T1DM Flashcards
what is the cause of hyperglycaemia in t1dm
destruction of insulin producing pancreatic beta cells
list some common symptoms of t1dm
polyuria
polydipsia
fatigue
weight loss
list some acute complications of diabetes
hypoglycaemia
hyperglycaemia
dka
dka is a life threatening emergency when the lack of insulin and high blood sugars leads to the build of x
ketones
hypo or hyper glycaemia :
shaky
disorientated
sweaty
anxious
palpitations
blurred vision
hypo
hypo or hyper glycaemia :
polyuria
polydipsia
tired
thrush
skin infections
weight loss
feeling sick
hyper
how can the 2 types of chronic or long term complications of diabetes be classified
micro and macro vascular
micro or macro vascular:
eye
kidneys
neuropathy
micro
micro or macro vascular:
increased stroke risk
cvd and peripheral vascular disease
macro
what is the point of exogenous insulin?
to mimic normal insulin secretion in response to meals
the mainstay of most insulin regimens for t1dm is the basal bolus regimen, what is this
combination of rapid and long acting insulins
type and onset of insulin glusiline/ apidra
quick acting and 15 mins
type and onset of insulin lispro/ humalog
quick acting and 15 mins
type and onset of insulin aspart/ novorapid
quick acting and 15 mins
type and onset of regular insulin/ actrapid
quick acting and 30 mins
what are the following all examples of in term s of type of insulin
glulisine/ aprida solostar
lispro/ humalog
aspart/ novorapid flexpen
actrapid
quick acting
type and onset of NPH insulin/ insulatard
intermediate acting and 60 mins
insulin glargine and detemir are both examples of x acting insulin
long (>60 mins)
basal bolus regime requires multiple injections a day and the ability to dose adjust according to x content of meals
carbohydrate
onset of action of biphasic insulins (pre mixed insulins)
15 mins
premixed or biphasic insulins allow for a more fixed regimen with X a day injections
twice
true or false, nice recommends that all type 1 diabetics have access to a continuous blood glucose monitor
true
long term control is measured by looking at the average blood glucose levels over the previous 2-3 months and this parameter is referred to as
hba1c
target fasting plasma glucose level on waking mmol/l
5-7
plasma glucose level before meals at times other than the morning in mmol/l
4-7
what is the usual blood glucose target in mmol/l if measured at least 90 mins after eating
5-9
The gold standard insulin regimen is the basal-bolus regimen. how many times a day does the person inject?
4 injections daily
rapid before meals
long acting once at bedtime
true or false, basal bolus regimen does not replicate the physiological secretion of insulin
false
where are patients advised to store insulin
in fridge until open and then fine for 4 weeks at room temperature
where are patients advised to inject insulin
sc injection so anywhere with fatty layer like leg bum or belly
what should the label be for insulin pens
as directed as they take varying amounts. be aware of strength as that is not the actual value they inject
does all hypoglycaemia need to be treated promptly
yes
should you allow self administration of insulin in hospital
yes - less errors
should you increase regular insulin doses in illness
yes
what does endogenous pro-insulin get converted to
c peptide and insulin
how do you know if someone has been poisoned by insulin
lack of c peptide. need to take level before its administered
what happens if someone is on a long acting insulin and does not have regular meals
become hypoglycaemic
