T1DM_Flashcards

Question 1

What are the three types of insulin therapy for T1DM?

Answer 1

1. Multiple Daily Injection Basal-Bolus
2. Continuous Subcutaneous Insulin Infusion (insulin pump therapy)
3. One, Two or Three Insulin Injections Per Day

Question 2

What is Multiple Daily Injection Basal-Bolus insulin therapy?

Answer 2

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

Question 3

What is Continuous Subcutaneous Insulin Infusion (insulin pump therapy)?

Answer 3

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

Question 4

What is the regimen for One, Two or Three Insulin Injections Per Day?

Answer 4

Injections of short-acting insulin or rapid-acting insulin analogue mixed with intermediate-acting insulin

Question 5

What insulin therapy should be offered from diagnosis?

Answer 5

Multiple daily injection basal-bolus insulin regimens

Question 6

What is considered if multiple daily injection basal-bolus insulin regimens are inappropriate?

Answer 6

Continuous subcutaneous insulin infusion (CSII or pump therapy)

Question 7

What dietary management is recommended for T1DM?

Answer 7

Offer level 3 carbohydrate counting education from diagnosis and to family members

Question 8

How often should blood glucose and HbA1c be monitored?

Answer 8

Routinely perform at least 5 capillary glucose tests per day

Question 9

What are the blood glucose targets for fasting plasma glucose and other times?

Answer 9

4-7 mmol/L

Question 10

What is the blood glucose target after meals?

Answer 10

5-9 mmol/L

Question 11

What is the blood glucose target if driving?

Answer 11

> 5 mmol/L

Question 12

Who should be offered ongoing real-time continuous glucose monitoring with alarms?

Answer 12

Children with frequent severe hypoglycaemia, impairment awareness of hypoglycaemia with adverse consequences, inability to recognise or communicate symptoms of hypoglycaemia

Question 13

What is the HbA1c target?

Answer 13

< 48 mmol/L (6.5%)

Question 14

What should be offered for blood ketone monitoring?

Answer 14

Offer blood ketone testing strips and a meter and advise testing for ketonaemia if they are ill or hyperglycaemic

Question 15

What psychological and social support should be offered?

Answer 15

Offer ongoing access to mental health services

Question 16

What lifestyle advice should be given?

Answer 16

Encourage healthy, balanced diet and regular exercise

Question 17

What complications should be monitored annually from 12 years?

Answer 17

Diabetic retinopathy, nephropathy, and hypertension

Question 18

When should thyroid disease be monitored?

Answer 18

At diagnosis and annually until transfer to adult services

Question 19

What are the symptoms of DKA?

Answer 19

Nausea/vomiting, abdominal pain, hyperventilation, dehydration, reduced consciousness

Question 20

What is the first-line medical treatment for hyperthyroidism?

Answer 20

Carbimazole or propylthiouracil

Question 21

What is DKA?

Answer 21

A complication of diabetes where the blood sugars get very high

Question 22

What are the features of DKA?

Answer 22

Drowsiness, abdominal pain, nausea

Question 23

Why is DKA important?

Answer 23

It can lead to severe dehydration

Question 24

What are the steps in the acute management of DKA?

Answer 24

Giving fluids and insulin to get the blood glucose back to a healthy range

Question 25

What factors can lead to an episode of DKA?

Answer 25

Intercurrent illness (e.g. viral infections leading to increased insulin demand)

Question 26

What advice should be given on managing intercurrent illness?

Answer 26

Increased insulin demand management

Question 27

What should be arranged for a patient after a DKA episode?

Answer 27

See diabetes specialist to discuss treatment

Question 28

What support organization can help with diabetes?

Answer 28

Diabetes UK

Question 29

How should you explain the diagnosis of hyperthyroidism?

Answer 29

A condition where the body is unable to control the sugar levels in the blood

Question 30

How common is hyperthyroidism?

Answer 30

It is reasonably common and well understood

Question 31

What does the management of hyperthyroidism involve?

Answer 31

Regular self-monitoring of glucose levels (using skin prick) and taking insulin injections

Question 32

What is the importance of good blood glucose control?

Answer 32

It helps prevent complications such as kidney and blood vessel damage

Question 33

How can you identify DKA?

Answer 33

Look for symptoms such as nausea, vomiting, abdominal pain, hyperventilation, dehydration, and reduced consciousness

Question 34

What is the importance of regular exercise and a balanced diet in managing diabetes?

Answer 34

They help maintain good blood glucose control and overall health