Diabetes Flashcards
Describe the blood of a T1DM patient?
Low/absent levels of circulating plasma glucose and high levels of glucose
pancreatic beta cells fail to respond to insulin secretory stumili
What % of T1DM patients have circulating autoantibodies?
85%
What genes and chromosome are associated with T1DM?
HLA genes found on chromosome 6
How can further beta cell destruction and complications be prevented in T1DM?
With tight glycemic control
What type of illnesses/diseases can also be associated with T1DM?
Viral infections
Give an example of a viral infection that lead to the development of T1DM?
enterovirus
rotavirus
Describe the pathophysiology of T1DM?
Destruction of pancreatic beta cells = loss of insulin production and therefore increased glucose concentration
How would the pancreas present in T1DM?
Pancreas would show lymphocytic infiltration and destruction of pancreatic islet cells
What are the 3 types of autoantibodies in T1DM?
Islet cells cytoplasmic autoantibodies
islet cell surface antigens
anti-GAD antibodies
Which is the primary autoantibody found in T1DM?
Islet cells cytoplasmic autoantibodies
What % of patients with T1DM have islet cell cytoplasmic autoantibodies present
90% of T1DM patients
What do islet cell cytoplasmic autoantibodies in T1DM target?
target islet cell cytoplasmic proteins
What do anti-GAD autoantibodies target in T1DM?
Against glutamic acid decarboxylase
What are the P’s present in T1DM?
Polyuria
Polydipsia
Polyphagia
When does hyperglycaemia in T1DM develop?
When 80-90% of beta islet cells have been destroyed
At what age is T1DM most likely to present?
5-15 years of age
What happens in DKA?
Extreme insulin deficiency causes osmotic diuresis, dehydration and the formation of free fatty acids
What would a random plasma glucose present in a T1DM patient?
> 11mmol/L
How would a fasting plasma glucose present in a T1DM patient?
> 6.9mmol/l
How would HbA1c of a T1DM patient present?
> 48mmol/L
What autoimmune markers would be present in a T1DM patient?
ICCA
Anti-GAD
ICSA
What is the target HbA1C in T1DM?
<48mmol/l
What are the main aims of treatment in T1DM?
Prevent chronic complications and maintain blood glucose levels
What is the treatment for T1DM?
Insulin therapy
What is a major risk associated with insulin therapy?
Can cause severe hypoglycaemia
how often should all diabetic patients be seen by the diabetic foot team
annually
when would you do with a diabetic patient with reduced sensation of the of the foot
refer to diabetic foot centre
what test is used to evaluate patients with polydipsia
water deprivation test
list 3 causes of nephrogenic diabetes insipidus
CKD
nephrotoxic drugs
metabolic disturbances
