Monitoring Diabetes Mellitus Flashcards Preview

Inflammation > Monitoring Diabetes Mellitus > Flashcards

Flashcards in Monitoring Diabetes Mellitus Deck (31)
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1
Q

Goal of blood glucose monitoring

A

Maintain glucose within target range

2
Q

Immediate benefit of blood glucose monitoring

A

Identify, treatment and prevention of highs and lows

3
Q

Long term benefit of blood glucose monitoring

A

Prevention of long term complications

4
Q

Challenge

A

Getting correct result every time

5
Q

Point of care test is

A

Any test performed on patient out side the laboratory

6
Q

Point of care test advantages

A

Faster stabilisation of threatening crises

Immediate result

Small sample volume

Better compliance

Reduce length of hospital stay
Reduce repeat visits
Better control of disease

7
Q

POCT results in

A

Way shorter waiting times

8
Q

POCT disadvantage

A

Analytical performance can be inferior to lab

Cost is higher than lab

Risk of poor operator competence
Risk of poor quality patient information
Risk of poor equipment maintenance

9
Q

Capillary glucose testing?

A

Often- decided by treatment

Test - for self management

More frequent test is associated with better control

10
Q

Measuring plasma glucose is

A

More accurate but must go to lab

11
Q

Difference between whole blood and plasma glucose

A

Whole blood glucose is q9-15% lower than plasma

12
Q

POCT results are converted to

A

Plasma equivalent

13
Q

Normal glucose % in urine

A

0.1%

Also small amount during pregnancy

14
Q

Urine glucose disadvantages

A

Test is retrospective

Hydration affected results

Not diagnositic

15
Q

Urine dipstick test disadvantage

A

Visual reading is subjective

16
Q

Long term control of blood glucose

A

Glycated haemoglobin ( measure of glucose over 1-3 months)

Serum fructosamine (mean glucose control over 2 preceding weeks)

17
Q

Glycated haemoglobin

A

HBA1C- addition of glucose to N terminal valine of B chain of HB

18
Q

Advantages of using HBA1C

A

Standardised
No patient preparation
Not influenced by stress
Small biological variation

19
Q

Disadvantage of HBA1C

A

Expensive
Increases with age misleading if anaemia or renal failure
Ethnicity

20
Q

Situations in which HbAqc must not be used

A

HbA1c reflects glycaemia over the preceding 2 – 3 months so may not be raised if blood glucose levels have risen rapidly All symptomatic children and young people Symptoms suggesting Type 1 diabetes (any age) Short duration diabetes symptoms Patients at high risk of diabetes who are acutely ill Taking medication that may cause rapid glucose rise e.g. corticosteroids, antipsychotics Acute pancreatic damage/pancreatic surgery

21
Q

What can interfere with HBA1C

A

Haemoglobin variants

Anaemia

Chemicallly altered hb (carbamylation/ acylation)

Reduced glycated not process

22
Q

Ketone measured in

A

Blood

23
Q

Ketones measured how

A

Boood test for hydroxybutyrate

24
Q

Define microalbuminuria

A

24 hour collection- 30-300 mg/24hr

25
Q

Microalbuminuuria can be detected by

A

Not urine dipstick test

26
Q

Diagnosis of microalbuminuria cannnot be made

A

In presence of an acute metabolic crisis and patients should not be screened during inter current illness

27
Q

Ideal glucose monitoring device

A

Minimally invasive/ non invasive

Continuous sensing

28
Q

Continuous glucose monitoring how

A

Subcutaneous implanted enzyme electrode

29
Q

Continuous glucose monitoring measures what

A

Glucose in the tissue

Lags behind blood glucose 5-15 minutes

30
Q

Advantages of cg

A

Frequency of testing

Viewing of trends

Less need for finger sticks

31
Q

Disadvantages of cgm

A

Safety- implanted sensor designed to be used for short amount of time

Efficiency and accuracy - can be rejected by immune system initially

Expensive