3BDS: diabetes

?
what is diabetes
Group of metabolic diseases characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action or bot
1 of 35
what is diabetes associated with
Commonly associated with excessive thirst and production of large amounts of urine.
2 of 35
what it is the HbA1c threshold value
>43mmol/mol
3 of 35
what is type 1 diabetes
pancreatic beta cell destruction/ insulin is required for survival, usually characterised by the presence of anti-GAD/anti-islet cell antibodies
4 of 35
what is type 2 diabetes
Insulin resistance and betal cell dysfunction are core defects (obesity. Genetic susceptibility)
5 of 35
what does insulin do in a healthy person, in terms of glucose transport
binds to receptor triggering production of glucose transport proteins to allow glucose to enter the cell.
6 of 35
what is insulin resistance, in terms of glucose transport
the receptor is not as responsive to the insulin molecule and therefore less glucose enters the cell. This results in a build-up of glucose in the blood.
7 of 35
what is insulin resistance associated with
o Intra-abdominal obesity
o Inactivity
o Genetics
o Medication
o Smoking
o Fetal malnutrition
o Endothelial disease
o PCOS
8 of 35
what is the first treatment for T2DM
Lifestyle! Improve diet, weight loss, exercise, smoking cessation
9 of 35
If exercise doesnt work to treat type2 diabetes, what is given next
oral mono therapy, oral combination, injectable and oral therapy
10 of 35
drugs are given taking in consideration some aspects, what are the aspects
duration of diabetes, weight/lifestyle, side effects, patient preference, cost, mode of delivery, degree of improvement required- hypoglycaemia risk
11 of 35
how much glucose does the brain and the body need
125g/day
12 of 35
what is incretin mimetic and what does it do
Incretins are a type of gastrointestinal hormone that cause an increase in the amount of insulin released from the beta cells after eating, even before blood glucose levels become elevated.
They also slow the rate of absorption of nutrients into the bloo
13 of 35
what is the aim of therapy in diabetes?
- Prevent hyperglycaemia
- Avoid hypoglycaemia
- Reduce chronic complications
14 of 35
what are the symptoms and signs of hyperglaemia
Thirst, tiredness, blurred vision, weight loss, polyuria, nocturia, fungal infections, poor healing, dental disease
Cognitive, mood state, information processing, working memory
Potential risk of diabetes ketoacidosis (DKA)
15 of 35
what are the symptoms and signs of hypoglycaemia
Pallor, sweating, tremor, palpitations, confusion, nausea, hunger
Cognitive: tense-tiredness, information processing, working memory, comma
16 of 35
give examples of chronic complications which could be caused by diabetes
of microvascular/ macrovascular disease
metabolic complications- DKA, SHG (severe hypoglycaemia)
psychosocial morbidity

erectile dysfunction
17 of 35
how is blood glucose monitored
• HbA1c
Measure of average blood glucose over a prolonged period of time (6-8 weeks)
• Home blood glucose (HBGM)
Target 4-7mmol/L pre meals, <8mmol/L after meals
• Flash glucose monitoring [freestyle libre]

• Ketones
18 of 35
what is the HbA1c target in diabetes
6.5-7.5%. 48-58mmol/mol
19 of 35
give examples of macro and microvascular diseases
macro: IHD, Stroke
micro: neuropathy, nephropathy, retinopathy
20 of 35
acute complication of hyperglaecamia in type 1 and type 2
Diabetic ketoacidosis (DKA)- type 1 diabetes
Hyperglycaemia hyperosmolar syndrome (HHS)- type 2 diabetes
21 of 35
how does diabetes affect dental diseases
higher risk of periodontal disease

high glucose- poor healing/increased infection/ xerostomia (Dry mouth, oral candidiasis, impaired wound healing)
small blood vessel change- reduced blood flow
22 of 35
so yet again, what could diabetes lead to
Stroke, visual impairment, renal disease cardiovascular disease
23 of 35
Glucose target in hospital
- Glucose target in hospital 6-10 mmol/L with 4-12 mmol/L acceptable
24 of 35
what type of diabetes uses ketone monitoring and what does this identify
type 1
risk of diabetic ketoacidosis
25 of 35
what devices are available to administer insulin
syringe, disposable pen, re-usuable cartridge pen, continuous subcutaneous insulin infusion pump
26 of 35
what is the diabetes management during illness
- Increase monitoring during illness
- Insulin requirements increase due to the body’s response to stress
- Corticosteroids can precipitate hyperglycaemia
- Medication/insulin may require adjustments
27 of 35
what are the signs of diabetic ketoacidosis
excessive thirst
polyuria
dehydration
shortness of breath and laboured breathing
abdominal pain
leg cramps
28 of 35
what are the signs hyperosmolar hyperglycaemic state
nausea
thirst and dry mouth
polyuria
disorientation or confusion

typically seen after several days with glucose levels consistently above 30mmol/L
29 of 35
BEFORE dental Treatment what should you consider
does the person need to fast?
no> then treat as usual
yes> the meds may require adjustments. will the person be able to eat and drink soon after procedure?

yes> continue prescribed meds as usual
no> review medication

presence of infection?
risk of inf
30 of 35
insulin/ medication adjustment for surgery
aim for first on the list
fast
omit morning meds/ insulin
administer insulin post procedure (providing the person is able to eat/ drink)
if prolonged fast is required hospital admission for IV insulin may be required
31 of 35
when is someone said to have hypoglycaemia
when the blood glucose <4mmol/L
32 of 35
What are the symptoms of hypoglycaemia
sweating, palpitation, hunger, confusion, speech difficulty, lack of coordination, drowsiness
33 of 35
what do you do after an episode of hypoglycaemia
provide a starchy carbohydrate snack, consider hospital admission for IV glucose infusion for people treated with oral hypoglycaemic meds
34 of 35
what can be the consequences of hypoglycaemia
death, weight gain, cognitive impairment, DVLA restrictions
35 of 35

Other cards in this set

Card 2

Front

what is diabetes associated with

Back

Commonly associated with excessive thirst and production of large amounts of urine.

Card 3

Front

what it is the HbA1c threshold value

Back

Preview of the front of card 3

Card 4

Front

what is type 1 diabetes

Back

Preview of the front of card 4

Card 5

Front

what is type 2 diabetes

Back

Preview of the front of card 5
View more cards

Comments

No comments have yet been made

Similar Dentistry resources:

See all Dentistry resources »See all diabetes: human diseases resources »