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Endocrine 2 > DM 1 > Flashcards

DM 1 Flashcards

1
Q

What is DM T1a vs T1b?

A

1a: Autoimmune etiology
1b: No evidence of autoimmunity

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2
Q

WHat are the genes that predispose you to T1 DM?

A

HLA-DR3
DQB
DR4

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3
Q

What are the compoonents of the immue process?

A 
Innate: Consistent for all attacks
-epi
-phago
-killer
-complement
-cytokines
Adaptive: Specific to the attack
-Lymphocytes
---Humoral
---Cellular (T cells)
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4
Q

What are the antibodies involved in T1 DM?

A

Glutamic Acid Decarboxylase antibody (GAD65)
Insulin Ab (IAA)
Islet Cell Ab (ICA)
Tyrosine Phosphatase (IA-2 or ICA512)

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5
Q

What are the environmental factors that affect risk for T1 DM?

A 
Hygeine Hypothesis
Perinatal Factors
Viruses 
Diet (Cows milk and cerial)
Protection by exposure to immune mediated diseases in childhood
Vit D and BF protective
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6
Q

How is T1 DM diagnosed?

A 
Family History of T1 or Autoimmune disorders
Age: Childhood and adolescence 
Clinical Presentation
OGTT (oral glucose tolerance test)
DKA
C-Peptide
Antibodies?
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7
Q

What are the signs of DKA?

A

Dehydration, acidosis, Low BP, orthostasis, tachycardia, acetone smell, dec Temp
Hyperglycemia
Low Bicarb and Low serum pH
Serum Ketones

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8
Q

WHat is the Tx of DKA?

A

Aggressive volume resuscitation
Correct hyperglycemia
Replace Electrolytes
Treat underlying cause

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9
Q

What are the Treatment goals in T1 DM?

A 
Normoglycemia: pre/post meal
Normal A1C
Normal Growth in children
Tx of Cardiac Risk factors
-BP
-Lipids
-Smoking
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10
Q

What are the forms of insulin therapy in T1DM?

A

Basal
Bolus/Rapid insulin: meal or stress needs
Pumps
Pramlitide

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11
Q

What are the Doses of Insulin in multiple daily injections?

A

Total Requiremet in T1 DM: .6U/Kg

Basal Insulin: 0.2-0.3 U/Kg

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12
Q

What is the purpose of an Insulin Pump in T1DM?

A

Continuous subcu insulin infusion
Best way to mimic basal and bolus insulin
Only Shorter acting insulin used in pumps

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13
Q

What are the pros/cons of a pump?

A

Adv: improvement in frequent and nocturnalhypoglycemia, flexibility in timing meals, improved compliance
Disad: Cost, psych factors, tethered at all times

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14
Q

What is Pramlitide?

A 
Mimcs Amylin
Slows GI transit
Dec Glucagon
Dec Appetitie
Net effect is better post meal control and often weight loss
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15
Q

What is CGMS?

A

Allows monitoringglucoseevery few minutes. Home use

Define problems with glucose management

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16
Q

What transplants have been usedin T1DM?

A

Pancreas

Islet Cells

17
Q

WHat are the ADA/AACE guidelines for T1 DM?

A

AIC 6.5%-7%
BP 45
Yearly Microalbumin, eye exam

Endocrine 2 (16 decks)

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