T1DM

Question 1

what is the cause of hyperglycaemia in t1dm

Answer 1

destruction of insulin producing pancreatic beta cells

Question 2

list some common symptoms of t1dm

Answer 2

polyuria
polydipsia
fatigue
weight loss

Question 3

list some acute complications of diabetes

Answer 3

hypoglycaemia
hyperglycaemia
dka

Question 4

dka is a life threatening emergency when the lack of insulin and high blood sugars leads to the build of x

Answer 4

ketones

Question 5

hypo or hyper glycaemia :

shaky
disorientated
sweaty
anxious
palpitations
blurred vision

Answer 5

hypo

Question 6

hypo or hyper glycaemia :

polyuria
polydipsia
tired
thrush
skin infections
weight loss
feeling sick

Answer 6

hyper

Question 7

how can the 2 types of chronic or long term complications of diabetes be classified

Answer 7

micro and macro vascular

Question 8

micro or macro vascular:

eye
kidneys
neuropathy

Answer 8

micro

Question 9

micro or macro vascular:

increased stroke risk
cvd and peripheral vascular disease

Answer 9

macro

Question 10

what is the point of exogenous insulin?

Answer 10

to mimic normal insulin secretion in response to meals

Question 11

the mainstay of most insulin regimens for t1dm is the basal bolus regimen, what is this

Answer 11

combination of rapid and long acting insulins

Question 12

type and onset of insulin glusiline/ apidra

Answer 12

quick acting and 15 mins

Question 13

type and onset of insulin lispro/ humalog

Answer 13

quick acting and 15 mins

Question 14

type and onset of insulin aspart/ novorapid

Answer 14

quick acting and 15 mins

Question 15

type and onset of regular insulin/ actrapid

Answer 15

quick acting and 30 mins

Question 16

what are the following all examples of in term s of type of insulin

glulisine/ aprida solostar
lispro/ humalog
aspart/ novorapid flexpen
actrapid

Answer 16

quick acting

Question 17

type and onset of NPH insulin/ insulatard

Answer 17

intermediate acting and 60 mins

Question 18

insulin glargine and detemir are both examples of x acting insulin

Answer 18

long (>60 mins)

Question 19

basal bolus regime requires multiple injections a day and the ability to dose adjust according to x content of meals

Answer 19

carbohydrate

Question 20

onset of action of biphasic insulins (pre mixed insulins)

Answer 20

15 mins

Question 21

premixed or biphasic insulins allow for a more fixed regimen with X a day injections

Answer 21

twice

Question 22

true or false, nice recommends that all type 1 diabetics have access to a continuous blood glucose monitor

Answer 22

true

Question 23

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

Answer 23

hba1c

Question 24

target fasting plasma glucose level on waking mmol/l

Answer 24

5-7

Question 25

plasma glucose level before meals at times other than the morning in mmol/l

Answer 25

4-7

Question 26

what is the usual blood glucose target in mmol/l if measured at least 90 mins after eating

Answer 26

5-9

Question 27

The gold standard insulin regimen is the basal-bolus regimen. how many times a day does the person inject?

Answer 27

4 injections daily
rapid before meals
long acting once at bedtime

Question 28

true or false, basal bolus regimen does not replicate the physiological secretion of insulin

Answer 28

false

Question 29

where are patients advised to store insulin

Answer 29

in fridge until open and then fine for 4 weeks at room temperature

Question 30

where are patients advised to inject insulin

Answer 30

sc injection so anywhere with fatty layer like leg bum or belly

Question 31

what should the label be for insulin pens

Answer 31

as directed as they take varying amounts. be aware of strength as that is not the actual value they inject

Question 32

does all hypoglycaemia need to be treated promptly

Answer 32

yes

Question 33

should you allow self administration of insulin in hospital

Answer 33

yes - less errors

Question 34

should you increase regular insulin doses in illness

Answer 34

yes

Question 35

what does endogenous pro-insulin get converted to

Answer 35

c peptide and insulin

Question 36

how do you know if someone has been poisoned by insulin

Answer 36

lack of c peptide. need to take level before its administered

Question 37

what happens if someone is on a long acting insulin and does not have regular meals

Answer 37

become hypoglycaemic