Notes in Type 1 Diabetes

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Published	10/08/2024	Type 1 diabetes mellitus (T1DM) is a disease where the {{c1::pancreas stops being able to produce insulin }}
Published	10/08/2024	Type 1 Diabetes may be triggered by the {{c1::Coxsackie B}} virus and {{c1::enterovirus}}.
Published	10/08/2024	The body ideally wants to keep the blood glucose concentration between {{c1::4.4}} and {{c1::6.1}} mmol/l.
Published	10/08/2024	Eating {{c1::carbohydrates}} causes in a rise in blood glucose (sugar) levels
Published	10/08/2024	Insulin is produced by the {{c1::beta}} cells in the {{c1::Islets of Langerhans}} in the pancreas. It is an {{c2::anabolic}} hormone (a …
Published	10/08/2024	Insulin reduces blood sugar in two ways:causes {{c1::cells}} to absorb glucose from the blood and use it as {{c2::fuel}}.causes {{c1::muscle}} and …
Published	10/08/2024	{{c1::Insulin}} reduces blood sugar levels. {{c1::Glucagon}} is a hormone that increases blood sugar levels.
Published	10/08/2024	Glucagon  produced by the {{c1::alpha}} cells in the {{c1::Islets of Langerhans}} in the pancreas{{c2::catabolic}} hormone (a breakdown horm…
Published	10/08/2024	{{c1::Ketogenesis}} occurs when there is an insufficient supply of {{c2::glucose}}, and glycogen stores are exhausted, such as in prolonged fasting…
Published	10/08/2024	People in ketosis have a characteristic {{c1::acetone}} smell to their breath.
Published	10/08/2024	About {{c1::25 - 50}}% of new type 1 diabetic children present in diabetic ketoacidosis (DKA)
Published	10/08/2024	{{c1::DKA}} occurs in a situation where the pancreas can no longer produce enough {{c2::insulin}} to maintain basic blood glucose regulation. …
Published	10/08/2024	classic triad of symptoms of hyperglycaemia: • {{c1::Polyuria}} • {{c1::Polydipsia}} • {{c1::Weight loss}}
Published	10/08/2024	T1DM can also present as secondary {{c1::enuresis}} & recurrent {{c1::infections}}
Published	10/08/2024	Symptoms of T1DM are usually present from {{c1::1 to 6}} weeks prior to developing DKA
Published	10/08/2024	New Diagnosis of T1DM• Baseline bloods including {{c1::FBC}}, {{c1::U&E}} and a formal laboratory {{c1::glucose}} • Blood {{c2::cultures}} s…
Published	10/08/2024	Injecting into the same spot repeatedly can cause a condition called {{c1::lipodystrophy}}, where the subcutaneous fat hardens and prevents normal …
Published	10/08/2024	Basal Bolus Regimes of Insulin  basal: injection of a {{c1::long}} acting insulin, such as “{{c2::Lantus}}”, typically in the evening. …
Published	10/08/2024	{{c1::Insulin Pump}} are an alternative to basal bolus regimes. continuously infuse insulin at different rates to control blood sugar levels&…
Published	10/08/2024	Insulin Pump Advantages better {{c1::blood sugar}} controlmore {{c1::flexibility}} with eatingless {{c1::injections}}.
Published	10/08/2024	Insulin Pump Disadvantages difficulties {{c1::learning}} to use the pumphaving it {{c1::attached}} at all times{{c1::blockages}} in the infusion set…
Published	10/08/2024	There are two types of insulin pump:  {{c1::Tethered}} pumps are devices with replaceable infusion sets and insulin. attached to the pa…
Published	10/08/2024	Short Term Complications of T1DM  • {{c1::Hypoglycaemia}} • {{c1::Hyperglycaemia}} (and {{c1::DKA}})
Published	10/08/2024	Hypoglycaemia  low blood sugar level. in diabetes it is caused by:too much {{c1::insulin}}not enough {{c1::carbohydrates}} not {{c…
Published	10/08/2024	Hypoglycaemia needs to be treated with a combination of {{c1::rapid acting glucose}} such as {{c2::lucozade}} and {{c1::slower acting carbohydrates…
Published	10/08/2024	treating severe hypoglycaemia (impairment of consciousness, seizures or coma)oral glucose would not be safeuse {{c1::IV dextrose}} and {{c1::IM glu…
Published	10/08/2024	Other causes of hypoglycaemia:{{c1::hypothyroidism}}{{c1::glycogen storage}} disorders{{c1::growth hormone}} deficiencyliver {{c1::cirrhosis}}{{c1:…
Published	10/08/2024	Nocturnal hypoglycaemia is a common complication. The child may be {{c1::sweaty}} overnight. Morning blood glucose levels may be {{c2::ra…
Published	10/08/2024	Chronic exposure to {{c1::hyperglycaemia}} causes damage to the {{c2::endothelial}} cells of blood vessels.  leads to {{c3::leaky}}, {…
Published	10/08/2024	Macrovascular Complications of Diabetes  • {{c1::Coronary artery disease}} is a major cause of death in diabetics • {{c1::Peripheral ischae…
Published	10/08/2024	Microvascular Complications of Diabetes  • {{c1::Peripheral neuropathy}} • {{c1::Retinopathy}} • {{c1::Kidney}} disease, particularl…
Published	10/08/2024	Infection Related Complications of Diabetes  • {{c1::Urinary tract infections}} • {{c1::Pneumonia}} • Skin and soft tissue infections, particul…
Published	10/08/2024	Monitoring T1DM HbA1C{{c3::glycated haemoglobin}} (how much glucose is attached to the haemoglobin).reflect the average blood glucose level ov…
Published	10/08/2024	typical presentations diabetes: {{c2::polyuria, polydipsia, weight loss }}DKA: {{c1::abdominal pain, vomiting, confusion, kaussmaul breathin…
Published	10/08/2024	the goal of T1DM management is to achieve a HbA1C <{{c1::48}}mmol/l & pre-prandial glucose between {{c2::4-7}}mmol/l
Published	10/08/2024	Basal Bolus Regimen for T1DM: 1 morning basal dose of {{c1::glargine}} 3 pre-prandial bolus doses of {{c1::Novorapid}}++ continuous insulin …
Published	10/08/2024	during DKA there is respiratory alkalosis from metabolic acidosis -> {{c1::kussmaul breathing}} to compensate
Published	10/08/2024	management of DKA: IV {{c1::0.9}}% saline for 1 hour {{c1::potassium}} if hypokalaemic basal {{c1::insulin}} & 5% {{c1::dextrose}}&…
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