T1 L19: T1 diabetes Flashcards
What is the pathophysiology of T1 diabetes?
Beta-cell events trigger autoimmune response
Antibodies to insulin or GAD generally appear first and then others follow like IA2, Zn2+ transporter 8
This causes selective immune beta-cell destruction
What can cause an autoimmune trigger for the development of T1 diabetes mellitus?
- Viral infection
- ER stress
- Cytokines
What other conditions are associated with T1 diabetes mellitus?
-Coeliac disease
-Hypothyroidism
-Grave’s disease
-Hypogonadism
-Pernicious anaemia
-Vitiligo
Autoimmune polyglandular syndromes
What are the symptoms of T1 diabetes mellitus?
- Lethargy
- Polyuria
- Polydipsia
- Blurred vision
- Candida infections
- Weight loss
- Ketosis/Ketoacidosis (and possibly death)
What features help diagnose T1 diabetes mellitus?
- Age of onset
- Rapidity of onset
- Phenotype
- Weight loss
- Ketosis
- GAD/IA2/ Zn transporter 8 antibody positive
-C-protein
What is the significance of C-protein when diagnosing T1 diabetes mellitus?
It’s produced 1:1 with insulin in the pancreas so if the levels are low, it indicates diabetes T1 instead of T2
What is the treatment for T1 diabetes mellitus?
Insulin is necessary for survival
Rapid-acting insulin taken pre-meal (Bolus). It reflects the carbohydrate intake
Long acting background insulin also used (Basal)
What factors affect blood glucose?
- Diet
- Injection site
- Temperature
- Exercise
- Illness
- Stress
- Alcohol
- Menstrual cycle
What are some symptoms of hypoglycaemia?
Autonomic symptoms:
Palpitation, sweating, tremor
Neuroglycopenic symptoms:
Confusion
What is the Edmonton protocol?
Method of transplantation of islets cells to treat diabetes
What is a freestyle libre device?
A continuous glucose monitoring system
How are ketones monitored in patients with T1 diabetes?
Urine: acetoacetate
Blood: beta-hydroxybutyrate
What is HbA1c?
Glycosylated haemoglobin
It reflects glucose over 3 months but is weighted towards the last 6 weeks
It affected by red cell proliferation
