Type 1 diabetes

Question 1

What is the pathophysiology of type 1 diabetes?

Answer 1

Beta-cell events trigger autoimmune response. antibodies to insulin or GAD generally appear first. other beta-cell antibodies follow: IA2, Zn2+ transporter 8. selective immune beta-cell destruction.

Question 2

What are the possible autoimmune triggers of type 1 diabetes?

Answer 2

Viral infection (coxsackie), ER stress, cytokines

Question 3

Which conditions are associated with type 1 diabetes?

Answer 3

Coeliac disease, hypothyroidism, Grave’s disease Addison’s disease, hypogonadism, pernicious anaemia,
vitiligo, autoimmune polyglandular syndromes

Question 4

What are the symptoms of type 1 diabetes?

Answer 4

lethargy, polyuria, polydipsia, blurred vision, Candida infections, weight loss, ketoacidosis, death

Question 5

What needs to be investigated when diagnosing type 1 diabetes?

Answer 5

Age of onset, rapidity of onset, phenotype, PMH, FH,
weight loss, ketosis, GAD/IA2/Zinc transporter 8 antibody positive.
C-Peptide

Question 6

Which factors affect blood glucose concentration?

Answer 6

Diet, injection site, temperature, exercise, illness, stress,
alcohol, menstrual cycle

Question 7

What are the autonomic and neuroglycopaenic symptoms of hypoglycaemia?

Answer 7

Palpitation, sweating, tremor.

Confusion.

Question 8

What are the types of pancreas transplantation?

Answer 8

SPK: simultaneous pancreas-kidney transplant.
PAK: pancreas after kidney transplant.

Question 9

How and when should glucose be monitored?

Answer 9

CGMS - continuous glucose monitoring system.
CGMS - flash continuous glucose monitoring system
HbA1c (glycated haemoglobin) - reflects glucose over last 3 months.
Minimum 4 x daily, driving, unwell, hypoglycaemia

Question 10

How are ketones monitored?

Answer 10

by patient - blood and urine.