DIABETES TYPE 1 Flashcards
What is T1DM?
a metabolic disorder characterised by hyperglycaemia due to absolute insulin deficiency
What causes T1DM?
destruction of Beta cells in the pancreas (mostly by Tcells) leading to decreased insulin production
What are the symptoms of T1DM?
Polydipsia
Polyuria
Glycosuria
Weight loss
Irritability
Lethargy
Nausea
What is the sign of T1DM?
Tachypnoea
Abdominal pain
Blurred vision
What are the risk factors of T-DM?
FHx
Viral infections
Race/Ethnicity
Other Autoimmune conditions
<30yo
What is Cushing Syndrome? And how does it link with DM?
Clinical manifesto of pathological hypercortisolism caused by steroid medications, pituitary adenoma, adrenal adenoma, paraneoplastic cushing’s
It causes hyperglycaemia because cortisol causes gluconeogenesis
What are the symptoms and signs of Cushing’s syndrome?
Round face Central obesity Abdominal striae Proximal limb muscle wasting Hypertension Hyperglycaemia Depression Osteoporosis
How do you diagnose Cushing’s syndrome?
Dexamethasone Suppression Test: high cortisol (low dose DST)/ normal (high dose DST)
Cortisol levels: high
ACTH levels: low
What is the treatment for Cushing Syndrome? And what are the side effects of drugs?
Removal of tumour
Ketoconazole: decreases secretion of cortisol
Mifepristone (for T2DM): inhibits glucocorticosteroid receptors blocking effect of cortisol
SE: fatigue, nausea, vomiting, low potassium, high blood pressure
What’s is the investigation for T1DM?
HbA1c: >48mmol/L
Random Plasma Glucose: >11.1mmol/L
Fasting Plasma Glucose: >6.9mmol/L (8hts after food)
Plasma/Urine Ketones: medium to high
What is the basal-bolus treatment for T1DM?
Insulin glargine or Detemir (LA)
Insulin neutral or Aspart (SA)
What is the pre-meal insulin correction medication used?
Humalog (SA)
What is the fixed-dose Insulin used?
Insulin isophane
What dietary changes can be made?
Regular meals and snacks
Exercise and control weight
What are the complications of T1DM?
CVD Stroke PVD Peripheral Ischaemia (ulcers, diabetic foot) Hypertension Retinopathy Cataract Kidney disease - glomerulosclerosis Pneumonia and skin infection
