Type 1 diabetes mellitus Flashcards
(25 cards)
What is the cause of T1DM?
Autoimmune destruction of islets
Recall 3 endocrine conditions that can rpesent with diabetes
Phaeocromocytoma
Cushing’s
Acromegaly
What is a less common form of autoimmune diabetes?
LADA
Latent AI Diabetes in Adults
Which haplotypes are implicated in T1DM?
DR3 and DR4
Recall 3 osmotic symptoms of T1DM
- Polyuria
- Polydipsia
- Nocturia
Recall 4 non-osmotic symptoms of T1DM
- Thrush
- Blurred vision
- Weight loss
- Fatigue
Recall 6 SIGNS of T1DM
Dehydration Cachexia Glycosuria Ketonuria Ketone smell Hyperventillation
Describe the hyperventillation experienced in T1DM
Due to metabolic acidosis - body is trying to get rid of CO2 = Kussmaul breathing
What blood marker is used to measure insulin function?
C peptide
What can me measured to confirm a T1DM diagnosis?
- ICA (islet cell auto-Ab)
2. GADA (Glu Acid Decarb Auto-Ab)
Recall the 2 types of insulin therapy and give an example of each
- Short-acting with meals eg glispro
2. Long-acting eg glargine
Recall 2 alternatives to insulin treatment that are used in more serious cases
- Insulin pump
2. Islet cell transplant
Recall 2 methods of measuring blood sugar
- Capillary monitoring
2. HbA1C
What is HbA1C and why is it useful?
Glycosylated Hb = gives an idea of blood sugar over last 120 days
Recall 2 conditions in which HbA1C is less accurate than usual
- Hbopathy
2. Renal failure
What is the main acute complication of T1DM
Rapid decompensation
What are the 2 main features of rapid decompensation in T1DM
- Metabolic acidosis
2. Hyperglycaemia
What are the 2 main effects of insulin deficiency on blood sugar
- HGO cannot be suppressed after a meal so remains high
2. Uptake into muscles is impaired
Recall the defining plasma glucose value of hypoglycaemia
<3.6mmol/L
At what plasma glucose level is consciousness impaired?
<2mmol/L
What are the 2 main risk factors for hypoglycaemia amongst diabetic patients?
- Poor glycaemic control
2. Low HbA1c
Recall and explain 5 clinical presentations of hypoglycaemia
1. Due to ANS activation: Tachycardia Tremor Sweating 2. Due to impaired CNS function Drowsiness Confusion
What is the best oral treatment solution to hypoglycaemia?
Rapid glucose solution compared with complex CHO to tackle short- and long-term needs
If IV nutrition is required in hypoglycaemia, what solution should be administered
dextrose
