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Monitoring diabetes - Coggle Diagram

- - - - Portable, cheap
      - Imprecise, inaccurate if hypoperfusion of peripheries
    - - Portable, continuous measurement, no blood needed
      - expensive, relatively imprecise, can give overwhelming amounts of data
      - Alarms when youre hypo/hyperglycaemic
    - - Prices and accurate
      - lengthy and need venous blood in lab
- - - - Glucose oxidase reaction coupled to a redox reaction which generates a current and gives result
  - - - Downloads data several times a day with readings and trends
  - - - Type of haemoglobin
    - - Passed through a column of negatively charged immobile phase
        
        Proteins pass at different speeds
        
        HbA1c passes quicker than HbA0
        
        Then Hb types are detected by UV absorption
    - - Conditions which affect this make HbA1c unsuitable for diagnosis
        
        Pregnancy
        
        Splenomegaly, rheumatoid arthritis, anti-retroviral therapy
        
        Haemoglobinopathies
    - - This is unsuitable for suspected type 1 diabetes diagnosis and steroid induced diabetes
      - Also unsuitable for those who have had recent blood transfusions
  - - - Hyperthyroidism
      - Nephrotic syndrome
      - Paraproteinaemias
  - - - Glycation of protein/collagen in glomerular capillary basement membrane
        
        Leads to inflammation and glomerular sclerosis
      - Atherosclerosis of renal artery / arterioles
        
        Ischaemic damage
    - - Progressive rise in creatinine, fall in eGFR
      - Proteinuria
        
        May be detected via dipstick testing and lab based albumin/protein measurement
        
        in lab based albumin/protein measurement creatinine is used: protein:creatinine ratio, albumin:creatinine ratio
    - - microalbuminuria = abnormally high level of albumin but still to low for detection by dipstick
        
        Can occur transiently
        
        predicts nephropathy in diabetes
- - - - Measure blood gas - test H+ content indicating metabolic acidosis
      - Test for ketone bodies in urine/blood
        
        Almost invariably indicates type 1
      - Measure c-peptide to check whether a diagnosis is type 1 or 2
      - Test for presence of autoantibodies
- - - - Diabetic foot
    - - End-stage renal failure
    - - Stroke
      - PVD
      - MI
    - - Sight loss
  - - - Diabetic ketoacidosis
    - - Sulphonylureas
      - Insulin changes in diet of exercise or stress
    - - Hypovolemia
      - Blurred vision
      - Polydipsia
      - Mental clouding
      - Polyuria
      - Increased risk of infection