Type 1 Diabetes Flashcards
what is type 1 diabetes?
cell mediated autoimmune destruction of pancreatic beta cells causing absolute deficiency of endogenous insulin
how does urine help with the diagnosis of diabetes?
Glucose in Urine – this happens when the plasma glucose concentration is above the renal threshold (6-14mmol/L). Higher in older people
what happens to vision in type 1 diabetes?
vision becomes blurred
how does ketoacidosis occur?
by the beta-oxidation of free fatty acids which leads to ketone bodies forming – these deplete acid buffers and acidosis occurs
what are symptoms of diabetic ketoacidosis?
- severe vomiting
- abdominal pain
- deep sighing respirations (kussmaul respirations)
- sweet smelling - acetone/nail varnish
- reduced consciousness
What are the 8 types of acting insulin?
- Ultra Rapid Acting
- Rapid acting.
- Short acting.
- Intermediate acting.
- Long acting.
- Ultra long acting
- Human mixed insulins.
- Analogue mixed insulins.
when should you take an ultra-rapid acting insulin?
just before, with or up to 20min after food
when should you take a rapid acting insulin?
just before, with or just after food
when should you take a short acting insulin?
30min before food
when should you take intermediate acting insulin?
30min before food or bedtime
when should you take a long-acting insulin analogue?
once or twice a day
when should you take an ultra long-acting insulin analogue?
once a day
when should you take an analogue mixed insulin?
just before, with or just after food
when should you take human mixed insulin?
30 minutes before a meal
what 5 things does the dose of insulin injected depended on?
- age
- exercise
- physical activity
- stress
- hormonal changes
explain how basal bolus works?
basal=just given once/twie daily for baseline insulin conc
bolus= given at each main meal
what is the honeymoon period?
a remission when either no insulin or a much reduced dose is required to remain euglycaemic
at what angle must one inject the insulin?
90 degrees
Where are the 5 injection sites?
- subcutaneous injection
- abdomen- faster
- back of arms- faster absorption
- thighs- slower absorption
- buttocks-slower
what is the injection technique?
- find clean skin
- insert the needle
- push the needle
- leave the needle in for 10 seconds
- remove the needle
what does DAFNE stand for?
dose adjustment for normal eating
how often should a diabetic check their blood glucose whilst driving?
every 2 hrs
at what blood glucose should a diabetic not drive?
<5mmol/L
how long should you not drive for if your blood glucose is <5mmol/L?
do not drive for 45 mins
what is the problem with having lypohypertrophy?
- delayed absorption can occur which leads to hypo or hyperglycaemic episodes
- may result in unncessary large doses of insulin being used
what temperature should insulin be used at?
at room temp
what are the SICK day rules?
- monitor blood glucose every 2-3 hrs or as neccessary
- take insulin- could cause DKA otherwise
- Drink lot of fluid and carbs (if sugars are low)
- check urine or blood ketones every 4hrs
Take rapid acting inslin if ketones are high
if a lady with diabetes goes on to become pregnant, what do you give her?
folic acid once a day
what three oral drugs can be added to the use of insulin?
- metformin
- GLP1
- SGLT2 inhibitors
what is the benefit of using metformin?
improves body weught
improved lipid profile
what is the benefit of using GLP1?
reduces HBA1C
reduces weight
what is the benefit of using SGLT2 inhibitors?
- reduced HBA1C
what is the downside to using SGLT2 inhibitors?
used in type 1 diabetes is associated with a 2-4 fold increase in ketoacidosis
