Diabetes and Hypoglycaemia Flashcards
(32 cards)
What are 4 complications of insulin therapy?
1) Hypoglycaemia
2) Lipohypertrophy
3) Insulin resistance and weight gain
4) Life style interference –> Weight Gain
What are the problems found with insulin in T2DM?
Insulin Secretion
Insulin Resistance
What is the aetiology of T2DM?
1) Genetic Predisposition
2) Environmental Factors (Weight, Exercise and Lifestyle)
Why is insulin secretion not functional in type 2 diabetes?
There is lipid deposition in the IOL in pancreas causing impairment of insulin secretion
Describe the pathophysiology of T2DM?
1) Impaired insulin secretion and increased resistance
2) Impaired Glucose Tolerance (Above normal levels) (IGT)
3) ^ FFAs and Hyperglycaemia
What is the driving force of hyperglycaemia in T2 diabetes?
Hepatic Insulin Resistance
What are 3 risk factors of T2 diabetes?
1) Family History
2) Obesity
3) Physical Inactivity –> Sedentary Lifestyle
What happens to insulin secretion, resistance and glucose levels in type 2?
Sec: Decreases
Resistance: Increases
GL: Increase
Why is diabetic ketoacidosis rarely seen in type 2?
Body still contains low plasma insulin levels, which can reduce chance of ketogenesis and muscle catabolism
What is the treatment procedure for treating type 2?
1) Change lifestyle –> Diet, exercise, weight etc.
2) Metformin
3) Metformin and Sulphonylurea
4) Metformin, sulphonylurea and insulin
5) Insulin dose increased as required
How do the two treatment methods work for treating type 2?
1) M: Increase insulin sensitivity, inhibit glucose production
2) S: Stimulates insulin release
What is a potential adverse effect of sulphonylurea?
Hypoglycaemia
What are 3 microvascular complications of diabetes?
1) Diabetic Nephropathy
2) Diabetic Retinopathy
3) Diabetic peripheral neuropathy
What is a macrovascular complication of diabetes?
Stroke and CVS
What are the complications of acute and chronic hyperglycaemia?
A: Diabetic ketoacidosis and hyperosmolar coma
C: Micro and macrovascular tissue complications
What is the most common form, clinical consequences and pain associated with diabetic neuropathy?
F: Distal symmetrical polyneuropathy
CC: Pain, Autonomic neuropathy, Insensitivity
P: Burning, Paraesthesia, Nocturnal exacerbation
What is autonomic neuropathy and what are 5 main signs?
Damage to the nerves that supply body structures that regulate functions such as BP, HR, bowel/bladder emptying.
1) Hypotension 2) HR affected 3) Diarrhoea 4) Incontinence 5) Erectile Dysfunction 6) Dry skin
What are the consequences found of diabetic neuropathy?
Insensitivity -> foot ulceration -> infection -> amputation
Where does insensitivity spread to in diabetic neuropathy?
Starts in the toes and moves up (proximally)
[ Glove and stocking distribution]
What are 5 risk factors of diabetic neuropathy?
1) Poor glycaemic control
2) Hypotension
3) Overweight
4) Long duration of diabetes
5) Hb1AC
6) Smoking
What are the treatments for diabetic neuropathy?
1) Antidepressants 2) Analgesic pain relief 3) Improvement in glycaemic control
What are the signs of acute ischaemia? (Complication of PVD -> 6P’s)
- Pulseless.
- Pale.
- Perishing cold.
- Pain.
- Paralysis.
- Paraesthesia.
Are there increased or decreased pulses in a diabetic neuropathic foot?
Increased
What are the 5 risk factors and resultant pathophysiology from diabetic retinopathy?
1) Long term DM
2) Poor glycaemic control
3) Hypertension
4) Insulin treatment
5) Pregnancy
6) High HbA1c
Micro-aneurysms -> pericyte loss and protein leakage -> occlusion -> ischaemia.
