T1DM_Flashcards

1
Q

What are the three types of insulin therapy for T1DM?

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

What is Multiple Daily Injection Basal-Bolus insulin therapy?

A

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

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3
Q

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

A

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

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4
Q

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

A

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

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5
Q

What insulin therapy should be offered from diagnosis?

A

Multiple daily injection basal-bolus insulin regimens

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6
Q

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

A

Continuous subcutaneous insulin infusion (CSII or pump therapy)

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7
Q

What dietary management is recommended for T1DM?

A

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

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8
Q

How often should blood glucose and HbA1c be monitored?

A

Routinely perform at least 5 capillary glucose tests per day

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9
Q

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

A

4-7 mmol/L

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10
Q

What is the blood glucose target after meals?

A

5-9 mmol/L

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11
Q

What is the blood glucose target if driving?

A

> 5 mmol/L

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12
Q

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

A

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

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13
Q

What is the HbA1c target?

A

< 48 mmol/L (6.5%)

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14
Q

What should be offered for blood ketone monitoring?

A

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

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15
Q

What psychological and social support should be offered?

A

Offer ongoing access to mental health services

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16
Q

What lifestyle advice should be given?

A

Encourage healthy, balanced diet and regular exercise

17
Q

What complications should be monitored annually from 12 years?

A

Diabetic retinopathy, nephropathy, and hypertension

18
Q

When should thyroid disease be monitored?

A

At diagnosis and annually until transfer to adult services

19
Q

What are the symptoms of DKA?

A

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

20
Q

What is the first-line medical treatment for hyperthyroidism?

A

Carbimazole or propylthiouracil

21
Q

What is DKA?

A

A complication of diabetes where the blood sugars get very high

22
Q

What are the features of DKA?

A

Drowsiness, abdominal pain, nausea

23
Q

Why is DKA important?

A

It can lead to severe dehydration

24
Q

What are the steps in the acute management of DKA?

A

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

25
Q

What factors can lead to an episode of DKA?

A

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

26
Q

What advice should be given on managing intercurrent illness?

A

Increased insulin demand management

27
Q

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

A

See diabetes specialist to discuss treatment

28
Q

What support organization can help with diabetes?

A

Diabetes UK

29
Q

How should you explain the diagnosis of hyperthyroidism?

A

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

30
Q

How common is hyperthyroidism?

A

It is reasonably common and well understood

31
Q

What does the management of hyperthyroidism involve?

A

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

32
Q

What is the importance of good blood glucose control?

A

It helps prevent complications such as kidney and blood vessel damage

33
Q

How can you identify DKA?

A

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

34
Q

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

A

They help maintain good blood glucose control and overall health