Type 1 diabetes mellitus

Question 1

define T1DM

Answer 1

The pancreas stops producing insulin, leading to the cells not being able to take in glucose and can lead to hyperglycaemia.

Question 2

Where is insulin produced?

Answer 2

Insulin is produced in the Beta Cells of the Pancreas

Question 3

what is insulin used for?

Answer 3

helps cells take in glucose and use it as fuel in addition to storing it as glycogen

Question 4

What is dysfunctional in T1DM?

Answer 4

the pancreas is dysfunctional (thought to be due to autoimmunity) and no longer produces insulin.
Without insulin, the body cannot use glucose as a fuel source.

Question 5

what accumulates in the blood and through which processes does it increase in T1DM?

Answer 5

-Glucose also accumulates in the blood, leading to hyperglycaemia.
-Gluconeogenesis is also increased which contributes to this
-Lipolysis also increases leading to more fatty acids which are broken down into ketones and can lead to ketosis.

Question 6

what type of hypersensitivity reaction is T1DM?

Answer 6

TYPE 4

Question 7

What are the signs of T1DM?

Answer 7

-Diabetic Retinopathy
-Diabetic Foot disease
-Glove and Stocking sensory loss
-BMI <25kg/m2
-Reduced Visual Acuity

Question 8

What Is the epidemiology for T1DM?

Answer 8

-Young (typically 5 – 15 years old)
-Lean
-North European Descent
-10% of all diabetes is type 1

Question 9

what are the symptoms for T1DM?

Answer 9

-Polyuria
-Polydipsia
-Fatigue
-Weight loss
-Recurrent infections

Question 10

What are the macrovascular complications of T1DM?

Answer 10

Atherosclerosis, linked with CVD, PVD and Stroke

Question 11

What are the microvascular complications of T1DM?

Answer 11

Nephropathy, Neuropathy (Diabetic Foot Disease) and Retinopathy (Glaucoma)

Question 12

what diseases is T1DM linked to?

Answer 12

Is linked to Thyroid disease, gastritis, anaemia, coeliac, vitiligo and Addison’s disease, DIABETIC KETOACIDOSIS

Question 13

what psychological problems are associated with T1DM?

Answer 13

Anxiety, Depression, Eating Disorders

Question 14

what is an abnormal random blood/ plasma glucose result?

Answer 14

> 11.1mmol/l

Question 15

what is an abnormal fasting blood/ plasma glucose result?

Answer 15

> 7mmol/l

Question 16

what is an abnormal Hb1Ac result?

Answer 16

> 48mmol/mol
( GOLD STANDARD)

Question 17

how may abnormal readings do you need to get a T1DM diagnosis?

Answer 17

In symptomatic patients, one abnormal result will do.

In asymptomatic patients, you need two abnormal readings on two different days.

Question 18

what is the first line of treatment of T1DM?

Answer 18

Basal-Bolus Insulin.
Basal insulin is long-acting whilst Bolus insulin is short-acting and taken before meals.

Question 19

what other treatment could you have for T1DM if you don’t like injections?

Answer 19

• Mixed Insulin Regimenwhich is taken twice a day and is a mixture of short-acting and intermediate-acting insulin.

-Insulin Pump which continually infuses insulin into the body. It is very effective at blood glucose control.