Diabetes
- Created by: Melissaloughlin
- Created on: 14-03-23 22:09
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- Diabetes
- Type 1
- Pancreatic beta cells are destroyed and cannot produce insulin
- Autoimmune disease
- Occurs at any age - more common before adulthood
- Symptoms include: Thirst, polyuria, weight loss, fatigue,
- Insulin therapy required
- Type 2
- Cells become insulin resistant/ insufficient pancreatic insulin production
- Associated with obesity, physical inactivity, hypertension, dyslipidemia
- Diabetes Insipidus
- Excessive urination
- Increased thirst due to this
- unrelated to diabetes mellitus
- Desmo-pressin tablets or nasal spray
- Mimics vasopressin which allows reabsorption of water back into body
- Excessive urination
- MODY
- Maturity Onset Diabetes of the Young
- Different types
- Some may not need treatment with insulin and SUs are enough to manage
- Gestational
- Develops during pregnancy and resolves after delivery
- 1st line - metformin
- 2nd line - insulin
- fasting plasma glucose >7mmol/L - give insulin straight away
- discontinue treatment straight after birth
- Secondary
- Diabetes as a consequence of another condition
- panncreas conditions, cushings, cystic fibrosis, PCOS
- Diabetes as a consequence of another condition
- Complications
- Microvascular
- Retinopathy
- 2-yearly eye screening
- High BG damage blood vessels that supply retina
- Diabetic maculopathy AKA Diabetic Macular Oedema (DMO)
- Blood vessels to macula become blocked
- High risk of affected vision
- Blood vessels to macula become blocked
- Nephropathy
- High BG and BP can damage blood vessels in kidney
- Leakage of protein into urine - Microalbuminurea
- ACR >3mg/mmol
- Leakage of protein into urine - Microalbuminurea
- Symptoms: ankle swelling, dark urine (blood), fatigue, SOB, nausea
- High BG and BP can damage blood vessels in kidney
- Retinopathy
- Macro vascular
- Heart
- Increased risk of MI or heart failure
- Brain
- Increased risk of stroke
- Extremities
- High BG - reduced circulation - slow healing
- Heart
- Hyper-glycemia over a long period
- Diabetic Keto Acidosis (DKA)
- Sweet breath, blurred vision, frequent urination, high ketones, thirst, high BG
- High BG with no insulin - accumulation of glucose - body breaks down fat for energy - produces ketones
- Ketones - high risk >3mmol/L
- Drugs to be discontinued after DKA - SGLT2i, GLP1 agonists, pioglitazone
- Type 1 mainly - can occur in type 2
- Linked to hypertension
- Hyperosmolar Hyper glycaemic State (HHS)
- Only occurs in type 2
- Severe hyper glycemia (>40mmol/L)
- Frequent urination, thirst, nausea, dry skin, disorientation/drowsiness
- Emergency
- Diabetic Keto Acidosis (DKA)
- Sweet breath, blurred vision, frequent urination, high ketones, thirst, high BG
- High BG with no insulin - accumulation of glucose - body breaks down fat for energy - produces ketones
- Ketones - high risk >3mmol/L
- Drugs to be discontinued after DKA - SGLT2i, GLP1 agonists, pioglitazone
- Type 1 mainly - can occur in type 2
- Diabetic Keto Acidosis (DKA)
- Combination of illness & dehydration
- Microvascular
- Type 1
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