Assalamualaikum wrt wbt.
Dah ala-ala buku medic plak jadinya blog ni. Tak kisah la. Musim exam ni.
Classification of diabetes mellitus
1. Type 1 - Autoimmune destruction of beta cells of Islet
2. Type 2 - insulin deficiency / resistance
3. Type 3 - drugs,genetics,endocrinopathy,exocrine pancrease
4. Type 4 - gestational diabetes (pregnancy)
Diagnosis of diabetes mellitus
1. Fasting plasma glucose >7.0 mmol on 2 separate occasions
2. Random plasma glucose >11.1mmol + symptoms of hyperglycaemia
3. HbA1c >6.5%
4. Oral glucose tolerance test (post 2 housr) > 11.1mmol.
Symptoms of hyperglycaemia
-polydipsia : thirst
-polyuria : increase volume of urine
-weight loss
-hyperphagia : excessive hunger
-tiredness/fatigue
-irritability/problem focusing
-infections
-eye problem : blurred vision
Questions for diabetic patient
-When diabetes was first diagnosed?
-Who diagnosed it? Any symptoms?
-Recent glycaemic control? (HbA1c) Are you keeping a diary for your glucose reading?
-What about your diet now?
-Do you exercise regularly?
-What kind of treatment are you on for your diabetes? :diet,injection,medication
-How long have you been on the treatment?
-Have your doctor make any recent changes to your medication? Why?
-Do you notice any complication for the treatment? :hypoglycaemia episode,site of injection
-Do you see your foot and eye doctors regularly?
-Have you had any hypoglycaemic epidose? Do you know what to do when you become hypo?
-Ask about micro + macrovascular complications of diabetes.
Complications
*MACROVASCULAR
-Do have any heart problem? -heart attack
-What about your brain?Any black out? -stroke
-Any problem/pain in your feet?
*MICROVASCULAR -associated with hyaline arteriosclerosis
-Retinopathy : Are your eye sight ok?
-Neuropathy : Have you notice any change in your sensation? Any pins and needles?
-Nephropathy : What about your kidney?
*INFECTION
-Have you been more prone to infection recently?
Acute diabetic emergency!
*DIABETIC KETOACIDOSIS (Type 1 DM)
-dehydration (thirst)
-nausea/vomiting
-abdominal pain
-ketotic breath
-confusion/drowsiness/coma
-weakness
-gastroparesis
*HYPEROSMOLAR HYPERGLYCAEMIC STATE -HHS (Type 2 DM)
-gross hyperglycaemia (plasma glucose>50mmol/L!)
-marked drowsiness/coma
-dehydration (thirst)
-hyperviscousity : blurred vision,headache,stroke
semua jaga kesihatan ye!
nota metatarsal : esok exam MCQ 25 soalan! Lusa exam clinical skills. Doakan saya dan rakan2! :)
BHA1c x guna kan untuk diagnosis diabetes? still under study kn for the use of dx?
how's exam last time?