Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

endocrine > Management of Diabetes type 1 > Flashcards

Management of Diabetes type 1 Flashcards

1
Q

Approach

A
  • Prompt diagnosis
  • Self-management of disease
  • Resolving complications/adjust medication
  • Facilitating long term health
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Statistics for diabetes in Scotland

A
  • Scotland has the 5th highest incidence of diabetes
  • 300 children per year are diagnosed with diabetes
  • 1 in 4 are diagnosed in DKA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the important aspects in educating in diabetes

A
  • Education
  • Nutrition and lifestyle
  • Skill training e.g. blood glucose measuring
  • How to approach days of sickness: e.g. risk of DKA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is involved in the safe use of insulin

A
  • Right type: check name
  • Right dose: 1 unit for 10gCHO
  • Right time
  • Right way : needle size, location, rotation, tecnique
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 4 different types of insulin analogues

A
  • Short acting: soluble/rapid
  • Intermediate acting
  • Long acting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are insulin analogues

A

They are similar to human insulin but grown in a lab to adjust some of their characters such as how they act

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the two different types of short acting insulin and how they work

A

1-Soluble insulin

  • Insulin is injected into the subcutaneous fat either via SC injection or by IV in those who are very ill
  • Here it self-associates into hexamers
  • In order for it to be absorbed into the capillaries it needs to be broken down into monomers
  • This takes a bit of time- hence why insulin is administered 30 mins before food -Fast onset, long duration

2-Rapid acting Insulin

  • Can be injected straight before a meal as it does not associate into hexamers
  • It has a faster onset than Soluble insulin but also shorter duration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do the different insulin regimens involve

A

Twice daily

  • Rapid acting insulin with intermediate
  • Before breakfast and before dinner

Three times daily

  • Rapid acting with intermediate acting before breakfast
  • Rapid acting before dinner
  • Intermediate acting before bed
  • short acting before breakfast, lunch and dinner
  • Intermediate acting before bed or Long acting fixed once a day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the main reasons for imbalances in diabetes management

A
  • Diet
  • Exercise
  • Insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is BG glucose level for hypoglycaemia

A

4mmol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Who is likely to suffer from hypoglycaemia (some examples)

A
  • Patients under tight control
  • Patients with cognitive impairment
  • Patients with malabsorption/coeliac disease
  • Pregnant
  • Patients with pancreatic/renal impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Autonomic symptoms of hypoglycaemia

A
  • Sweatiness
  • Palpitations
  • Tremor
  • Hunger
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Neurological symptoms of hypoglycaemia

A
  • Confusion
  • Drowsiness
  • speech difficulty
  • Behaviour difficulty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

General symptoms of hypoglycaemia

A
  • Malaise

- Fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complications of hypo

A
  • If hypoglycemia is prolonged it can lead to coma/hemiparesia and seizures
  • If prolonged neurological symptoms may become permanent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mild hypo

A

-Patient conscious, not fasting, able to swallow
-Give 15-20g of carbohydrates :
• Detrosol tables
• Glucojuice/ glucotabs
• Pure fruit juice

17
Q

Moderate hypo

A
  • Patient conscious and able to swallow but confused/aggressive
  • If patient is co-operative and capable treat as mild
  • If patient is conscious/can swallow but uncooperative give 1.5-2 tubes of glucose gel
18
Q

Severe hypo

A

-Patient unconscious/fitting or cannot be fed by mouth
-Give IV glucose over 10-15 mins:
• 75ml of 20% glucose
• 150ml of 10//5 glucose

19
Q

Driving and hypo

A
  • Patients should be advised to check their BG within 2 hours of driving
  • When driving for lomg distances then CHO should be carried in the car
  • Cannot drive if they have more than one severe hypoglycemic attack in a year.
20
Q

What approach to take for DKA

A

Check blood glucose levels
• If BG >12 mmol/litre then likely to be DKA
• If BG< 12 mmol/litre might be starvation diabetes
-Check urine for signs of ketones
-DO NOT stop taking insulin
-Drink lots of sugar-FREE fluids do prevent dehydration

21
Q

Complications of DKA

A

-Hyper/hypokalemia
-Hyperglycemia:
• Recurrent ketoacidosis
• Arrythmias
• Acute brain injury
-Cerebral oedema
-Aspiration pneumonia
-Arterial/Venous thromboembolism
-Acute respiratory distress syndrome (ARDS)

22
Q

Treating DKA in hospital

A
  • Measure Glucose/U&E’s/ Ketones/ ABGs
  • Give IV saline
  • Give IV insulin (drives uptake of glc and potassium hence..)
  • Give IV potassium
  • Antiobiotics?
  • Heparin/NG tube?
23
Q

what is being done to optimise long term health

A
  • Optimisation of cutaneous insulin delivery
  • Donor transplants e.g. Islets/Pancreas
  • Other cell based therapies
  • Sensor augmented pumps

endocrine (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions