T1DM Flashcards
ideal BG conc.
4.4-6.1mmol/l
insulin reduces blood sugar by -
- causes cells in body to absorb Glc and use it for fuel
2. causes muscel and liver to absorb Glc and store it as glycogen
how does glucagon increase BG
- tells liver to breakdown glycogen into glucose - glycogenolysis
- tells liver to convert proteins and fats into glucose - gluconeogenesis
when does ketogenesis occur
when there is insufficient glucose supply and glycogen stores are exhausted
ketogenesis
liver takes fatty acids and converts them to ketons –> water soluble fatty acids which can be used as fuel
how can ketone levels be measure
urine dipstix
blood ketone meter
T1DM
pancreas unable to produce insulin
–> cells cannot take up Glc –> think theyre being fasted and Glc levels continue to rise in blood
DKA
occurs when body doesn’t have enough insulin to use and produce glucose
–> ketoacidosis, dehyrdation, potassium imbalance
pathophys of DKA: ketoacidosis
cells in body have no fuel and think theyre starving to initiate ketogenesis
–> higher and higher glc and ketone levels
ketone acids use up bicarb produced by kindeys and blood becomes acidotic –> ketoacidosis
pathophys of DKA: dehydration
hyperglycemia overwhelmes kidneys and glc starts being filtered into urine
causes osmotic diuresis –> polyuria and polydiypsia
pathophys of DKA: potassium imbalance
without insulin, K is not driven into cells
serum K normal but total body K low as none in cells
when given insuline Rx, pt can develop severe hypokalaemia –> arrythmias
presentation of DKA
hyperglycaemia, dehyrdration, ketosis, metabolic acidosis, K+ issues
polyuria polydipsia N&V actone smell breath dehydratino --> low BP alt conscoussness
most dangerous aspects of DKA
dehydration
K+ imbalance
acidosis
diagnosing DKA
hyperglycaemia >11
ketosis >3
acidosis ph < 7.3
treating DKA
fluid - IV resus w normal saline ] insulin 0.1unit/kg/hr glucose potassium ketones
