Type 1 diabetes Flashcards
Why is glucose high in T1 DM?
As insulin is no longer produced the glucose cannot be taken up into the skeletal and adipose tissue therefore it concentrates in the blood leading to osmotic diuresis (polyuria) which in turn leads to excessive thirst (polydipsia)
Two tests that can diagnose T1DM?
fasting glucose >7mmol/L
Oral glucose tolerance test >11.1mmol/L (2 hours pose glucose load|)
Symptoms of T1DM
polyuria
polydipsia
weight loss
excessive tiredness and weakness
What three things need to be present to diagnose DKA
hyperglycaemia >11mmol/L
acidosis (measured by venous bicarbonate <15mmol/l or arterial pH 7.3)
ketonaemia / ketonuria ++
it is a medical emergency because it leads to dehydration and electrolyte imbalance
Ketones in the blood make it leading to ketoacidosis.
Symptoms of ketoacidosis
- polyuria & polydipsia
- nausea & vomitting
- abdominal pain
- shortness of breath (kussmaul respiration)
- dehydration, hypotension, tachycardia
- ketotic smell of breath
- confusion, drowsiness, rarely coma.
How do we treat DKA?
IV insulin
NaCL
K+ (replace what insulin reduces)
The target of HbA1c for T1DM is
48mmol/L
insulin should be prescribed by brand rather than generically, true or false?
True
Symptoms of type 1 diabetes include
nocturia polydipsia fatigue weight loss blurred vision
What class of insulin is absalagar?
long-acting
What class of insulin is toujeo?
long-acting
What class on insulin is fiasp?
rapid-acting
What class of insulin is lantus?
long-acting
What class of insulin is apidra?
rapid-acting
what class of insulin is humulin-I
intermediate acting
what class of insulin is heparin bovine protamine zinc?
long-acting
Three points about tresiba
- it is neutral pH so does not hurt as much compared to lantus which is acidic
- it has a reduced rate of hypo’s compared to lantus
- it comes in 100units/ml and 200 units/ml
Threshold to diagnose someone with a hypo is
4mmol/L
Treasons contains
Degludec
In DKA should a patient receive sodium bicarbonate to increase their PH?
No
PotentiAl complications of DKA and it’s management are
Hypokalaemia
Peripheral oedema
Different brands of insulin as part?
Novorapid
Fiasp
What dose of rapid acting Insulin do we use in DKA,
0.1 unit/kg/hr
Rounded to the nearest uni5 so 6.6units would be 7 units
What reduction in blood sugar and ketones do we want to see when we initiate treatment in DKA?
Blood sugar reduction 3mmol/litre/hr
Ketones 0.5mmol/litre/hr
