Endo - Type 1 diabetes Flashcards
What is type 1 diabetes?
An autoimmune disease where the insulin-producing beta-cells in the pancreas are destroyed
What is the direct effect of type 1 diabetes?
Hyperglycaemia
How can type diabetes be treated/managed?
- Multiple daily insulin injections
- Insulin pump
- Islet cell transplant
- Artificial pancreas (pump + glucose monitoring)
Why is C peptide used as marker for beta cell function?
Proinsulin is cleaved to form both insulin and C peptide which means that C peptide is a direct correlation of insulin levels and therefore beta cell funtion
What are the symptoms of type 1 diabetes?
- Polyuria
- Nocturia
- Polydipsia
- Blurring of vision
- Recurrent infection
- Weight loss
- Fatigue
What are the signs of type 1 diabetes?
- Dehydration
- Cachexia
- Hyperventilation
- Smell of ketones
- Glycosuria
- Ketonuria
What are the aims of treatment in type 1 diabetes?
- Maintain glucose levels
- Restore close to physiological insulin profile
- Prevent acute metabolic decompensation
- Prevent micro and macrovascular complications
What is the acute complication of hyperglycaemia?
Diabetic ketoacidosis
What are the chronic complications of hyperglycaemia?
Microvascular: - Retinopathy - Neuropathy - Nephropathy Macrovascular: - Ischaemic heart disease - Cerebrovascular disease - Peripheral vascular disease
What are the 2 types of insulin that can be given to a patient with type 1 diabetes?
Short / Quick-acting insulin - Human insulin replicate or insulin analogue
Basal / Long-acting insulin - Bound to zinc or protamine or insulin analogue
How does islet cell transplantation occur?
- Islet cells from a cadaver are isolated
- They are injected into the hepatic portal vein
- Requires life-long immunosuppression
Why is HbA1c a good thing to measure to diagnose diabetes?
- It is a long lasting substance in the blood so reflects the last 3 months of glycaemia
- It is biased to the last 30 days however
- There is a linear relationship
- Irreversible reaction
