Treatment of Type 1 Diabetes Flashcards
what devices are available for secreting insulin?
syringe
disposable pen
reuasable cartridge pen
insulin infusion pump
what is the clinical presentation of hyperglycaemia?
thirst tiredness polyuria nocturia blurred vision weight loss fungal infections
what is the clinical presentation of hypoglycaemia?
pallor sweating tremor palpitations confusion nausea hunger cognitive dysfuntion eg confusion coma
what is basal insulin?
the first round of insulin secreted by the body in reacting to the body’s fasting glucose
what is post prandial insulin?
insulin secreted in relation to post meal glucose
what could be happening if the patient is spiking after a meal?
they aren’t taking their insulin properly
are analogues or pure human insulin?
analogues
what duration does levemir have?
long acting
what duration does novamix 30 have?
rapid acting analogue-intermediate
what duration does humulin 1 have?
intermediate acting
what duration does humulin m3 have?
short acting intermediate
what is the basal bolus regime of insulin aiming to replicate?
normal endogenous insulin production
what is the basal dose of insulin aiming to do?
keep resting glucose levels normal
what is the bolus does of insulin aiming to do?
keep post prandial glucose levels normal
how often is basal insulin takn?
once or twice depending on the insulin
how often is bolus insulin taken?
before insulin
what does prandial insulin need to be matched to?
carb intake
pre meal glucose
future activity eg exercise
how should you work out how many units someone needs of basal bolus insulin?
have 0,3 units per kg body weight
what would you give a 60kg male for his basal/bolus injections?
9 units basal before bed
3 units before each meal (9)
glucose target for T1DM’s pre meal?
4-7mmol/l
glucose target after a meal?
<10mol/l
how long does soluble insulin take to work?
30-60mins
when does soluble insulin peak in activity?
2-4hrs
when do insulin analgoes peak?
60-90 mins
how long do analogues take to work?
10-15 mins
what glucose level should patients not go to bed with?
<8mmol/l
what does DAFNE stand for?
dose adjusted for normal eating
what does SCII stand for?
constinuous subcutaneous insulin infusion
what BGL would make you consider the patients insulin to carb ratio?
if BGL is more than 2mmol/l above fasting glucose after 2hr of eating on 3 consecutive days
what kind of insulin is secreted by insulin pumps?
short acting
do they administer basal doses, bolus doses or both?
both
is the patient’s basal rate a constant?
no, it changes every day
how is the patients glucose montiored?
home blood close monitor
urinalysis for glucose and ketones
HbA1C
CGM
why do some patients get hyperglycaemic even when taking insulin?
too slow to work
what checks of the patient are important to reduce risk of hyperglycaemia?
check injection sites for lipohypertrophy
check patients needle and equipment
check they arent sharing needles
are insulin units and grams the same thing?
NO
when would you give IV insulin?
DKA
hyperosmolar hyperglycaemic state
acute illness
patients who cant have PO
when should you check ketones in a patient with IV insulin?
BG >12mmol
which mode of insulin therapy can cause lung cancer?
inhaled
what are all the different types of insulin delivery?
inhaled
subcutaneous
iv
oral
