Diabetes Type 1

Question 1

What is the pathophysiology of T1D?

Answer 1

• failure of T-cell tolerance to ß cells
• auto-antibodies (anti-GAD and anti islet cell are implicated) cause destruction of ß cells
• absolute insulin deficiency

Question 2

What are the high risk genes for T1D?

Answer 2

• HLA-DR3 or DR 4

- concurrent risk with HLA-DQ8

Question 3

What are signs and symptoms of T1D?

Answer 3

• polyuria
• polydipsia
• polyphagia
• hyperglycaemia
• weight loss
• ketosis
• diabetic complications

Question 4

How is diagnosis of T1D made?

Answer 4

• FBG >7 mmol/L
• HbA1c >48 mmol/mol
• Clinical signs + random BG >11.1 mmol/L
• Oral glucose tolerance test >11.1mmol/L

Question 5

What are DDx for T1D?

Answer 5

• T2D
• Gestational DM
• Addison’s disease

Question 6

What is the management of T1D?

Answer 6

• relieve symptoms
• prevent long term symptoms
• avoid adverse effects of treatment
• managed with short acting insulin before meals and long acting over night