clinical features of T1 diabetes Flashcards
what is the risk that HLA genes represent?
50% familial risk
what is the diagnosis criteria for diabetes?
Fasting glucose ≥ 7.0mmol/l
Random ≥ 11.1mmol/l
and symptoms, OR repeat test
if in doubt-GAD/IA2 antibodies
what is the definition of T1 diabetes?
due to autoimmune β-cell destruction, usually leading to absolute insulin deficiency
what is the definition of T2 diabetes?
due to a progressive loss of β-cell insulin secretion frequently on the background of insulin resistance
can some forms of T1 have no known aetiologies?
yes
what is the classic age ranges that people present with T1?
Pre-school and peri-puberty
Small peak in late 30’s
what are the clinical features of T1?
Acute Onset
severe symptoms
severe weight loss
ketonuria with/without metabolic acidosis
no evidence of microvascular disease at diagnosis
immediate and permanent requirement for insulin
what is the typical age range for T2?
middle-aged/elderly
what are the clinical features of T2?
usually obese
pre-diagnosis duration of probably 6-10 years
insidious onset over weeks to years
ketonuria minimal or absent
evidence of micro-vascular disease at diagnosis in 20 %
what is the initial management of T2?
diet and tablets
what does ketosis indicate?
T1
what is the general presentation of diabetes?
Thirst
Polyuria
Thrush
Weakness Fatigue
Blurred Vision
Infections
(Weight Loss)
management of newly diagnosed T1 (patient POV)?
Blood glucose and ketone monitoring
Insulin: usually basal [once daily] bolus [with meals] regimen
Carbohydrate estimation
Regular DSN and Dietitian contact
Appropriate medical clinic review
Education about self management
-Structured education DAFNE BERTIE
-Sick day rules
management of newly diagnosed patient (Dr POV)
Annual review assessment
Weight
Blood pressure
Bloods: HbA1c, Renal Function and Lipids
Retinal screening
Foot risk assessment
Record severe hypoglycaemic episodes or admission with diabetic ketoacidosis
