What is it?
Dependent on insulin. The body does not produce insulin (no beta cells - autoimmune). Cells starve → liver gluconeogenesis and glycogen released → hyperglycaemia → glucose in urine → excessive thirst & urination |
S/S
3 Ps (polyuria, polydipsia, polyphagia). Glucosuria |
|
|
Management
1 unit of insulin for every 15g CHO – varies on individual sensitivity – insulin resistance higher in overweight, children, teens. Doctor will prescribe dose, we can make sure that they match their intake. |
Insulin Sensitivity Factor (ISF)[only related to bolus insulin] = 1 unit insulin: 2mmol reduction |
General healthy eating principals. 45% CHO, 15-20% P, 20-30% fat |
Nut Objectives Achieve or maintain body weight, HbA1c <7%, delay or prevent complications. |
Strategies
Carb counting app, label reading, matching insulin w/ CHO intake |
Get pt to create a CHO list based on their common foods |
Get pt to pre-portion amounts into bags, so they don’t need to weigh all the time |
Education: T2DM vs T1DM, complications, hypos after exercise, hypos when drinking |
|
|
Treatment hypoglycaemia
BGL <4.0mmol (with or without S/S) |
S/S: Hunger, Irritability, Sweating, Weakness/shaking, Light headedness, and/or Headache |
STEP 1 |
1. Consume 15g CHO – lollies, juice, soft drink |
2. Wait 10-15 mins. Check again. |
3. BGL >4.5mmol, they can process to step 2 |
4. If levels hasn't risen to >4.5mmol, they need to repeat with another 15g of CHO |
STEP 2 |
1. If your next meal is less than 20 minutes away, consume this meal |
2. If your next meal is more than 20 minutes away, eat some slower acting |
Example PESS
P: inadequate energy intake, inappropriate intake of types of carbohydrates, inconsistent carbohydrate intake |
|
