1What are some symtpoms of hypoglycaemia?
Diffculty concentrating; Confusion; Weakness; Vision changes; Dizziness; Tiredness
2What is the definition value of hypoglycaemia?
Blood glucose below 4.0mmol/L; Blood glucose below 3.0mmol/L is classified as clinically significant
3What are the levels of severity of hypoglycaemia?
Level 1: Between 3 and 3.8mmol/L; Level 2: less than 3 mmol/L; Level 3 : severe hypoglyaemia
4What hormones can oppose hypoglycaemia?
Glucagon; Adrenaline; Cortisol; GH
5What are some causes of hypoglycaemia in T1D?
Skipped meals when taking medications; Increasing physical activity without adjusting food or medications; Renal impairment; Excess alcohol consumption
6What is nocturnal hypoglycaemia?
Hypoglyacemia is delayed after physical activity that appears during the night
7What is hypoglycaemi associated automonomic failure chacracteried by?
Reduced cointer regulatory hormone response; Reduced autonomic symptoms; Lowered glycaemic tresholds for triggeriing symtptoms and hormonal responses
8What is a CGM?
Continuous glucose monitoring
9What is an AID?
Automated insulin delivery system
10What is dyslipidaemia?
An abnormal amount of lipids in the blood
11What are some chronic complications of diabetes?
Microvascular - kidney disease, nerve disease, blindess; Macrovascular - atheroscleroiss and cardiovascular events
12What effects does reactive oxygen species accumulation and oxidative stress have?
Activation of pro inflammatory signalling cascades —> impaired vasodillation and increased vascoconstriction
13What is a proposed mechanism of hyperglycaemia induced cellular damage?
Advanced glycation end products which increase expression of TNF alpha and NOX
14What are AGEs?
Advanced glycation end products caused by non enzymaticc reactions
15What is an example of a mechanism linking AGEs and hyperglycaemia?
Increased glycolysis increases ROS levels; Activation of enzymes involved in DNA repair can impair glycolysis and lead to generation of AGEs; AGEs increase oxidative stress and ROS; Cycle begins again
16How does AGEs affect cellular functions?
Cause structual protein modification - basement membrane thickness, reduced vascular elasticity; Interactions with AGE receptors - gene expression of pro inflammatory molecules
17What is diabetes retinopathy?
Chronic progressive disease of the retinal microvasculature
18What is diabetes nephropathy?
Progressive kidney disease caused by long standing diabetes
19What is diabetes nephropathy characterised by?
Proteinuria; Glomerular hypertrophy; Renal fibrosis; Reduced glomerular filtration
20What is diabetes neuropathy?
Chronic progressive disorder of the peripheral nervous system due to damage to the vasa nervorum
21What is a diabetes foot ulcer?
22What are some macrovascular complications of diabetes?
Stroke; Heart disease - MI, heart failure; Peripheral artery disease
23What are some other complications of diabetes?
Community aquired pneumonia