Pathophysiology of Type 1 Diabetes

Question 1

_______have among the highest incidence and prevalence of T1D in the world with as many as 1:100 affected by T1D by 20 years of age and an incidence of T1D in the general population approaching 40/100,000/year

Answer 1

Finland and Sardinia

Question 2

T1D is diagnosed throughout childhood with the peak incidence between ______ years of age.

Answer 2

10-12

Question 3

T1D is a ______ mediated autoimmune disease

Answer 3

T cell

Question 4

what antigens do islet cell antibodies react to

Answer 4

insulin,
glutamic acid decarboxylase 65 (GAD65),
tyrosine phosphatase like protein (IA-2),
zinc transporter (ZnT8).

Question 5

Patients with _____ islet autoantibodies, will progress to T1D with overt hyperglycemia

Answer 5

> 2

Question 6

The sum of the insulin released in the first and third minute after IV glucose is referred to as the ______

Answer 6

First Phase Insulin Response (FPIR).

Question 7

what is the first identifiable metabolic abnormality in Type 1 diabetes

Answer 7

decrease in first phase Insulin release (FPIR)

Question 8

diabetes can be diagnosed on the basis of a single blood glucose greater than _____ in the presence of symptoms of _______.

Answer 8

200 mg/dL,

hyperglycemia

Question 9

what is the Definition of glucose abnormalities in fasting glucose levels

Answer 9

Normal: <100 mg/dL
Impaired: 100-125 mg/dL
Diabetes: >125 mg/dL

Question 10

List the normal and abnormal definitions of 2hr OGTT

Answer 10

Normal:<140 mg/dL
Impaired: 140-199 mg/dL
Diabetes: >199 mg/dL

Question 11

subjects present with the classic signs and symptoms of diabetes when ______ of the beta cell mass has been destroyed.

Answer 11

80-90%

Question 12

Approximately _____ of patients diagnosed with T1D do not have a relative with T1D

Answer 12

85%

Question 13

If you have high genetic risk and a FDR with Type 1 diabetes then your chance of getting T1D is _____

Answer 13

1:4 to 1:2

Question 14

____ is the gene that infers over 50 % of the genetic risk for type 1 diabetes

Answer 14

HLA DR3/4

Question 15

what evidence supports the hygiene hypothesis

Answer 15

the inverse correlation of a specific viral infection (enterovirus) with the development of diabetes.

Question 16

Infant diet studies have shown an Increased risk for diabetes is related to ________

Answer 16

1) shorter duration of breastfeeding,
2) earlier introduction of cows’ milk.
3) introduction of cereals (before 4 months, after 7 months).

Question 17

What infant dietary factors may be protective against T1D

Answer 17

Vitamin D supplementation may be protective for T1D. Omega-3 fatty acids have been associated with a decreased risk for the development of T1D in high risk children.

Question 18

what is the accelerator hypothesis

Answer 18

obesity results in Beta cell stress exposing Beta cell antigens to the immune system and initiating the autoimmune attack.