Type 1 Diabetes Overview and Symptoms

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Questions and Answers

What typically triggers the onset of type 1 diabetes in children?

Destruction of beta cells by the immune system (correct)

Lifestyle choices and obesity

Excessive sugar consumption

Gradual insulin resistance

Which symptom is NOT commonly associated with type 1 diabetes?

Excessive thirst

Blurred vision

Excessive fat accumulation (correct)

Unexplained weight loss

Which management method is most commonly used for type 1 diabetes?

Dietary changes only

Oral medication

Physical exercise programs

Insulin injections or insulin pump (correct)

What is the role of insulin in the body?

It allows glucose to enter the body's cells Signup and view all the answers

What is the consequence of untreated type 1 diabetes?

Diabetic ketoacidosis (DKA) Signup and view all the answers

Which characteristic is NOT typically associated with type 1 diabetes?

Currently linked to obesity Signup and view all the answers

Which measurement is essential for managing type 1 diabetes?

Blood glucose monitoring Signup and view all the answers

Which symptom relates to excessive appetite in type 1 diabetes?

Polyphagia Signup and view all the answers

What is the primary mechanism of action for Biguanides such as Metformin?

Lowers insulin resistance Signup and view all the answers

What is the primary role of insulin in the body?

To enhance glucose uptake by cells Signup and view all the answers

Which of the following is a common side effect of Metformin?

Diarrhea Signup and view all the answers

Which cells in the pancreas are responsible for producing insulin?

Beta cells Signup and view all the answers

In which scenario should Metformin therapy be avoided?

In patients with renal function issues Signup and view all the answers

What triggers the release of glucagon in the body?

Decreased levels of glucose in the blood Signup and view all the answers

What potential effect can alcohol have when taken with Metformin?

Enhances the effect of Metformin Signup and view all the answers

How does insulin facilitate glucose entry into cells?

By binding to receptors and initiating a transport mechanism Signup and view all the answers

What is a critical nursing consideration when administering Metformin?

Evaluate renal function prior to therapy Signup and view all the answers

What is one of the consequences of low glucose levels in the blood?

Stimulation of glucagon release Signup and view all the answers

What is the main benefit of Metformin compared to other oral hypoglycemic agents?

It reduces mortality rates Signup and view all the answers

What process is stimulated by insulin in response to high glucose levels?

Glycogen production and fatty acid synthesis Signup and view all the answers

Which condition is a contraindication for the use of Metformin?

Liver disease Signup and view all the answers

Which of the following organs do not require insulin for glucose entry?

Brain Signup and view all the answers

How does Metformin affect ketone body development?

Prevents development of ketones Signup and view all the answers

What inhibits the action of insulin?

Low glucose levels and negative feedback from high insulin levels Signup and view all the answers

What is the role of the endothelium in vascular health?

It maintains vascular homeostasis. Signup and view all the answers

What complication can arise from peripheral vascular disease?

Foot damage due to reduced sensation. Signup and view all the answers

Which blood glucose level is classified as hyperglycemia for non-fasting patients?

Above 8 mmol/l Signup and view all the answers

Which factor is NOT a contributor to hyperglycemia?

High physical activity Signup and view all the answers

Which complication arises from long-term hyperglycemia?

Damage to blood vessels Signup and view all the answers

What condition may result from an embolus formed in an atherosclerotic plaque?

Stroke Signup and view all the answers

What is a potential outcome if diabetes is poorly managed regarding foot health?

Leg amputation Signup and view all the answers

Which of the following is a goal of hyperglycemia management?

Monitoring for complications Signup and view all the answers

What primarily causes Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)?

Deficiency of insulin Signup and view all the answers

Which of the following is a characteristic feature of HHNS?

Plasma hyperosmolality greater than 320 mosm/kg Signup and view all the answers

What should be the first focus of treatment in HHNS?

Rehydration and electrolyte homeostasis Signup and view all the answers

Which counterregulatory hormones are released during HHNS that stimulate gluconeogenesis?

Glucagon, growth hormone, cortisol, and catecholamines Signup and view all the answers

What is the primary reason for avoiding rapid reduction of serum sodium in HHNS management?

Risk of cerebral edema Signup and view all the answers

Which fluid is preferred for rehydration in patients with HHNS?

Normal saline Signup and view all the answers

What effect does insulin have on ketone body formation in HHNS?

Inhibits ketone body formation Signup and view all the answers

What is a significant consequence of severe hyperglycemia in HHNS?

Osmotic diuresis Signup and view all the answers

Study Notes

Type 1 Diabetes

The pancreas does not produce insulin in Type 1 diabetes.
Type 1 diabetes represents around 10% of all diabetes cases.
Type 1 diabetes is one of the most common chronic childhood conditions.
Type 1 diabetes has an abrupt onset in children and symptoms are usually obvious.
Type 1 diabetes has a slower onset in adults.
Type 1 diabetes symptoms include excessive thirst and urination, unexplained weight loss, weakness and fatigue, and blurred vision.
Type 1 diabetes is managed with insulin injections several times per day or with an insulin pump.

Type 1 Diabetes Pathophysiology

The body's immune system destroys the beta cells in the pancreas which produce insulin.
Without insulin, glucose cannot enter the body’s cells where it is usually converted into energy.

Type 1 Diabetes Signs and Symptoms

Polydipsia: Excessive thirst.
Polyurea: Passing more urine.
Fatigue: Feeling tired and lethargic.
Polyphagia: Always feeling hungry.
Slow Healing: Cuts heal slowly.
Itching and Infections: Skin itching and infections.
Blurred Vision: Blurred vision.
Unexplained Weight Loss: Unexplained weight loss.
Diabetic Ketoacidosis (DKA): Untreated type 1 diabetes can lead to a medical emergency, Diabetic Ketoacidosis (DKA).

Type 1 Diabetes Management

Insulin cannot be taken as a tablet, as it would be digested by the body's digestive process.
Blood glucose can be measured using a blood glucose monitor or a continuous glucose monitor.

Insulin

Insulin is an anabolic hormone, which creates molecules.
Insulin is crucial in building cell proteins, lipids, and nucleic acids.
Insulin is produced by pancreatic beta cells.
Insulin is released in response to high levels of glucose, amino acids, and fatty acids in the blood.
Insulin binds to and enters the cell, and initiates the glucose transport mechanism so glucose can enter cells.
Insulin can be inhibited by low glucose levels, negative feedback from high insulin levels, and sympathetic nervous system stimulation of alpha cells.
Insulin reduces blood glucose levels by increasing glucose uptake in cells.
The brain, nerves, and kidneys don’t need insulin for glucose entry into cells.

Metformin (Biguanides)

Metformin a first line treatment option in type 2 diabetes.
Metformin is an insulin sensitizer, meaning it improves the body's sensitivity to insulin.
The general action of Metformin is to reduce hepatic glucose production and intestinal glucose absorption.
The general use of Metformin is as an adjunct to diet to lower blood glucose level in individuals with type 2 diabetes mellitus.
Metformin has antiketogenic activity, preventing the development of ketones and thus preventing ketosis.
General side effects: diarrhea, nausea , vomiting, abdominal pain, lactic acidosis, and metallic taste.
General interactions: Beta blockers (can mask hypoglycemia signs); calcium channel blockers; corticosteroids; oral contraceptives; thiazide diuretics (may cause hyperglycemia )
Metformin can interact with contrast dye causing acute renal failure.
Metformin can interact with alcohol, causing potentiated drug effects.
Metformin is excreted unchanged in the urine, making it important to monitor renal function.
Contraindicated in patients at risk of developing lactic acidosis (liver disease, elderly, people taking alcohol or drugs that raise Metformin levels).
Monitor blood glucose levels.
Metformin should be administered with meals.

Endothelium and Vascular Homeostasis

Endothelium is the thin membrane lining the inside of the heart and blood vessels.
The endothelium is crucial for maintaining vascular homeostasis and balance of vasoactive factors that regulate vascular permeability, adhesiveness, and integrity.
Diabetes compromises vascular homeostasis.
Atherosclerotic changes result in the formation of plaques which can occlude blood vessels.
Obstruction of blood vessel circulation in the brain can cause stroke.

Peripheral Vascular Disease

Peripheral vascular disease is reduced blood circulation to the body’s extremities (other than the brain or heart), due to blood vessel narrowing or blockage.
Reduced blood supply to the extremities can cause poor wound healing due to microvascular complications in the feet.

Hyperglycemia

Hyperglycemia is a fasting blood glucose level above 6 mmol/L or non-fasting blood glucose level above 8 mmol/L.
Hyperglycemia can be caused by food choices (processed and high sugar), low physical activity, illness, non-diabetes medications (such as corticosteroids), skipping or not taking enough glucose-lowering medication or insulin.
Long-term hyperglycemia damages blood vessels and can lead to complications that affect nerves, eyes, kidneys, and the heart.
Management of hyperglycemia includes monitoring blood glucose levels, medication (insulin/oral antidiabetic agents), hydration, managing the cause of hyperglycemia, and monitoring for complications like DKA(Diabetic Ketoacidosis) and HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome).

Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)

HHNS is a complication of type 2 diabetes.
HHNS results in a decrease in glucose utilization by peripheral tissue causing hyperglycemia.
The body enters a state of starvation in HHNS.
Glucagon, growth hormone, cortisol, and catecholamines stimulate gluconeogenesis and glycogenolysis.
HHNS symptoms include severe hyperglycemia (>30 mmol/L), osmotic diuresis, profound dehydration, hypovolemia, plasma hyperosmolality (>320 mosm/kg), and hypernatraemia.
Hypernatraemia can cause an altered mental state and can lead to coma.
Ketogenesis is minimal in HHNS.
HHNS is treated with fluid replacement to correct osmolality and electrolyte disturbances, especially potassium depletion.
Fluid replacement should be made in accordance with cardiac and renal function.
Rapid reduction in serum sodium should be limited due to the risk of cerebral oedema.
Normal saline is the preferred rehydration fluid.

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Description

This quiz covers essential information about Type 1 diabetes, including its causes, symptoms, and management strategies. Learn about the role of insulin, the immune system's impact on the pancreas, and how to recognize signs of this condition. Perfect for anyone looking to deepen their understanding of diabetes.