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/twice 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 10seconds
- 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 hours
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 45minutes
what is the problem with having lypohypertrophy?
- delayed absorption can occur which leads to hypo or hyperglycaemic episodes
- may result in unnecessary 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 to 3 hours or as necessary
- Take insulin - could cause DKA otherwise
- Drink lots of fluid and carbs (if sugars are low)
- Check urine or blood ketones every 4hours. Take rapid acting insulin 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?
- improved body weight
- improved lipid profile
what is the benefit of using GLP1?
- reduces HbA1c
- reduces weight
what is the benefit of using SGLT2 inhibitors?
-reduces HbA1c
what is the downside to using SGLT2 inhibitors?
-its use in type 1 diabetes is associated with a 2-4fold increase in ketoacidosis
