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Endocrinology > Type 1 Diabetes > Flashcards

Type 1 Diabetes Flashcards

1
Q

Identify three clinical features of T1DM

A
  • Polyuria
  • Polydipsia
  • Weight loss
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2
Q

What random plasma glucose concentration is indicative of T1DM?

A
  • Greater than 11 mmol/l
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3
Q

What fasting plasma glucose is indicative of T1DM?

A
  • Greater than 6.9 mmol/l
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4
Q

How long should a patient be fasted for when performing a fasting plasma glucose?

A
  • 8 hours
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5
Q

What does HbA1c reflect?

A
  • Degree of hyperglycaemia over preceding 3 months
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6
Q

What HbA1c concentration is indicative of T1DM?

A
  • Greater than 48 mmol/l
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7
Q

Identify two further investigations (and their results) that can be used to differentiate between T1DM and T2DM

A
  • C-peptide: Negative

- Anti-GAD: Positive

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8
Q

What is the diagnostic criteria for symptomatic people?

A
  • Random plasma glucose greater than 11 mmol/l

OR

  • HbA1c greater than 48 mmol/L
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9
Q

What is the diagnostic criteria for asymptomatic people?

A
  • Random plasma glucose greater than 11 mmol/l AND fasting glucose greater than 6.9

OR

  • HbA1c greater than 48 mmol/L
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10
Q

When should a patient be referred to a diabetic specialist team?

A
  • On the same day
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11
Q

Identify 3 differential diagnoses of T1DM

A
  • MODY
  • Neonatal diabetes
  • Type 2 diabetes
  • LADA
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12
Q

How many times a year should a child attend a diabetes clinic?

A
  • 4
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13
Q

How often should dental examinations be performed?

A
  • Every 4-6 months
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14
Q

How often should eye examination be performed?

A
  • Every 2 years
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15
Q

What is a multiple daily injection basal bolus insulin regimen?

A
  • Intermediate insulin (isophane) for basal dosing once daily
  • Short acting insulin (aspart) for bolus dosing before meals
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16
Q

What is the daily dose of insulin during childhood and then following puberty?

A
  • 0.5 to 1 units /kg/day in childhood

- 1 to 1.5 units/kg/day following puberty

17
Q

What is a honeymoon period?

A
  • Partial remission phase involving a low dose of insulin that is sufficient to maintain HbA1c under target
18
Q

Identify 3 criteria for continuous subcutaneous insulin infusion (insulin pump)

A
  • MDI causes hypoglycaemia
  • MDI is inappropriate or impractical
  • HbA1c remains high despite high level of care
19
Q

What is the target HbA1c in children?

A
  • 48 mmol/mol
20
Q

How many capillary blood glucose tests should be performed each day in children?

A
  • 5
21
Q

What are the optimum targets for short term glucose control in children?

A
  • 4 - 7 on waking
  • 4 - 7 before meals
  • 5 - 9 after meals
22
Q

What should be monitored once yearly?

A
  • Thyroid disease
  • Albuminuria (ACR 3-30 mg/mmol)
  • Hypertension
  • Retinopathy
  • Diabetic foot
23
Q

Identify three sick day rules

A
  • Never stop insulin
  • Check blood glucose more frequently (every 2 hours)
  • Maintain adequate fluid intake (3L)
  • Maintain normal meal patterns
  • Seek medical advice if violently sick, drowsy or unable to keep fluid down
24
Q

Identify basal and bolus dosing for MDI in adults

A
  • Basal: Long acting insulin (detemir) once daily

- Bolus: Short acting insulin (aspart) before meals

25
Q

When should metformin be considered in T1DM? Why?

A
  • BMI greater than 25 kg/m2

- Causes weight loss.

26
Q

Outline the criteria for starting antihypertensive medication in T1DM

A
  • No albuminuria or features of metabolic syndrome = 135/85

- Albuminuria + 2 or more features of metabolic syndrome = 130/80

27
Q

What is the initial antihypertensive treatment in T1DM?

A
  • ACE inhibitor (Ramipril)
28
Q

Identify three criteria for prescribing atorvastatin in T!DM

A
  • Older than 40
  • Has had diabetes more than 10 years
  • Established nephropathy
  • Other CVD risk factors
29
Q

What is the target HbA1c in adults with T1DM?

A
  • Less than 48 mmol/mol
30
Q

How often should HbA1c be measured in in adults with T1DM?

A
  • Every 3 - 6 months
31
Q

What are the short-term plasma glucose target ranges in adults?

A
  • Fasting: 4 - 7
  • Before meals: 4 - 7
  • After meals: 5 - 9
  • When driving: At least 5
32
Q

Identify three conditions in which more regular glucose testing is required?

A
  • Desired glucose target is not achieved
  • Frequency of hypoglycaemic episodes increases
  • During periods of illness
  • Before, during, and after sports
  • Before driving

Endocrinology (7 decks)

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