type 1 diabetes Flashcards
(13 cards)
how does type 1 diabetes typically present
with ketoacidosis
type 1 diabetes investigations
- urine dip
- fasting + random glucose
HbA1c NOT useful if possible/suspected T1DM - may not accurately reflect recent rapid rise in serum glucose
C-peptides = low
which test is helpfful in distinguishing between type 1 and 2 diabetes
diabetes-specific autoantibodies
T1DM;;
- anti-GAD
- islet cell antibodies
- insulin autoantibodies
diagnostic criteria for T1DM
symptomatic
- fasting - >=7
- random - >=11.1
if asymptomatic, above criteria must be demonstrated on 2 separated occasions
investigation of choice when distinguishing between type 1 + 2 diabetes
C-peptide levels
diabetes specific autoantibodies
side effects of insulin
hypoglycaemia
weight gain
lipodystrophy
how often should HbA1c be monitored in T1DM and what should their target be
every 3-6months
target - <=48
how often should T1DM monitor their blood glucose
at least 4 times daily
before each meal + before bed
blood glucose targets on waking vs before meals at other times of day
on waking = 5-7
throughout day = 4-7
preferred choice of insulin
multiple daily injections (MDI) basal bilus regime
–> twice daily basal insulin determir, insulin aspart bolus with meals
when should metformin be added to management of T1DM
if BMI >=25
fasting plasma glucose + HbA1c indicating prediabetes
fasting plasma glucose - 6.1-6.9
HbA1c - 42-47
management of prediabetes
lifestyle measures
at least yearly follow up
metformin for adults at high risk ‘whose blood glucose shows they are still progressing T2DM despite participation in intensive lifestyle-change
