Management of type 1 diabetes Flashcards
What are the common symptoms of type one diabetes
Polyuria
Polydipsia
Tired
Weight loss
Blurred vision
What is the immediate test for diagnosis of diabetes
Finger prick glucose test - random glucose - more than 11mmol/l is diagnostic
What insulin is given to new T1 diabetics
Levemir with a rapid acting analogue such as humalog
What are the different types of basal bolus insulin therapies
rapid bolus acting insulin to cover carbohydrates during a meal - 1 unit per 10g carbohydrates
Basal long acting insulin - twice daily
What are the symptoms of DKA - diabetic ketoacidosis
Nausea and vomiting
Abdominal pain
ketone breath
drowsiness
deep respiration
coma
What are the signs of ketoacidosis
Dry mucous membranes
tachycardia
hypotension
ketone breath
Kussmaul breathing - rapid deep breathing
What is a normal blood ketone level
Less than 0.6 mmol/l
What is a ketone level diagnostic of DKA
3.0mmol/l and above
What to do if the ketone level is found raised
Give excess insulin and recheck if the ketone levels have decreased after 2 hours
Describe management of type 1 diabetes
1000ml/hour 0.9% saline for hour 1 and again at hour 2
Start actrapid 6 units/hour for hour 1 and if blood glucose is still over 14, give another 6 units/jour and hour 2
At hour 3+4 give 500ml/hour 0.9% saline with or without KCL
4 hours before discharge, reduce saline and KCL
What are complications of ketoacidosis
Hyper and hypokalaemia
Hypoglycaemia
cerebral oedema
aspiration pneumonia
Arterial and venous thromboembolisms
Acute respiratory distress syndrome
What is hypoglycaemia
Blood glucose lower than 4mmol/L
What are symptoms of hypoglycaemia
neuroglycopenic - symptoms which arrise from the CNS having low access to blood glucose
What can cause hypoglycaemia
Too much insulin
Inadequate food intake
exercise
alcohol
What does an insulin pump do
Gives the exact amount of insulin required
