Type 1 DM Flashcards
what drugs can induce diabetes?
glucocorticoids
atypical antipsychotics
T1DM with autoimmune etiology
Type 1a
T1DM with no evidence of autoimmunity
Type 1b
which chromosone has major susceptibility genes for T1DM
on HLA region of chrom 6
which haplotypes make one more susceptible for DM1
HLA-DR3
DQB
DR4
is genetic risk higher for kids who has affected mother or father?
affected father
what mediates the immune response in Type 1 DM?
inappropriate adaptive immune response that targets beta cells
does type 1A or 1B have an HLA association?
type 1A
what specifically mediates destruction of the beta cells
T cells
80% of ppl are positive for what Ab at time of dx?
glutamic acid decarboxylase Ab (GAD65)
is risk of Type1 DM proportional to number of Ab present?
yes
perinatal factors related to incr risk of Type 1 DM (5)
- maternal age >25
- smoking
- preeclampsia
- neonatal respiratory distress
- jaundice
what may be protective against type 1 DM?
breastfeeding, vitamin D, exposure to immune-mediated diseases in childhood
what is the bimodal distribution of T1DM?
age 4-6, 10-14
what is needed for Dx of T1DM (3)
- formal OGTT
- Ab may be present
- low C-peptide
how does DKA present?
dehydration, acidosis, low BP, orthostasis, tachycardia, acetone smell, decr body temp
tx of DKA (3)
- aggressive volume resuscitation
- correct hyperglycemia with insulin
- replete elecrolytes
tx goals of diabetes (4)
- normoglycemia
- normal A1c
- normal growth
- tx cardiac risk factors
which meds are used to meet basal needs (2)
- glargine
2. detemir
what sort of insulin to use for meal or stress needs
bolus/rapid insulin
what is the total insulin requiremnt in T1DM
0.6 units/ kg bodyweight
what is basal insulin requirement?
0.2-0.3 U/Kg body weight
what percentage of daily insulin needs to be given as basal insulin?
50%
what is a continous subcut insulin infusion
pump
