Diabetes Flashcards
(29 cards)
Hypoglycaemia values
CBG <3mmol/L
Hyperglycaemia values
CBG >11mmol/L
Normal values for CBG
4-7mmol/L
Which cells are responsible for the secretion of insulin
Beta cells within the cells of the pancreas called islets of Langerhans
Which cells are responsible for the secretion of glucagon
Alpha cells of the islets of langerhans within the pancreas
Triggers for insulin release
Increased plasma glucose concentration
Increased amino acids
Increased sympathetic input
What is the duration of the half life of insulin?
4-6minutes
What enzyme and organs remove insulin from circulation?
Insulase removes 60%.
Skeletal muscle, adipose tissue and the liver remove the remaining 40%.
Meaning of mild hyper/hypoglycaemia
Recognised by self and self resolving
Meaning of severe hyper/hypoglycaemia
Pt unable to recognise and self manage, requires treatment by a 3rd party
Lifestyle factors that can contribute to hypoglycaemic episode
Exercise Occupation- shift work Diet Smoking Fasting/meal skipping Alcohol
Medical treatments that may lead to hypoglycaemic episode
RRT Over administration of insulin Warfarin Surgery Nil by mouth NSAIDS Monoamine oxidase inhibitors (MOIs)
Route through which glucogel should be administered
Buccal
What does DKA stand for?
Diabetic ketoacidosis
Signs and symptoms of hyperglycaemia
Severe unquenchable thirst Headache Polyurea Anxiety Blurred vision Warm dry skin Leg cramps Increased RR Weight loss Vomiting Confusion Ketone urea
Risk factors for hyperglycaemia
Infection Illness Stress Decreased level of exercise/activity Diarrhoea
In DKA what is the rate of insulin administration with FRIII?
0.1u/kg/hr
Whilst pt is on sliding scale should Lantus be omitted?
No.
Following DKA how often should CBG be checked?
Once every hour
What can hypos lead to?
MI
Coma
Seizures
Cognitive function
What are the symptoms of hypoglycaemia? (loads)
Weakness Shaking Sweating Tachycardia Palpitations Nervousness Irritability Tingling of mouth and fingers Hunger Headache Hypothermia Visual disturbance Confusion
What are symptoms of hyperglycaemia? (loads)
Thirst Polyuria Fatigue Weight loss Nausea Tachycardia Hyperventilation Ketosis Warm dry skin Hypotension Bradycardia Decreased resps Hypothermia Hypoxia Coma
What is the clinical criteria for admission to HDU with hyperglycaemia?
Ketones >6mmol/L Bicarbonate <5mmol/L pH <7.1 Hypokalemia <3.5mmol GCS <12 O2% <92 on air Sys <90mmHg HR >100/<60
What are the treatment priorities in hyperglycaemia?
Correct dehydration and electrolyte imbalance
Enable uptake of glucose into cells
Increase blood pH
