Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine Type 2 DM november 23 > Endocrine part 1 November 23 > Flashcards

Endocrine part 1 November 23 Flashcards

Diabetes Insipisus | Insulin |HbA1c

1
Q

Q1: What is diabetes and what are the main causes of diabetes?

A
  • Diabetes is a general term for metabolic disorders affecting blood sugars.
  • Subtypes include Type 1 (lack of insulin),
  • Type 2 (insulin resistance),
  • Gestational (during pregnancy),
  • Diabetes insipidus (water balance), Secondary diabetes (due to other conditions).
  • Causes vary: Type 1 (autoimmune),
  • Type 2 (lifestyle, genetics),
  • Gestational (pregnancy),
  • Diabetes insipidus (genetics, damage),
  • Secondary diabetes (organ damage).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Q3: What is diabetes insipidus and what are the different types?

A
  • Diabetes insipidus involves water regulation due to decreased ADH.
  • Types include Cranial (brain produces less ADH)
  • Nephrogenic (kidneys resist ADH).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Q4: What are the main complications of diabetes insipidus?

A

Complications include
* hyponatremia,
* hyponatremic
* convulsions,
* dehydration.

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

Q5: What is used to treat diabetes insipidus?

A

Treatment depends on type.

For Cranial:
* Vasopressin,
* Desmopressin.

For Nephrogenic:
* Oxytocin,
* Thiazide diuretics,
* Carbamazepine.

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

Q6: What is the main side effect of desmopressin and what are the symptoms of this electrolyte imbalance?

A

The main side effect is

extreme water dilution,

leading to hyponatremic convulsions.

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

Q7: What’s the DVLA advice for diabetics?

A
  • Diabetic drivers on insulin or hypoglycemic drugs must inform DVLA.
  • Monitoring, safe blood glucose levels,
  • actions during hypo,
  • not driving with low BG are advised.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Q8: How often should diabetics check their glucose levels while driving and what should their blood glucose levels be?

A

Check every 2 hours while driving, with BG above 5 mmol/L.

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

Q9: What should diabetics do if their blood sugars get too low while driving?

A
  • If BG falls
  • <4mmol/L
  • hypo signs develop,
  • stop driving,
  • eat,
  • wait 45 mins after BG normal before continuing journey.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Q10: What blood glucose level should diabetics never drive?

A

BG should never be below 4 mmol/L.

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

Q11: What advice would you give to a diabetic regarding alcohol consumption?

A

Alcohol can mask hypo signs,

drink in moderation and with food.

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

Q12: What is an oral glucose tolerance test and what is it used for?

A

It’s a test to diagnose Impaired Glucose Tolerance and gestational diabetes.

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

Q13: What is HbA1c and what is it used for?

A
  1. HbA1c shows blood sugar control over 2 months,
  2. predicts complications,
  3. Is used to monitor both Type 1 and Type 2 diabetes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Q14: When do you avoid using the HbA1c test?

A

Avoid for diagnosing diabetes
1. In children,
2. pregnant women, 2 months postpartum,
3. type 1,
4. Monitoring in Type 2 with symptoms <2 months, high diabetes risk, certain treatments,
5. CKD,
6. HIV.

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

Q15: How often should HbA1c be used in terms of monitoring Type 1 and Type 2 diabetes?

A

Type 1: every 3-6 months,

Type 2: every 3-6 months until stable,

then every 6 months.

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

Q16: What is Type 1 diabetes?

A

Type 1 diabetes is the complete deficiency of endogenous insulin secretion in the pancreas,

requiring insulin replacement.

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

Q17: What are the main diabetic complications?

A

Major acute complications include
1. foot infections,
2. neuropathy,
3. nephropathy,
4. retinopathy,
5. CVD, cancers,
6. sexual dysfunction,
7. hyperglycemia, hypoglycemia, DKA, and Hyperosmolar Hyperglycemic States.

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

Q18: What are the signs and symptoms of Type 1 diabetes?

A
  1. increased thirst,
  2. frequent urination at night
  3. hyperglycemia,
  4. extreme hunger,
  5. unintended weight loss,
  6. irritable mood,
  7. fatigue, blurred vision.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Q19: For Type 1 diabetes, what are the main aims of treatment?

A
  1. achieving optimal BG levels,
  2. avoiding hypoglycemic episodes,
  3. minimizing complications,
  4. preventing disability from complications,
  5. individualizing glycaemic control targets.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Q20: How many times a day should a Type 1 diabetic measure their blood sugars?

A

At least 4 times a day,
including before each meal
and before bed.

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

Q21: What are the common target ranges for blood glucose levels in Type 1 and Type 2 diabetes?

A

Ranges vary before and after meals,
waking, and during driving,

with targets typically between 4-9 mmol/L.

22
Q

Q22: Give a simple overview of the drug and non-drug treatments for Type 1 diabetes.

A
  1. Type 1 diabetes requires insulin replacement.
  2. Lifestyle,
  3. exercise,
  4. planned meals,
  5. medication management are crucial.
23
Q

Q23: What is insulin, and what are the 2 types of insulin secreted naturally by the body?

A
  • **Insulin is a hormone that regulates blood sugar.
  • The 2 types are
  1. Basal insulin (steady background)
  2. Bolus insulin (in response to meals).
24
Q

Q24: What are the 3 types of insulin available in the UK?

A

Human insulin,
Human insulin analogue,
Animal insulin.

25
Q

Q25: How is insulin administered to patients?

A

Insulin is given subcutaneously (S/C) and should not be taken orally due to enzymatic destruction.

26
Q

Q26: What is the main advice you’d give to a patient on how to inject their insulin?

A

Administer insulin S/C in fatty areas like abdomen or outer thigh.

Rotate injection sites to avoid lipoatrophy or lipohypertrophy.

27
Q

Q27: What are the 3 groups of insulin used in treating diabetes?

A

Short-acting insulin

(soluble + rapid-acting),

Intermediate-acting insulin, Long-acting insulin.

28
Q

Q28: Give examples of short-acting insulins.

A

Examples include soluble insulin like Actrapid.

29
Q

Q28: Give examples of rapid-acting insulins.

A

Examples include

Aspart (Fiasp, NovoRapid),

Glusine (Apidra),

Lispro (Humalog).

30
Q

Q28: Give examples of intermediate-acting insulins.

A

Examples include Insulin isophane (NPH, Humulin I).

31
Q

Q28: Give examples of long-acting insulins.

A

Examples include
1. Detemir (Levemir),
2. Glargine (Lantus, Tou

32
Q

Q29: What are the 3 main types of insulin regimes diabetics use?

A

The main types are

  1. Basal Bolus (multiple injections throughout the day),
  2. Once Daily (single dose each day),
  3. and Mixed (combination of short- and intermediate-acting insulins).
33
Q

Q30: What is the basal bolus regime, and who is it suitable for?

A

Basal Bolus involves multiple injections throughout the day, with basal (background) and bolus (mealtime) insulin. It’s suitable for both Type 1 and Type 2 diabetics who want flexible mealtime control.

34
Q

Q31: What is the once daily regime, and who is it suitable for?

A

The once daily regime involves a single daily dose of insulin, typically for Type 2 diabetics with oral tablets. It helps maintain stable BG levels but can risk hypo with long-acting insulin.

35
Q

Q32: What is the mixed regime, and who is it suitable for?

A

The mixed regime combines short-acting and intermediate-acting insulins, often taken before meals. It’s suitable for those with set routines and can be used by both Type 1 and Type 2 diabetics.

36
Q

Q33: What type of insulin regime is used in patients with severe debilitating hypoglycemia?

A

Continuous subcutaneous insulin infusions are used in such cases.

37
Q

Q34: What can cause poor blood glucose control?

A

Medication issues, lifestyle factors, psychological stress, and comorbidities like renal disease and thyroid disorders can cause poor control.

38
Q

Q35: What activity increases and decreases the body’s insulin demands?

A

Increased demands are caused by infection, stress, trauma, pregnancy, physical activity, and vomiting. Decreased demands result from reduced food intake, impaired renal function, and certain endocrine disorders like Addison’s disease.

39
Q

Q36: What should patients do with the used needles they have?

A

Patients should be advised on the safe disposal of needles, lancets, and syringes, using suitable disposal containers and arrangements for collection.

40
Q

Q37: What are the sick day rules for diabetic patients?

A

During illness, patients should monitor blood sugars more frequently,

potentially increase insulin doses,

never stop insulin,

maintain fluid and food intake,

Be prepared to deal with hypo episodes.

41
Q

Q38: What drugs can be stopped during the sick day rules?

A

Some medications like SGLT2 inhibitors,
ACE inhibitors,
diuretics,
metformin,
ARBs, and

NSAIDs

can be temporarily stopped during illness due to dehydration and other risks.

42
Q

Q39: What are the most common insulin errors reported?

A

Common errors include failure to manage insulin, dosing errors, wrong frequency, and delayed or missed doses.

43
Q

Q40: What guidance has been issued by the EMA on reducing errors with regards to insulins?

A

The EMA advises prescribing insulin by brand name, avoiding unit abbreviations, and providing adequate patient information.

44
Q

Q41: What mistakes have caused DKA when it comes to prescribing and administering insulins?

A

DKA can result from using GLP1 agonists and insulin together and then quickly reducing insulin doses instead of tapering them gradually.

45
Q

Q42: What mistakes have patients made when it comes to self-administering insulins that have caused severe harm and death?

A

Patients should not use insulin syringes to withdraw insulin from pens or cartridges, as syringes calculate doses differently, risking overdose.

46
Q

Q43: What mistakes have prescribers made when it comes to dispensing insulins and caused confusion?

A

Prescribers should ensure correct strength, avoid abbreviating ‘units,’ and prescribe and dispense insulin by brand name to prevent confusion.

47
Q

Q44: What is the MHRA warning regarding the risks of all insulin devices, and what should patients be advised to do as a result of this?

A

MHRA warns of the risk of amyloid deposits with constant site use. Patients should rotate injection sites and consult their GP for dose adjustments if they repeatedly use the same site.

48
Q

Q45: In terms of blood sugar monitoring, what efforts should be made to never go below what blood glucose concentration?

A

Patients should never let their blood glucose levels go below 4 mmol/L.

49
Q

Q46: What are the 3 main patient and carer advice measures given to patients when giving them insulin?

A

Patients should be advised to avoid hypoglycemia, understand insulin types and doses, and be aware of driving and skilled task regulations.

50
Q

Q47: When converting animal insulin to human insulin, what are the dose adjustments, if any?

A

When converting from bovine (cow) to human insulin, reduce the dose by 10% to avoid hypoglycemia. There’s usually no dose change when converting from porcine (pig) to human insulin.

51
Q

Q48: What are the 8 main classes of drugs used to treat Type 2 diabetes?

A

The main drug classes include

  1. Biguanides (e.g., Metformin),
  2. Sulfonylureas,
  3. Meglitinides (e.g., Repaglinide),
  4. Acarbose,
  5. Dipeptidylpeptidase-4 (DPP-4) inhibitors (e.g., Sitagliptin),
  6. Sodium glucose co-transporter 2 (SGLT2) inhibitors (e.g., Canagliflozin),
  7. Thiazolidinediones (e.g., Pioglitazone),
  8. Glucagon-like peptide-1 (GLP-1) receptor agonists (e.g., Liraglutide).
52
Q

What is Hba1c used to diagnose

A

Hba1c used to diagnose type 2 diabetes only

Endocrine Type 2 DM november 23 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions