Type 1 DM Flashcards
What is Type 1 DM?
Epidemiology points about T1DM
If both parents have Type 1 DM then your chance of getting it is 30%, for Type 2 it’s 80%
More prevalent in winter months
Peak age at diagnosis is 10-14 years old
Genotype: HLA complex chromosome - HLA class II, responsible for about 50% of familial clustering
What is the ratio of basal level insulin secretion and post-prandial insulin secretion?
1:1
How are T1 T2 biopsy pathology different?
T1 has lymphocytes stacking, while T2 has amyloid buildup
What are risk factors and accelerating factors of pre-diabetes stage/clinical diabetes for T1DM?
What are the three stages of T1DM and what are the diagnostic criteria?
Hba1c is not really used for diagnosis in T1, as opposed to T2
Often T1 is diagnosed on the history and presentation (like DKA) alone
If in doubt, GAD/IA2 antibodies and C-peptide may help
How does idiopathic type 1 diabetes present?
How does LADA (latent autoimmune disease in adults) present?
Often misdiagnosed as Type 2
Some endogenous insulin production in the first few years, but would stop around 5 years after diagnosis
What questions and investigations would be required for a newly presenting patient?
Does the patient drive?
How to differentiate between different sub-types of T1?
How to manage newly-diagnosed patient with T1 (including pharmacological ones)?
What is glycaemic memory and how is it clinically relevant?
If you control blood glucose intensively for the first few years after diagnosis, it is more likely for the patient to have better outcome decades after
What are the aims of therapy in T1DM?
How are analogue insulins better than human ones?
Smoother action and less risk of hypoglycemia
Compare between insulin analogues and soluble insulins (both post-prandial ones)
