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ENDOC > Type 1 diabetes > Flashcards

Type 1 diabetes Flashcards

1
Q

What is type 1 diabetes

A

insulin deficiency - destroyed beta cells in islet of langerhans

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2
Q

when is type 1 most common

A

before adulthood

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3
Q

typical features of type 1

A

-hyperglycaemia >11mmol/l
-ketosis
-rapid weight loss
-BMI <25
-<50yr
-FH of autoimmune disease

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4
Q

how often should blood glucose be monitored and when?

A

-four times a day including before each meal and before bed
-walking
-fasting BG before meals
-90 mins after eating
-driving

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5
Q

how many meals should type 1 diabetics have?

A

3 meals always

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6
Q

what is the target level for walking

A

5-7

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7
Q

what is the target level for fasting BG before meals

A

4-7

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8
Q

90 minutes after eatingwhat is the target level 90 minutes after eating

A

5-9

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9
Q

what is the target level for driving

A

> 5

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10
Q

what are the insulin regimens

A

1) multiple daily dose injections **basal-bolus **
2) bipharic mixture
3) continuous SC insulin infusion (insulin pump)

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11
Q

what is included in multiple daily injection basal-bolus insulin regimen

A

-basal (long/intermediate acting) OD/BD AND
-bolus (short/rapid acting) before meals

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12
Q

what is first line basal insulin regimen

A

detemir BD

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13
Q

What is second line basal insulin regimen

A

glargine OD

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14
Q

What is included in bipharic mixture insulin regimen

A

short acting mixed with intermediate insulin inj 1-3 times a day

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15
Q

when is continuous SC insulin infusion (insulin pump) insulin regimen given?

A

in adults = suffer disabling/uncontrolled hypoglyc

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16
Q

insulin requirements for more insulin

A

infection
stress
trauma

17
Q

insulin requirements for less insulin

A

-physical activity
-intercurrent illness
-less food intake
-impaired renal function
-thyroid disorders
-coeliac disease
-addisons disease

18
Q

why is insulin given by SC

A

if oral it will be inactivated by GI enzymes

19
Q

what are the injection sites for insulin

A

-body areas with SC fat
-abdomen (fastest absorption sites)
-outer thigh/buttocks (slower)

20
Q

why do you need to rotate sites when injecting

A

lipohypertropy can occur due to repeatedly inj same small area erratic absorption of insulin

21
Q

what are the different types of short acting insulin?

A

-soluble insulin
-rapid-acting insulin

22
Q

what is in soluble insulin

A

human + bovine/porcine

23
Q

when should soluble insulin be injected?

A

15-30 mins before food

24
Q

what is onset of soluble injection

A

30-60mins

25
Q

what is peak action of soluble injection

A

1-4hr

26
Q

what is duration of soluble injection

A

upto 9hr

27
Q

types of rapid acting insulin

A

no LAG
-lispro
aspart
glulisine

28
Q

when should rapid-acting injection be injected

A

immediately before meals

29
Q

what is onset of rapid-acting injection

A

<15mins

30
Q

what is duration of rapid-acting injection

A

2-5hr

31
Q

what are the types of insulin

A

-intermediate-acting insulin
-long-acting insulin

32
Q

what is types of intermediate-acting insulin

A

bisphasic isophane
biphasic aspart
lispro (isophane inj mixed with SA insulin)

33
Q

what is onset of intermediate-acting insulin

A

1-2hr

34
Q

what is peak effect of intermediate-acting insulin

A

3-12hr

35
Q

what is duration of intermediate-acting insulin

A

11-24hr

35
Q

what are the types of long-acting insulin

A

Detemir (BD)
Degludec (OD)
Glargine (OD)

36
Q

what is onset of long-acting insulin

A

2-4DY to reach steady state

37
Q

what is duration of long-acting insulin

A

36hr

ENDOC (13 decks)

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