7: Pathophysiology of T1 DM Flashcards Preview

Endocrine Week 1 2017/18 > 7: Pathophysiology of T1 DM > Flashcards

Flashcards in 7: Pathophysiology of T1 DM Deck (24)
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1

Type 1 diabetes is a state of (relative / absolute) insulin deficiency.

absolute insulin deficiency

2

In all likelihood, Type 1 diabetes is an autoimmune disease with ___ and ___ causes.

genetic and environmental causes

3

What are the diagnostic criteria for Type 1 diabetes?

Fasting glucose > 7.0 mmol/L

Random glucose > 11.1 mmol/L

and symptoms:

polyuria

polydipsia

weight loss

fatigue

+/- blurred vision, UTI

4

What are some possible triggers for T1 DM?

Viral infection

Maternal factors

Weight gain (adiposity??)

5

If you're unsure whether a person has Type 1 or Type 2 diabetes and you've tested glucose, what other two tests could you carry out?

Islet autoantibody test

C-peptide levels

6

What happens to beta cells histologically in Type 1 diabetes?

Insulitis 

Infiltration by lymphocytes

Destruction of cell

7

What genes mutate to cause T1 DM?

HLA-DR3/DR4

To add to the list:

Coeliac disease - HLA-DQ2 or HLA-DQ8

Spondyloarthropathies - HLA-B27

8

What specific autoantibodies cause T1 DM?

Islet cell antibodies (ICA)

9

At what point is the onset of T1 DM irreversible?

Loss of first phase insulin response

10

What are the classic symptoms of diabetes?

Polyuria

Polydipsia

Weight loss

Fatigue

+/- Symptoms of complications - blurred vision, neuropathy, glycosuria, DKA, CVD

11

People suffering from DKA will have what positive sign?

Ketonaemia

12

How is Type 1 diabetes managed?

Blood glucose and ketone monitoring

Insulin

13

What insulin plan are patients with Type 1 diabetes put on?

Basal-bolus

They take long-acting insulin before bed to last them throughout the night (and day), plus fast-acting insulin matched to their meals

14

What is the ideal HbA1c level in patients with Type 1 diabetes?

< 48 mmol/mol

15

In the management of most patients with Type 1 diabetes, you aim for an HbA1c level of 48 - ___ mmol/mol.

48 - 58 mmol/mol

16

What is assessed at review of patients with Type 1 diabetes?

Weight

BP

FBC - HbA1c, renal function, lipids

Retinal screening

Foot assessment

17

Type 1 diabetes is most common in (young / older) people.

young people

18

What congenital disease, causing pancreatic damage, predisposes patients to developing secondary diabetes?

Cystic fibrosis

19

What are some types of diabetes you're likely to see in young people?

Type 1 diabetes

Monogenic diabetes  / MODY (which covers neonatal diabetes)

LADA (late-onset T1 diabetes)

Secondary diabetes (to something like cystic fibrosis)

 

20

Insulin secretion is ___.

biphasic

21

A male patient develops diabetes at the age of 30, is lean and positive for Islet cell antibodies. He has Crohn's disease, doesn't require insulin but can't control his diabetes very well with drugs.

What does he likely have? 

LADA

Late-onset Type 1 diabetes

22

What is a rare autosomal recessive disease which causes:

Diabetes insipidus

Diabetes mellitus

Optic atrophy

and deafness?

Wolfram syndrome

23

Out of Type 1 diabetes, LADA, MODY and Type 2, which is most associated with ketonaemia?

Type 1 diabetes

24

What are some autoimmune diseases associated with Type 1 diabetes?

Thyroid disease

Coeliac disease

Pernicious anaemia (parietal cells destroyed leading to Vit B12 insufficiency)

Addison's disease (hypoadrenalism)

Vitiligo