w4 - paediatric diabetes and endo Flashcards
Type 1 Diabetes: Presentation
WHO:
fasting blood glucose >7.0 mmol/l
random blood glucose >11.0 mmol/l
Classic symptoms:
polyuria; polydipsia; weight loss; general malaise
Diabetic Ketoacidosis
vomiting; abdominal pain; altered consciousness; acidotic breathing
pH < 7.3; urine ketones +++
dehydrated
severe or untreated leads to coma and death
as beta cell loss progresses, symptoms of ___ appear
hypoglycaemia
__ __ __ is the commonest symptom of new diabetes in children
secondary nocturnal enuresis
what risk involved in treating DKA in children
cerebral oedema
4Ts of type 1 diabetes in children
Toilet
Tired
THirsty
Thinner
aims for blood glucose during the day
before meals - 4-7
2hrs after 5-9
bedtime 4-7
effect of poor control in childhood diabetes
social and emotional disruption
sub-optimal physical growth
biophysical changes in microvasc disease (Eyes, kidneys)
7 early changes of vascular disease in kids type 1 D
Microalbuminuria Cardiovascular autonomic neuropathy Sensory nerve damage Retinopathy Cheiroarthropathy - thickened skin, joint contractures Skin vascular changes Vascular endothelial pathology
insulin pump give you continous
short acting insulin
risk for using insulin pump?
dka
if it breaks
outline insulin pump
continuous glucose sensor tells the pump when to give insulin
most common acquired thyroid disease in toung
autoimmune
look for if coeliaac, type 1DM,
hypothyroidism in young
Often slow progress Growth “failure”; delayed puberty Poor general health Educational difficulties Goitre Thyroid function tests: High TSH; low Free T4 and T3 levels
treatment for hypothyroidism
Thyroxine replacement for life
Dose related to size of child
in children, most common to get hyperthyroidism
young girls
