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2 Endocrine > Treatment of Type 1 Diabetes > Flashcards

Treatment of Type 1 Diabetes Flashcards

1
Q

what devices are available for secreting insulin?

A

syringe
disposable pen
reuasable cartridge pen
insulin infusion pump

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2
Q

what is the clinical presentation of hyperglycaemia?

A 
thirst
tiredness
polyuria
nocturia
blurred vision
weight loss
fungal infections
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3
Q

what is the clinical presentation of hypoglycaemia?

A 
pallor
sweating
tremor
palpitations
confusion
nausea
hunger
cognitive dysfuntion eg confusion
coma
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4
Q

what is basal insulin?

A

the first round of insulin secreted by the body in reacting to the body’s fasting glucose

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5
Q

what is post prandial insulin?

A

insulin secreted in relation to post meal glucose

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6
Q

what could be happening if the patient is spiking after a meal?

A

they aren’t taking their insulin properly

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7
Q

are analogues or pure human insulin?

A

analogues

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8
Q

what duration does levemir have?

A

long acting

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9
Q

what duration does novamix 30 have?

A

rapid acting analogue-intermediate

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10
Q

what duration does humulin 1 have?

A

intermediate acting

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11
Q

what duration does humulin m3 have?

A

short acting intermediate

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12
Q

what is the basal bolus regime of insulin aiming to replicate?

A

normal endogenous insulin production

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13
Q

what is the basal dose of insulin aiming to do?

A

keep resting glucose levels normal

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14
Q

what is the bolus does of insulin aiming to do?

A

keep post prandial glucose levels normal

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15
Q

how often is basal insulin takn?

A

once or twice depending on the insulin

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16
Q

how often is bolus insulin taken?

A

before insulin

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17
Q

what does prandial insulin need to be matched to?

A

carb intake
pre meal glucose
future activity eg exercise

18
Q

how should you work out how many units someone needs of basal bolus insulin?

A

have 0,3 units per kg body weight

19
Q

what would you give a 60kg male for his basal/bolus injections?

A

9 units basal before bed

3 units before each meal (9)

20
Q

glucose target for T1DM’s pre meal?

A

4-7mmol/l

21
Q

glucose target after a meal?

A

<10mol/l

22
Q

how long does soluble insulin take to work?

A

30-60mins

23
Q

when does soluble insulin peak in activity?

A

2-4hrs

24
Q

when do insulin analgoes peak?

A

60-90 mins

25
Q

how long do analogues take to work?

A

10-15 mins

26
Q

what glucose level should patients not go to bed with?

A

<8mmol/l

27
Q

what does DAFNE stand for?

A

dose adjusted for normal eating

28
Q

what does SCII stand for?

A

constinuous subcutaneous insulin infusion

29
Q

what BGL would make you consider the patients insulin to carb ratio?

A

if BGL is more than 2mmol/l above fasting glucose after 2hr of eating on 3 consecutive days

30
Q

what kind of insulin is secreted by insulin pumps?

A

short acting

31
Q

do they administer basal doses, bolus doses or both?

A

both

32
Q

is the patient’s basal rate a constant?

A

no, it changes every day

33
Q

how is the patients glucose montiored?

A

home blood close monitor
urinalysis for glucose and ketones
HbA1C
CGM

34
Q

why do some patients get hyperglycaemic even when taking insulin?

A

too slow to work

35
Q

what checks of the patient are important to reduce risk of hyperglycaemia?

A

check injection sites for lipohypertrophy
check patients needle and equipment
check they arent sharing needles

36
Q

are insulin units and grams the same thing?

A

NO

37
Q

when would you give IV insulin?

A

DKA
hyperosmolar hyperglycaemic state
acute illness
patients who cant have PO

38
Q

when should you check ketones in a patient with IV insulin?

A

BG >12mmol

39
Q

which mode of insulin therapy can cause lung cancer?

A

inhaled

40
Q

what are all the different types of insulin delivery?

A

inhaled
subcutaneous
iv
oral

2 Endocrine (35 decks)

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