Diabetes

Question 1

Classic triad of symptomss in T1DM

Answer 1

Polyuria, polydipsia and weight loss

Question 2

Symptoms of child with type 1 diabetes

Answer 2

Tired, tummy pain, toilet, thirst.
Can also present with DKA, secondary enuresis and recurrent infections

Question 3

What to do after a new diagnosis of type 1 diabetes

Answer 3

Baseline bloods - FBC, renal profile, formal lab glucose.
Blood cultures in suspected infection.
HbA1c
Insulin antibodies, anti-GAD antibodies and islet cell antibodies

Question 4

Associated diseases screened for after diagnosis of T1DM

Answer 4

TFTs and TPOs.
Anti-TTG - associated coeliacs

Question 5

Management of componants of T1DM

Answer 5

SC insulin regimes
Monitoring dietary carb intake
Monitoring blood sugar levels on waking at each meal and before bed
Monitoring for and managing complications

Question 6

Types of regimes for insulin

Answer 6

Basal-bolus (Lantus and Actrapid)
Insulin pumps (tethered or patch pumps)

Question 7

Symptoms of hypoglycaemic episodes

Answer 7

Hunger, tremor, sweating, irritability, dizziness, pallor - more severe can reduce consciousness, coma and death

Question 8

Treatment of hypoglycaemic episodes

Answer 8

Combination of rapid acting glucose and slower acting carbohydrates. When there is impaired consciousness can give IV dextrose and IM glucagon

Question 9

Causes of hypoglycaemic episodes

Answer 9

Malabsorption, diarrhoea, vomiting, sepsis, hypothyroidism, glycogen storage disorders, GH deficiency, liver cirrhosis, alcohol and fatty acid oxidation defects

Question 10

Long term complications of diabetes

Answer 10

Immune system suppression, coronary artery disease, peripheral ischaemia (diabetic foot), stroke, HTN, peripheral neuropathy, retinopathy, kidney disease, UTIs, pneumonias, SSTIs, fungal infections