Type 1 Diabetes Flashcards
What is the other name for Type 1?
Insulin Dependent Diabetes Mellitus (IDDM)
What are the causes of Type 1?
Genes (autoimmune)
Environment
What genes are thought to be involved?
HLA’s
What environmental factors are thought to be involved?
Chemicals
Viral sensitisation leading to autoimmune response
What is the pathology of Type 1?
Insulin DEFICIENCY
- Autoimmune destruction of B cells in Islets by lymphocyte infiltration
What are the presenting symptoms of type 1?
Polydipsia
Polyuria
Weight loss
Visual blurring
What is the algorithm you should follow in suspected type 1?
Triple T
- Think
- Test
- Telephone
What is the Think part of the algorithm?
THINK - symptoms
- Thirst
- Thinner
- Tired
- Polyuria (return to bedwetting in children)
What actually causes the polyuria?
Osmotic gradient created by increased glucose secretion in the nephrons
What is the TEST part of the algorithm?
Immediately do finger prick cap glucose
What random glucose level in the finger prick allows a diabetes diagnosis?
> 11mmol/l
What tests should not be done in primary care with suspected DKA and why?
OGTT
Urinalysis
Fasted glucose
All take too long and DKA can fuck people up real quick
What tests can be done when DKA is not suspected?
Venous glucose
What venous glucose levels indicate diabetes (fasted and random)?
Random = 11.1 mmol/l Faster = 7mmol/l
What are red flag symptoms indicating DKA?
Ketones on breath
Dehydration
Pre shock symptoms
Lowered GCS
What treatment is required for Type 1?
Insulin injections
Home glucose monitoring
How many grams of carbs will 1 unit of insulin cover?
12-15g
Where is insulin injected?
Usually abdomen
- Subcutaneous
What advice should be given?
Lifestyle
- Exercise
- Alcohol
- DVLA
- Conception
How to avoid hypos
Fingertip care
What are the signs of a hypo?
Weakness
Nausea/vomiting
Malaise
Shaking
Tachycardia
Altered mental state
What advice should be given to patients to prevent hypos?
Carry around carbohydrate
What are the types of insulin?
Short
Intermediate
Long acting
How can the different timeframes of insulin be used?
Can be used in different combinations to fit the persons regime
