Diabetes mellitus: Type 1

Question 1

Give the definition of diabetes mellitus

Answer 1

A disorder of carbohydrate metabolism characterised by hyperglycaemia. Plasma glucose has to be >11mmol/l with a fasting plasma glucose of >7mmol/l

Question 2

List the main types of diabetes

Answer 2

1. ) Type 1
2. ) Type 2 (including medication induced and gestational)
3. ) Monogenic
4. ) Pancreatic
5. ) Endocrine

Question 3

List the main side effects of diabetes

Answer 3

1. ) Retinopathy
2. ) Nephropathy
3. ) Neuropathy
4. ) Stroke
5. ) Cardiovascular disease

Question 4

List the key epidemiological features of type 1 diabetes

Answer 4

1. ) Young age
2. ) Northern European
3. ) Lean

Question 5

Describe the main risk factors for developing type 1 diabetes

Answer 5

1.) Family history AND/OR past medical history of autoimmune disease (HLA-DR3 and HLA-DR4)

Question 6

Describe the pathology of type 1 diabetes

Answer 6

It is an autoimmune condition, where autoantibodies destroy the beta cells (in the islet of Langerhans) within the pancreas

Question 7

Describe the clinical signs you would expect to see in type 1 diabetes

Answer 7

1. ) Short history (weeks) of severe symptoms
2. ) Large urinary ketones
3. ) Weight loss

Question 8

Describe and explain the main symptoms of type 1 diabetes

Answer 8

1. ) Polydipsia (thirst): there is osmotic activation of the hypothalamus
2. ) Polyuria: osmotic diuresis. Glucose gets excreted and as it has an osmotic effect it can essentially pulling more water out so the person urinates more
3. ) Weight loss: get lipid and muscle loss due to unrestrained gluconeogenesis (as body feels like it’s getting no sugar)
4. ) Hunger: due to lack of useable energy source
5. ) Pruritis vulvae and balanitis: vaginal and chest infections
6. ) Blurred vision: visual acuity due to uptake of glucose (and with glucose comes water) into the lens, so the lens can’t change shape very well

Question 9

What are the main investigations and diagnosis for type 1 diabetes

Answer 9

• Complete a random plasma glucose test: >11mmol/L
• Complete a fasting plasma glucose test: >7 mmol/L
• Symptoms of hyperglycaemia with one or more of: ketosis/low BMI/history of autoimmune disease/rapid weight loss

Question 10

What are the treatment options for type 1 diabetes?

Answer 10

1. ) Short acting insulin
2. ) Short acting insulin analogues
3. ) Long acting insulin