Flashcards in Type I Diabetes Management Deck (20):
How does diabetes lead to glucose in the blood and muscle wasting?
lack of insulin = lack of cellular glucose uptake
Cellular starvation leads to proteolysis and muscle wasting. Excess circulating glucose leads to glucose in urine
T/F Type I diabetes is an absolute lack of insulin
True, whereas type II is a relative deficiency
Is type I diabetes a slowly progressing disease
Yes, because you need to lose quite a bit of beta cells to get symptoms
What are some examples of long acting insulin? Which one is the most used?
Glargine (Lantus), most used
Some short acting insulin drugs are modified. What's the modification?
modified to make quicker action - how fast it is absorbed from subcutaneous deposition (not the cellular effect)
What are some general structural modifications of insulin
adding or deleting amino acids
adding fatty acids (Detemir)
What is a typical regime of insulin injection? (how is insulin administered)
one long acting insulin at bed time
one short acting insulin before each meal
What is the advantage of using insulin pumps?
provides a background rate of insulin, so long acting insulin is not needed
Patient has control of insulin injected
What is the advantage of artificial pancreas
Adds sensor of glucose, hence preventing hypoglycaemia at night
What are the major issues with pancreas transplantation for diabetes
availability of tissue
life-long immunosuppression leading to increased risk of cancer
Which three tissues are particularly endangered with hyperglycaemia
T/F diabetes is the most common cause of blindness and nephritis
What are some complications of neuropathy from diabetes?
numbness of feet + amputation
autonomic neuropathy - problem controlling blood pressure
Why is it important to measure blood glucose while being put on insulin?
so we can check the effectiveness of the dose given
In what circumstance do we measure fructosamine for diabetes
When the patients have high red cell turnover and artificially low HbA1C
Why do we check for urinary microalbumin
Check for renal function
What are the symptoms of rapid glucose decline?
trigger SNS causing tachycardia, anxiety, tremor. Can also trigger silent angina due to racing heart rate
What are the symptoms of absolute low glucose level?
brain malfunction, paralysis, coma, death
T/F glucagon is the only factor influencing glucose liberation
False, there is some cross interaction with growth hormone and adrenoceptor blockers