Flashcards in Diabetes type 1 Deck (81)
What level of fasting glucose is needed to diagnose diabetes?
What random glucose levels are required to diagnose diabetes?
True or Fale
DKA is more common in type 2 diabetics
DKA is only present in type 1
What can be seen on histology of an islet in type 1?
What are ICA?
Islet cell antibodies
What infection can be present in those with type 1?
What is balanitis?
Inflammation of the head of the penis
What is the only treatment for type 1?
Insulin (basally and bolus)
What is the ideal HbA1c range?
Below 59 mmol/L
What is studied at annual review?
Bloods- HbA1c, renal, lipids
True or False
There is often ketonuria in type 2
Present in type 1
What are children under the age of 6 diagnosed with, rather than type 1?
What is type 1.5 diabetes?
Latent onset diabetes of adulthood.
This is type 1 diabetes.
What is LADA?
Elevated levels of pancreatic auto-bodies in patients who do not require insulin
When is LADA suspected?
Other autoimmune conditions
True or False
Diabetes is common in cystic fibrosis.
What are the symptoms of Wolfram syndrome?
What acronym can be used for Wolfram syndrome?
What causes Wolfram syndrome?
Genetic default in the wolfram gene which is present in the pancreas, inner ear and brain
What are the symptoms for Bardet-Biedl syndrome?
What makes Bardet-Biedl syndrome more likely?
Parents who are related.
In what types of diabetes are antibodies negative?
Which autoimmune conditions are related to diabetes?
How common is it to have coeliac disease in type 1?
Compared to 1% in population
What antibody is present in coeliac disease?
What antibodies are present in diabetes type 1?
What other GP available tests can be done to exclude diabetes 2?
What kind of tumour can cause diabetes?
Which drugs can induce diabetes?
What does HbA1c measure?
Control of glucose over the past few months
Which infection of the bone may be present in diabetic neuropathy?
What antibodies may be present in type 1?
What relation does type 1 have with DVLA?
Must inform DVLA of diagnosis
What HbA1c is ideal for a diagnosed type 1?
How much does carbohydrate loading need to be changed by when exercising?
1g CHO per kg of body weight per hour exercising.
What is DKA?
Absolute insulin deficiency with an increase in counter-regulatory hormone
What is the danger of a DKA in young children?
What are the four possible regimes for insulin release?
Basal bolus which mimics endogenous release
What factors need to be taken into account when calculating insulin dosages?
Give an example of rapid acting analogue insulin
Give an example of short acting insulin/soluble
Give an example of intermediate acting (isophane)
Give an example of a long acting analogue
How do rapid-intermediate analogue mixtures work?
Novomix30 - 30% short action. 70% basal insulin
When is a once daily insulin inj. given?
Nursing homes, mental retardation.
What is the standard treatment for T1D?
MDI 3/4 or CSII
What is the target glucose levels pre-meal?
What is the target glucose levels post-meal?
less than 9
What are the education programmes called on insulin management?
DAFNE (dose adjustment for normal eating)
TIM (tayside insulin management)
What can cause DKAs?
What kind of symptoms can ketone bodies cause?
Ketones on breath
What ketone is tested for in bloods?
What is the normal amount of ketone?
Less than 0.6
Beware! How far can the ketone meter read?
Only to 8 so if above 8 you'd never know.
What is the danger of measuring ketones in urine?
Shows ketones 2 hours previously.
Biochemically, how is lactate produced?
Anaerobically produced from pyruvate
How is lactic acidosis different to hyperlactaemia?
Lactic acidosis involves a high ion gap with low ketone level.
When does type A lactic acidosis occur?
Tissue hypoxaemia e.g. infarcted tissue, hypovolemic shock
When does type B lactic acidosis occur?
What is the equation for working out anion gap?
[Na+ +K+] - [HCO3 + Cl-]
How can endogenous insulin be measured?
Which antibodies are clinically tested for?
At what blood glucose level is coma associated?
Less than 2mmol/L
What percent should someones HbA1c be?
Around 6.5% is 48mmol/L
What 3 things must be present to diagnose DKA?
presence of ketones
What is involved in the management of DKA?
In what medical procedures should metformin be avoided?
Anything involving contrasts e.g. angiogram
What is hyperglycaemic hyperosmolar syndrome?
Hyperglycaemia but no ketones in blood
What can cause HHS?
Poor glycaemic control
What may precipitate HHS?
Other illness- MI, stroke
Why are fluids added more slowly in HHS?
Higher risk of cerebral oedema
How is osmolality calculated?
2Na+ + glucose + urea
What is the reference value for osmolality?
What osmolality is diagnostic of HHS?
What must blood glucose be to diagnose HHS?
What should be given as treatment for HHS?
Saline with potassium
What HbA1c level should be obtained before an elective procedure?
less than 75mmol/L
What is the risk of fluid resuscitation of DKA in children?
What is the target HbA1c in children?
less than 58mmol/L
What is cheriarthropathy?
Thickening of skin over joints