T1DM_Flashcards
What are the three types of insulin therapy for T1DM?
- Multiple Daily Injection Basal-Bolus
- Continuous Subcutaneous Insulin Infusion (insulin pump therapy)
- One, Two or Three Insulin Injections Per Day
What is Multiple Daily Injection Basal-Bolus insulin therapy?
Injections of short-acting insulin or rapid-acting insulin analogue before meals, with 1 or more separate daily injections of intermediate acting insulin or long-acting insulin analogue
What is Continuous Subcutaneous Insulin Infusion (insulin pump therapy)?
Programmable pump and insulin storage device that gives regular or continuous amounts of insulin (usually rapid-acting insulin or short-acting insulin) by a subcutaneous cannula
What is the regimen for One, Two or Three Insulin Injections Per Day?
Injections of short-acting insulin or rapid-acting insulin analogue mixed with intermediate-acting insulin
What insulin therapy should be offered from diagnosis?
Multiple daily injection basal-bolus insulin regimens
What is considered if multiple daily injection basal-bolus insulin regimens are inappropriate?
Continuous subcutaneous insulin infusion (CSII or pump therapy)
What dietary management is recommended for T1DM?
Offer level 3 carbohydrate counting education from diagnosis and to family members
How often should blood glucose and HbA1c be monitored?
Routinely perform at least 5 capillary glucose tests per day
What are the blood glucose targets for fasting plasma glucose and other times?
4-7 mmol/L
What is the blood glucose target after meals?
5-9 mmol/L
What is the blood glucose target if driving?
> 5 mmol/L
Who should be offered ongoing real-time continuous glucose monitoring with alarms?
Children with frequent severe hypoglycaemia, impairment awareness of hypoglycaemia with adverse consequences, inability to recognise or communicate symptoms of hypoglycaemia
What is the HbA1c target?
< 48 mmol/L (6.5%)
What should be offered for blood ketone monitoring?
Offer blood ketone testing strips and a meter and advise testing for ketonaemia if they are ill or hyperglycaemic
What psychological and social support should be offered?
Offer ongoing access to mental health services