Diabetic Complications

Question 1

What is BP target if T1DM with ACR <70mg/mmol

Answer 1

140/90

Question 2

What is BP target if T1DM and ACR ration >70mg/mmol

Answer 2

130/80

Question 3

What is BP target if T1DM and aged 80+ and ACR >70mg/mmol

Answer 3

150/90

Question 4

What is BP target if T1DM and aged 80+ and ACR <70mg/mmol

Answer 4

150/90

Question 5

When is proteinura considered

Answer 5

ACR of more than or equal to 3mg/mmol

Question 6

For both T12DM what is added in kidney disease proteinura ACR >3mg/mmol

Answer 6

ACEi/ARB

Question 7

What is 2nd line add on for proteinura if T2DM and ACR >30mg/mmol

Answer 7

SGLT2-i

Question 8

Diabetic neuropathy

What is treatment for chronic painful neuropathy

Answer 8

Amitriptyline
Duloxetine
Gabapentin
Pregabalin

Question 9

Diabetic neuropathy

What is treatment for erectile dysfunction

Answer 9

Sildenafil
Vardenafil
Tadalafil

Question 10

Diabetic neuropathy

What is treatment for gastroparesis

Answer 10

Domperidone
Metoclopramide

Relieve N&V, stimulate gastric emptying

Question 11

Diabetic neuropathy

What is used to treat hyperhidrosis

Answer 11

Antimuscarinics:
Topical glycopyrrolate
Oral oxybutynin
Glycopyronium bromide

Question 12

3 diabetic complications

Answer 12

Periodontitis - gum inflammation

Eye disease - blood vessel damage

Feet problems - nerve damage

Question 13

What is initial investigation for DKA

Answer 13

Severe hyperglycaemia >11mmol/L

Question 14

Ketone levels and meaning

Answer 14

0.6-1.5 - slight risk retest in 2 hours

1.6-2.9 - increased risk comtact GP

3+ - medical emergency

Question 15

What 3 parameters classifies DKA

Answer 15

BG >11mmol/L

Ketones >3mmol

Venous pH <7.3

Question 16

What is resolution of DKA defined as

Answer 16

Ketones <0.6mmol/L

Venous pH >7.3

Question 17

What is emergency treatment of DKA

Answer 17

IV fluids NaCl
IV glucose if hypo risk
IV insulin human soluble insulin

Question 18

What is classed as hypoglycaemia

Answer 18

<4mmol/L

Question 19

If hypoglycaemic but conscious and able to swallow. What is treatment plan

Answer 19

Fast acting carbohydrate 10-20g orally

3-6 glucose tablets
2-4 spoonfuls of sugar
90-180ml fizzy drink or squash

Question 20

What is the monitoring plan for hypoglycaemic conscious able to swallow patient

Answer 20

Recheck BG after treatment correction

Recheck every 15 minutes

Question 21

If patient is hypoglycaemic, unconscious or unable to swallow. What is treatment plan

Answer 21

IM glucagon

If due to alcohol, IV glucose

Question 22

Which drugs could be stopped in AKI/Risk of dehydration

Answer 22

Diuretics
NSAIDs
Metformin
SGLT2-i
GLP-1 agonist

Question 23

What is the target HbA1c for diabetic patient that has become pregnant

Answer 23

<48mmol/L

Question 24

What is statistic with diabetic patients becoming pregnant

Answer 24

Increased problems
5x more likely to have preterm

Question 25

What medications need to be stopped in pt with diabetes and pregnant What is plan

Answer 25

Statins and ACEis STOP Metformin and insulin safe Rapid acting + isophane as 1st line long acting

Question 26

What add on precaution do we give to diabetic patient that is prregnant

Answer 26

Folic acid 5mg before concieving And until 12 weeks pregnant