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Pharmacy Stage 3 - Endocrine System > Type 1 Diabetes > Flashcards

Type 1 Diabetes Flashcards

1
Q

what is type 1 diabetes?

A

cell mediated autoimmune destruction of pancreatic beta cells causing absolute deficiency of endogenous insulin

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2
Q

how does urine help with the diagnosis of diabetes?

A

Glucose in Urine – this happens when the plasma glucose concentration is above the renal threshold (6-14mmol/L). Higher in older people

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3
Q

what happens to vision in type 1 diabetes?

A

vision becomes blurred

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4
Q

how does ketoacidosis occur?

A

by the beta-oxidation of free fatty acids which leads to ketone bodies forming – these deplete acid buffers and acidosis occurs

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5
Q

what are symptoms of diabetic ketoacidosis?

A
  1. severe vomiting
  2. abdominal pain
  3. deep sighing respirations (kussmaul respirations)
  4. sweet smelling - acetone/nail varnish
  5. reduced consciousness
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6
Q

What are the 8 types of acting insulin?

A
  1. Ultra Rapid Acting
  2. Rapid acting.
  3. Short acting.
  4. Intermediate acting.
  5. Long acting.
  6. Ultra long acting
  7. Human mixed insulins.
  8. Analogue mixed insulins.
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7
Q

when should you take an ultra-rapid acting insulin?

A

just before, with or up to 20min after food

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8
Q

when should you take a rapid acting insulin?

A

just before, with or just after food

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9
Q

when should you take a short acting insulin?

A

30min before food

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10
Q

when should you take intermediate acting insulin?

A

30min before food or bedtime

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11
Q

when should you take a long-acting insulin analogue?

A

once or twice a day

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12
Q

when should you take an ultra long-acting insulin analogue?

A

once a day

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13
Q

when should you take an analogue mixed insulin?

A

just before, with or just after food

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14
Q

when should you take human mixed insulin?

A

30 minutes before a meal

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15
Q

what 5 things does the dose of insulin injected depended on?

A
  1. age
  2. exercise
  3. physical activity
  4. stress
  5. hormonal changes
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16
Q

explain how basal bolus works?

A 
basal = just given once/twice daily for baseline insulin conc
bolus = given at each main meal
17
Q

what is the honeymoon period?

A

a remission when either no insulin or a much reduced dose is required to remain euglycaemic

18
Q

at what angle must one inject the insulin?

A

90 degrees

19
Q

Where are the 5 injection sites?

A
  1. Subcutaneous Injection
  2. Abdomen – faster
  3. Back of Arms – faster absorption
  4. Thighs – slower absorption
  5. Buttocks–slower
20
Q

what is the injection technique?

A
  1. find clean skin
  2. insert the needle
  3. push the needle
  4. leave the needle in for 10seconds
  5. remove the needle
21
Q

what does DAFNE stand for?

A

Dose Adjustment For Normal Eating

22
Q

how often should a diabetic check their blood glucose whilst driving?

A

every 2 hours

23
Q

at what blood glucose should a diabetic not drive?

A

<5mmol/L

24
Q

how long should you not drive for if your blood glucose is <5mmol/L?

A

do not drive for 45minutes

25
Q

what is the problem with having lypohypertrophy?

A
  1. delayed absorption can occur which leads to hypo or hyperglycaemic episodes
  2. may result in unnecessary large doses of insulin being used
26
Q

what temperature should insulin be used at?

A

at room temp

27
Q

what are the SICK day rules?

A
  1. Monitor blood glucose every 2 to 3 hours or as necessary
  2. Take insulin - could cause DKA otherwise
  3. Drink lots of fluid and carbs (if sugars are low)
  4. Check urine or blood ketones every 4hours. Take rapid acting insulin if ketones are high
28
Q

if a lady with diabetes goes on to become pregnant, what do you give her?

A

folic acid once a day

29
Q

what three oral drugs can be added to the use of insulin?

A
  1. Metformin
  2. GLP1
  3. SGLT2 inhibitors
30
Q

what is the benefit of using metformin?

A
  • improved body weight

- improved lipid profile

31
Q

what is the benefit of using GLP1?

A
  • reduces HbA1c

- reduces weight

32
Q

what is the benefit of using SGLT2 inhibitors?

A

-reduces HbA1c

33
Q

what is the downside to using SGLT2 inhibitors?

A

-its use in type 1 diabetes is associated with a 2-4fold increase in ketoacidosis

Pharmacy Stage 3 - Endocrine System (9 decks)

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