Type 1 Diabetes

Question 1

Target BMs for before a meal

Answer 1

4-7

Question 2

Target BMs on waking

Answer 2

5-7

Question 3

Describe optimum insulin regimen (3)

Answer 3

1. Basal-bolus preferred
2. Insulin detemir 2x day or Glargine 1x a day
   plus
3. Rapid acting insulin analogues for boluses - better than animal or human insulins

Question 4

When to add metformin to T1DM management/workup? (1)

Answer 4

1. at BMI >25

Question 5

Describe how you would administer insulin in DKA? (rate, timing, what to do with patients home insulin) (3)

Answer 5

1. 0.1 unit/kg/hr
2. Don’t stop background SC long-acting insulins
3. Wait 1hr after fluids in children to give insulin as increases cerebral oedema risk to do so before this)

Question 6

Treatment for Hypos in a conscious patient (2)

Answer 6

1. 10 - 20g of rapidly available oral glucose (gel buscuit, drink)
2. Repeat every 15 minutes if glucose not rising up to 3 attempts

Question 7

List three GI complications of DM (3)

Answer 7

1. Gastric Paraesis - casued by autonomic neuropathy
2. Chronic diarrhoea
3. GORD from decreased sphincter strength - neuropathy