Essential Reading: Type 1 diabetes in adults: diagnosis and management. The following guidance is based on the best available evidence.
The full guideline gives details of the methods and the evidence used to develop the guidance. Blood glucose and plasma glucose This guideline refers frequently to circulating glucose concentrations as 'blood glucose'. A lot of the evidence linking specific circulating glucose concentrations with particular outcomes uses 'plasma' rather than 'blood' glucose. In addition, patient‑held glucose meters and monitoring systems are all calibrated to plasma glucose equivalents. 1.1 Diagnosis and early care plan Diagnosis 1.1.1 Diagnose type 1 diabetes on clinical grounds in adults presenting with hyperglycaemia, bearing in mind that people with type 1 diabetes typically (but not always) have one or more of: ketosis rapid weight loss age of onset below 50 years BMI below 25 kg/m2 personal and/or family history of autoimmune disease.
Early care plan. Essential Reading: Type 2 diabetes in adults: management. The following guidance is based on the best available evidence.
The full guideline gives details of the methods and the evidence used to develop the guidance. Terms used in this guideline 1.1 Individualised care 1.1.1 Adopt an individualised approach to diabetes care that is tailored to the needs and circumstances of adults with type 2 diabetes, taking into account their personal preferences, comorbidities, risks from polypharmacy, and their ability to benefit from long‑term interventions because of reduced life expectancy.
Such an approach is especially important in the context of multimorbidity. 1.1.2 Take into account any disabilities, including visual impairment, when planning and delivering care for adults with type 2 diabetes. Essential Reading: Overactive thyroid (hyperthyroidism) An overactive thyroid, also known as hyperthyroidism, is where the thyroid gland produces too much of the thyroid hormones.
The thyroid is found at the front of the neck. It produces hormones that affect things such as your heart rate and body temperature. Extra levels of these hormones can cause unpleasant and potentially serious problems that may require treatment. An overactive thyroid can affect anyone, but it's about 10 times more common in women than men and it typically starts between 20 and 40 years of age. This page covers: Symptoms When to see your GP Treatments Causes Further problems. Essential Reading: Underactive thyroid (hypothyroidism)
An underactive thyroid gland (hypothyroidism) is where your thyroid gland doesn't produce enough hormones.
Common signs of an underactive thyroid are tiredness, weight gain and feeling depressed. An underactive thyroid can often be successfully treated by taking daily hormone tablets to replace the hormones your thyroid isn't making. There's no way of preventing an underactive thyroid. Most cases are caused either by the immune system attacking the thyroid gland and damaging it, or by damage to the thyroid that occurs during some treatments for an overactive thyroid or thyroid cancer. Read more about the causes of an underactive thyroid. When to see your GP Symptoms of an underactive thyroid are often similar to those of other conditions, and they usually develop slowly, so you may not notice them for years.
You should see your GP and ask to be tested for an underactive thyroid if you have symptoms including: Introduction - HSE.ie. An underactive thyroid (hypothyroidism) happens when your thyroid gland doesn't produce enough of the hormone thyroxine, also called T4.
Most cases of underactive thyroid are due to either the immune system attacking the thyroid gland or a damaged thyroid. Immune system Most cases of underactive thyroid happen when the immune system, which normally fights infection, attacks the thyroid gland. Doctors describe this as an autoimmune reaction. This damages the thyroid, which means it is not able to make enough of the hormone thyroxine, and leads to the symptoms of an underactive thyroid. Hashimoto's disease is the most common type of autoimmune reaction that causes an underactive thyroid. It is not clear what causes Hashimoto's disease, but the condition runs in families. Thyroid Disease and Pregnancy - American Thyroid Association.
The risks to the baby from Graves’ disease are due to one of three possible mechanisms: 1) UNCONTROLLED MATERNAL HYPERTHYROIDISM: Uncontrolled maternal hyperthyroidism has been associated with fetal tachycardia (fast heart rate), small for gestational age babies, prematurity, stillbirths and possibly congenital malformations.This is another reason why it is important to treat hyperthyroidism in the mother. 2) EXTREMELY HIGH LEVELS OF THYROID STIMULATING IMMUNOGLOBLULINS (TSI): Graves’ disease is an autoimmune disorder caused by the production of antibodies that stimulate thyroid gland referred to as thyroid stimulating immunoglobulins (TSI).
These antibodies do cross the placenta and can interact with the baby’s thyroid. Although uncommon (2-5% of cases of Graves’ disease in pregnancy), high levels of maternal TSI’s, have been known to cause fetal or neonatal hyperthyroidism. Fortunately, this typically only occurs when the mother’s TSI levels are very high (many times above normal).