Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BNF Endocrine system > Diabetes > Flashcards

Diabetes Flashcards

(92 cards)

Start Studying
1
Q

Which diabetic patients must inform the DVLA

A
  • all insulin patients (unless temp treatment)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What advice does the DVLA recommend for diabetic drivers

A
  • always carry glucose monitor
  • check glucose at least 2 hours before driving and every 2 hours of the drive
  • Blood glucose should always be >5 when driving
  • supply of fast acting carb always in the car
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What should a diabetic driver do if their BM <4mmol/L whilst driving?

A
  • stop driving
  • switch off enginge
  • eat/drink sugar
  • wait 45 mins after BM normal before driving
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why is alcohol an issue for diabetic patients

A

It can mask hypoglycaemia and cause delayed hypoglycaemia

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

Symptoms of diabetes

A

Poldipsia, Polyuria, weight loss, fatigue, blurred vision, poor wound healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Long term complications of diabetes

A

Macrovascular: CVD
Microvascualr: retinopathy, nephropathy, peripheral neuropathy

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

What medication can be offered to diabetic patients to prevent risk of CVD

A

Atorvastatin 20mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How often should T1DM patients have HbA1C test taken?

A

every 3 to 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How often should T2DM patients have HbA1C test taken?

A

Every 3 to 6 months when stable 6 monthly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the glucose level aim on waking?

A

5-7mmol/L

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

What is the glucose level aim before meals other than breakfast?

A

4-7mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the glucose level aim >90mins after eating?

A

5-9mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the glucose level aim when driving?

A

> 5mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In T1DM what is the HbA1C aim?

A

<48mmol/L

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

In T2DM what is the HbA1c aim?

A
  • Diet controlled/no hypo meds: 48mmol/L (6.5%)

- Hypo meds / >2 AD meds: 53mmol/L (7%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which diabetes is due to an absolute deficiency in insulin?

A

Type 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How often should glucose levels be monitored in T1DM patients?

A

at least QDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a basal bolus regime?

A

long acting insulin + short acting bolus given at meals times

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Levemir BD + Novorapid is an example of what time of insulin regime

A

Basal bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Tresiba OD + Fiasp at mealtimes is an exmaple of what insulin regime?

A

Basal bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Advantages of a basal bolus regime

A

Good glucose control, allows for mealtime flexibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Disadvantages of basal bolus regime

A

Multiple daily injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

First line insulin regime in T1DM

A

Basal bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the concept behind a Continuous SC insulin infusion and what patients can it be used in?

A
  • Insulin pump
  • regular amounts of insulin delivered by a preprogrammed pump
  • for T1DM only
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is a biphasic insulin regime?
Short acting insulin mixed wiht intermediate acting that can be given as up to 3 injections a day
26
Humulin M3 and Novomix 30 are used in what type of insulin regime
Biphasic
27
Advantages of Biphasic regimes
Fewer injections compared to basal bolus
28
Disadvantages of Biphasic regime
Does not allow for mealtime flexibility
29
Intermediate acting/basal only regimes can only be used in which type of diabetes
T2DM
30
If a T1DM patient has a HbA1C of 69mmol/L or suffers from diabling hypoglycaemia what insulin regime can they be offered
insulin pump
31
What is a side effect associated with continuous inejection of insulin to the same area?
Lipodystrophy
32
Short acting insulin examples
Actrapid + Humulin S
33
Which insulin type takes 30mins for onset?
Short acting
34
How long do short acting insulins last for?
6-8 hours
35
When are short acting insulins adminsitered?
15-30 mins before food
36
Novorapid, Humalog and Apidra are examples of what type of insulin?
Rapid acting
37
When are rapid acting insulins adminsitered?
Immediately before meals
38
Onset of action of rapid acting insulins
5 - 15 mins
39
Peak onset of rapid acting insulins
0.5-1.5 houts
40
Which insulin type has a duration of 3-5 hours
Rapid acting insulins
41
What insulin is classed as ULTRA rapid fast acting
Fiasp - within 2 mins
42
Examples of intermediate acting insulins
Humulin I, Insuman and Insultard
43
Onset of action of intermediate acting insulins
2-4 hours
44
Duration of action of intermediate acting insulins
14-16 hours
45
Lantus, Levemir, Abasaglar and Toujeo are examples of what type of insulin?
Long acting
46
Long acting insulin duration of action
up to 36 hours
47
Lantus, Abasaglar and Toujeo are all examples of what insulin?
Insulin Glargine
48
Insulin detemir brand namw
Levemir
49
Onset of action of Long acting insulin
0-2 hours
50
Insulin degludec is what type of insulin
Ultra long acting (tresiba)
51
Humulin M3, Novomix, Humalog mix and Insuman Comb are what type of insulin?
Mixed insulin - mixture of intermediate and rapiding acting or a soluble insulin
52
Xultophy contains what?
Insulin degludec + Liraglutide
53
Is a patient is ill, should they continue to use their insulin?
Yes - as per sick day rules. Dose may need to be altered according to BG levels
54
Target BP for diabetic patients with CKD
130/80
55
Diabetes characterised by insulin resistance
T2DM
56
First line drug treatment for T2DM
Metformin
57
Which antidiabetic drug lowers basal and postprandial blood glucose concentrations therefore not causing hypos?
Metformin
58
Gliclazide, Glimepiride, Glipizide and Glibenclamide are examples of what drug class
Sulphonylureas
59
What side effect is associted with Sulphonylureas
Hypos + weight gain
60
What is Glibenclamide?
Long acting sulphonylurea
61
If HbA1c rises >58 despite metformin, what can be started?
Dual therapy with either a SU, DPP4 inhibitor, SGLT2 inhibitor, GLP1 or pioglitozone
62
Common side effects of metformin
GI disturbances, Lactic acidosis (if renally impaired), decreased absorption of B12
63
How do sulphonylureas work?
Stimulate insulins secretion therefore take with or after food
64
What EGFR is metformin contraindicated?
<30
65
What can interact with metformin during surgery?
Contrast media - increased risk of AKI
66
What condition are Meglitinides used for?
T2DM
67
Which antidiabetic drug is a PPAR agonsit and increases insulin sensitivity and reduces hepatic glucose output?
pioglitazone
68
Side effects of pioglitazone
Weight gain, Bladder cancer, HF, increased risk of bone fracture
69
Alogliptan, Linagliptan, sitagliptan and saxogliptan are examples of?
DPP4 inhibitors
70
Which oral antidiabetic drugs increase GLP! and thus stimulate insulin secretion?
DPP4 inhibitors
71
What is a side effect to be aware of with DPP4 (gliptans)
pancreatitis
72
Which oral antidiabetic drugs have excellent evidence for reducing HF and CVD?
SGLT2 inhibitors
73
Canaglifozin, Dapagliflozin and Empagliflozin are examples of?
SGLT2 inhibitors
74
What risk do SGLT2 inhibitors carry?
Risk of DKA
75
GLP1 agonist examples
Liraglutide, Dulaglutide, Semaglutide, Exenatide, Lixisenatide
76
Why can GLP1 agonsits help with weight loss?
They delay gastric emptying
77
Side effect of GLP1 agonsits
Pancreatitis, GI side effects
78
Other than diabetes, what can metformin be used to treat?
PCOS
79
What criteria is needed for GLP1 agonist intiated?
Third line intensification | BMI >35 AND psychological/medical problems with obesity OR BMI<35 and occupational issues with insulin therapy
80
In diabetic nephropathy, what medication should be started?
ACEI
81
In autonomic diabetic neuropathy, diabetic diarrhoea can be managed wiht ehat?
Tetracycline or codein
82
How is DKA managed?
1. Fixed rate IV insulin (supress ketogenesis + reduce BG) + Long acting background 2. Fluid replacement (Nacl and K+) 3. IV glucose
83
In DKA, what do we aim to get ketones below?
<0.3
84
When can the VRII be stopped if a patient has started their Sc fast acting insulin and has eaten?
1 hour after
85
At what BG level is a person having a hypo?
<4mmol/L
86
How is a hypo treated?
1. fast acting glucose (fruit juice/jelly babies/gluco gel) OR if unconscious IM glucagon or 20% IV glucose 100mL over 15 mins 2. Once >4 mmol, give long acting carb (bread)
87
The Gold or Clarke score measures for what?
Hypoglycaemia awareness
88
What should women with preexisiting diabetes who are planning on becoming pregnant take?
Folic acid 5mg
89
Can oral antidiabetic drugs be used in pregnancy?
All should be switched to insulin except metformin
90
What insulin is first choice in pregnancy?
Isophane
91
What antidiabetic drughas an increased risk of lower limb amputations?
canagliflozin (SGLT2)
92
What antidiabetic class has an increased fourniers gangrene?
SGLT2 inhibitors

BNF Endocrine system (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions