Patho of Type 1 Diabetes
What causes Type 1 Diabetes?
Type 1 diabetes develops because the body's immune system destroys beta cells in a part of the pancreas called the islet tissue. These beta cells produce insulin. So people with type 1 diabetes can't make their own insulin. The pancreas normally adjusts the amount of insulin it makes based on your changing blood sugar.
What blood might be needed to diagnose Type 1 diabetes?
(Name 2 blood tests)
-Fasting blood sugar (FBS) measures blood glucose after you have not eaten for at least 8 hours. It is often the first test done to check for prediabetes and diabetes. (Equal or greater than 7mmol/L)
-Random blood sugar (RBS) measures blood glucose regardless of when you last ate. Several random measurements may be taken throughout the day. Random testing is useful because glucose levels in healthy people do not vary widely throughout the day. Blood glucose levels that vary widely may mean a problem. (equal to or greater than 11.1 millimoles per litre (mmol/L)
-Hemoglobin A1c (also called glycated hemoglobin A1c or glycohemoglobin A1c) measures how much sugar (glucose) is stuck to red blood cells. This test can be used to diagnose diabetes. It also shows how well your diabetes has been controlled in the last 2 to 3 months and whether your diabetes medicine needs to be changed. The result of your A1c test can be used to estimate your average blood sugar level. (Not ideal for diagnosing children)
- C-peptide test or test for autoantibodies. (Autoantibodies are produced when the body's immune system does not work right.) For example, many people with type 1 diabetes produce the autoantibody zinc transporter 8 (ZnT8Ab). People with type 2 diabetes or gestational diabetes do not produce ZnT8Ab.
This type of insulin lasts for 10-16 hours. It’s generally taken twice a day, and it’s used to imitate basal secretion. The basal secretion is the small amount of insulin that’s always in your blood (if you don’t have diabetes).
What represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin. Often one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate depending on hospital policy and doctors orders.
What is it called when cells in the body are unable to get the glucose they need for energy because there is not enough insulin, so the sugar cannot get into the cells and it stays in the blood. The kidneys filter some of the sugar from the blood and remove it from the body through urine.
Because the cells cannot receive sugar for energy, the body begins to break down fat and muscle for energy. When this happens, ketones, or fatty acids, are produced and enter the bloodstream, causing the chemical imbalance (metabolic acidosis)
What causes high blood sugars?
(Get at least three right)
-Not getting enough insulin.
-Eating more food than usual.
-Stress and being ill (such as with severe flu) or having an infection, especially if you aren't eating or drinking enough.
-Taking medicines that can raise blood sugar levels, such as those for sleep, some decongestants, and corticosteroids (such as prednisone).
The dawn phenomenon or the Somogyi effect, which can cause early-morning high blood sugar.
-Adolescence, because of hormone changes and rapid growth.
-Pregnancy.
This type of insulin lasts for 20-24 hours, so you usually take it once a day. Some people may take this type of insulin twice of day for better control of their blood sugar.
what is the formula that 1 unit of rapid acting insulin will generally lower your blood glucose over 2 to 4 hours when you are in a fasting or pre-meal state called?
Correction factor
Example: If your baseline dose of insulin at breakfast is 4 units and your before breakfast blood sugar is 10.5 mmol/L, and your food and activity will be the usual, you need to take 6 units (4 units to cover your food and 2 units to correct for the high blood sugar).
(2 specifically)
2. Fruity acetone breath
What causes low blood sugars?
-Taking too much insulin.
-Skipping or delaying a meal or snack.
-Exercising more than usual without eating enough food.
-Drinking too much alcohol, especially on an empty stomach.
-Taking medicines that can lower blood sugar, such as large amounts of aspirin and medicines for mental disorders.
-Starting your menstrual period, because hormonal changes may affect how well insulin works.
To measure levels of triglycerides and total cholesterol.
This insulin takes effect within 30 minutes to an hour. It’s also taken before a meal, but its effect lasts longer than rapid-acting insulin. It is injected 30 minutes to an hour before meals.
What are signs and symptoms of Type 1 diabetes?
(Name three signs and/or symptoms)
-Urinating a lot, which may be more noticeable at night. The kidneys are trying to get rid of the excess sugar in the blood. To do that, they have to get rid of more water. More water means more urine.
-Being very thirsty. This happens if you urinate so often that you lose enough water to become dehydrated.
-Losing weight without trying. This happens because you are dehydrated. Weight loss may also happen if you are losing all of those sugar calories in your urine instead of using them.
-Increased hunger. You feel hungry because your body isn't using all the calories that it can. Many of them leave your body in your urine instead.
-Blurry vision. When sugar builds up in the lens of your eye, it sucks extra water into your eye. This changes the shape of the lens and blurs your vision.
-Feeling very tired. You feel tired for the same reason you feel hungry. Your body isn't using the calories you are eating, and your body isn't getting the energy it needs.
-Extreme weight loss
This insulin combines two other types of insulin—for example, a rapid-acting and an intermediate-acting insulin. This makes sure that you have insulin to cover the bolus and basal secretions.
-Heart disease
-Nephropathy
-Neuropathy
This type of insulin takes effect within 15 minutes, and you take it right before a meal. In someone without type 1 diabetes, the body releases insulin when they eat; it’s the insulin that should help them process and use the carbohydrates in the food. That release of insulin at mealtime is called the bolus secretion.
What items should you carry with you in case your blood sugars drops under 3.9mmol/l
Eat or drink a fast-acting carbohydrate (15 grams):
15 grams of glucose in the form of glucose tablets (preferred choice)
15 millilitres (one tablespoon) or three packets of table sugar dissolved in water
175 millilitres (¾ cup) of juice or regular soft drink
Six LifeSavers® (one = 2.5 grams of carbohydrate)
15 millilitres (one tablespoon) of honey (do not use for children less than one year old)
HHNK (Hyperglycaemic Hyperosmolar State)