Type 1 diabetes is a state of (relative / absolute) insulin deficiency.
absolute insulin deficiency
In all likelihood, Type 1 diabetes is an autoimmune disease with ___ and ___ causes.
genetic and environmental causes
What are the diagnostic criteria for Type 1 diabetes?
Fasting glucose > 7.0 mmol/L
Random glucose > 11.1 mmol/L
+/- blurred vision, UTI
What are some possible triggers for T1 DM?
Weight gain (adiposity??)
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
What happens to beta cells histologically in Type 1 diabetes?
Infiltration by lymphocytes
Destruction of cell
What genes mutate to cause T1 DM?
To add to the list:
Coeliac disease - HLA-DQ2 or HLA-DQ8
Spondyloarthropathies - HLA-B27
What specific autoantibodies cause T1 DM?
Islet cell antibodies (ICA)
At what point is the onset of T1 DM irreversible?
Loss of first phase insulin response
What are the classic symptoms of diabetes?
+/- Symptoms of complications - blurred vision, neuropathy, glycosuria, DKA, CVD
People suffering from DKA will have what positive sign?
How is Type 1 diabetes managed?
Blood glucose and ketone monitoring
What insulin plan are patients with Type 1 diabetes put on?
They take long-acting insulin before bed to last them throughout the night (and day), plus fast-acting insulin matched to their meals
What is the ideal HbA1c level in patients with Type 1 diabetes?
< 48 mmol/mol
In the management of most patients with Type 1 diabetes, you aim for an HbA1c level of 48 - ___ mmol/mol.
48 - 58 mmol/mol
What is assessed at review of patients with Type 1 diabetes?
FBC - HbA1c, renal function, lipids
Type 1 diabetes is most common in (young / older) people.
What congenital disease, causing pancreatic damage, predisposes patients to developing secondary diabetes?
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)
Insulin secretion is ___.
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?
Late-onset Type 1 diabetes
What is a rare autosomal recessive disease which causes:
Out of Type 1 diabetes, LADA, MODY and Type 2, which is most associated with ketonaemia?
Type 1 diabetes
What are some autoimmune diseases associated with Type 1 diabetes?
Pernicious anaemia (parietal cells destroyed leading to Vit B12 insufficiency)
Addison's disease (hypoadrenalism)