diuresis –> polyuria and polydiypsia

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11
Q

pathophys of DKA: potassium imbalance

A

without insulin, K is not driven into cells

serum K normal but total body K low as none in cells

when given insuline Rx, pt can develop severe hypokalaemia –> arrythmias

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12
Q

presentation of DKA

A

hyperglycaemia, dehyrdration, ketosis, metabolic acidosis, K+ issues

polyuria 
polydipsia 
N&V
actone smell breath
dehydratino --> low BP
alt conscoussness
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13
Q

most dangerous aspects of DKA

A

dehydration
K+ imbalance
acidosis

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14
Q

diagnosing DKA

A

hyperglycaemia >11
ketosis >3
acidosis ph < 7.3

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15
Q

treating DKA

A
fluid - IV resus w normal saline ]
insulin 0.1unit/kg/hr
glucose
potassium 
ketones
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16
Q

long term mx T1DM

A

patient education
s/c inuslin regeime
monitor BG AM, each meal, PM
monitor and manage complications

17
Q

typical insuline regime

A

combo:

background, long acting insulin OD

short acting insulin 30min before meal

18
Q

short term complicatinos

A

hypoglycaemia

hyperglycaemia –> DKA

19
Q

long term complications - why do they occur

A

chronic hyperglycaemia damages endothelial cells of blood vessels —> leakly, malfunctining vessels

high BG also suppreses immune system

20
Q

long term complication: macrovacular

A

CAD
peripheral ischemia
stroke
htn

21
Q

long term complications- microvascular

A

peripheral neuropathy
retinopathy
kidney disease

22
Q

long term complications- infection related

A

UTIs
pneumonia
skin and soft tissue esp feet
fungal esp candidiasis