Type 1 Diabetes Mellitus Flashcards
1
Q
What is type 1 diabetes?
A
- usually presents in childhood or early adulthood
- it is caused by autoimmune destruction of the insulin-producing B-cells of the pancreatic islets leading to insulin dependency
2
Q
What are the signs and symptoms of the condition?
A
- the symptoms are of hyperglycaemia and include
- thirst
- polydipsia
- weight loss
- fatigue
- blurred vision
3
Q
What are the complications of type 1 diabetes?
A
- microvascular complications -> caused by chronic hyperglycaemia
- retinopathy -> can cause blindness
- nephropathy -> can progress to chronic kidney disease
- neuropathy
- cataract formation
4
Q
How is it treated?
A
- subcutaneous insulin injections
- some patients use a continuous subcutaneous insulin infusion
- diabetic diet is high in unrefined carbohydrate and low in fat
- patients are encouraged to monitor their own capillary glucose concentrations
5
Q
What are some of the issues in pregnancy?
A
- miscarriage
- hypoglycaemia
- hyperemis gravidarum
- congenital malformation
- IUGR
- macrosomia
- polyhydramnios
- premature labour
- pre-eclampsia
- unexplained fetal death
6
Q
What is the role of the midwife antenatally?
A
- referral to combined diabetic-obstetric antenatal clinic
- ensure that all screening procedures are performed in a timely manner
- advise on weight management if appropriate
- discuss plans for infant feeding, ?colostrom harvesting
- ensure plan of delivery is made
- advise to go to unit if feels unwell or has reduced fm
- advise about risk of hypoglycaemia
- advise on aspirin treatment from 12 wks gestation
- insulin dose needs to be increased from 20-36 wks
7
Q
What is the midwives role in labour?
A
- hourly measurement of maternal blood glucose
- continuous EFM
- anticipate shoulder dystocia
- notify paeds once labour is established and call for delivery
- optimise blood glucose control at 4-7mmol/l using intravenous insulin
- prevent maternal hyperglycaemia and neonatal hypoglycaemia
8
Q
What is the midwives role postnatally?
A
- monitor neonatal blood glucose levels should be monitored as per policy
- infants offered early feeding and observed for signs of hypoglycaemia
- observe for maternal hypoglycaemia
- breast feeding actively encouraged
- follow up appt made to diabetes team
