Diabetes Mellitus Type 1

Question 1

Define diabetes mellitus type 1.

Answer 1

Type 1 diabetes mellitus is a metabolic disorder characterised by hyperglycaemia due to absolute insulin deficiency. The condition develops due to destruction of pancreatic beta cells, mostly by immune-mediated mechanisms.

Question 2

Explain the aetiology/risk factors of diabetes mellitus type 1.

Answer 2

Geographical region
Genetic predisposition
Infectious agents

Question 3

Summarise the epidemiology of diabetes mellitus type 1.

Answer 3

Type 1 diabetes accounts for about 5% to 10% of all patients with diabetes. It is the most commonly diagnosed diabetes of youth (under 20 years of age) and causes ≥85% of all diabetes cases in this age group worldwide.

Question 4

Recognise the presenting symptoms of diabetes mellitus type 1. Recognise the signs of diabetes mellitus type 1 on physical examination.

Answer 4

Polyuria
Polydipsia
Young age
Weight loss
Blurred vision
Nausea and vomiting
Abdominal pain
Tachypnoea
Lethargy

Question 5

Identify appropriate investigations for diabetes mellitus type 1 and interpret the results.

Answer 5

Random plasma glucose
Fasting plasma glucose
2-hour plasma glucose
Plasma or urine ketones
HbA1c

Question 6

Generate a management plan for diabetes mellitus type 1.

Answer 6

1st line: Basal-bolus insulin

Adjunct:
Pre-meal insulin correction dose
Amylin analogue
Fixed-dose insulin

Question 7

Identify the possible complications of diabetes mellitus type 1 and its management.

Answer 7

Diabetic ketoacidosis (DKA)
Hypoglycaemia
Retinopathy
Diabetic kidney disease
Peripheral or autonomic neuropathy
Cardiovascular disease

Question 8

Summarise the prognosis for patients with diabetes mellitus type 1.

Answer 8

Untreated type 1 diabetes is a fatal condition due to diabetic ketoacidosis. Poorly controlled type 1 diabetes is a risk factor for chronic complications such as blindness, renal failure, foot amputations, and heart attacks.