T1DM 1

Question 1

T1DM
- Presentation

Answer 1

Polydipsia, Polyuria, Polyphagia

Weight Loss

Diabetic Ketoacidosis

Hyperglycemia (Little glucose is used for cellular energy)

Question 2

What groups usually present with T1DM

Answer 2

75% will develop TD1M before 20 years of age

Question 3

Diabetic Ketoacidosis
- Symptoms (7)

Answer 3

Dehydration

Abdominal Pain

Electrolyte Imbalance (Sodium, Potassium)

Metabolic Acidosis
- pH<7.4, Low HCO3; anion gap

Increased Respiratory Rate

Acetone (Fruity) Breathe

Decrease in level of consciousness

Question 4

T1DM
- Risk Factors

Answer 4

Family History

Autoantibodies
- GADA, IA-2A, Insulin Antibodies

Genetic Markers
- Human Leukocyte Antigen (DR/DQ Alleles)

Environmental Factors
- Stress
- Cow’s Milk Protein
- Irregular Vaccination
- Fetal Injections
- Nitrosamine

Question 5

T1DM (Glycemic Target for Most People)
- A1c

Answer 5

< 7.0%

Question 6

T1DM (Glycemic Target for Children)
- A1c

Answer 6

< 7.5%

Question 7

T1DM (Glycemic Target for Most People)
- Fasting and Pre-meal blood glucose

Answer 7

4-7 mmol/L

Question 8

T1DM (Glycemic Target for Most People)
- Fasting and Pre-meal blood glucose

Answer 8

4-8 mmol/L

Question 9

T1DM (Glycemic Target for Most People)
- 2-hour post prandial blood glucose

Answer 9

5-10 mmol/L

Question 10

Hexamer vs Monomer

Answer 10

Hexamer is absorbed slowly
- Basal Dose
- Long acting

Monomer is absorbed quickly
- Bolus Dose
- Rapid Acting

Question 11

Recommended Insulin Regimen

Answer 11

Basal-Bolus
- Basal = Long/Intermediate Acting Insulin
- Bolus = Rapid/Short Acting Insulin

Question 13

Not Recommended Insulin Regimen

Answer 13

Split Mixed (Not preferred)
- Rapid/Short Insulin + Intermediate Insulin before breakfast and supper

Sliding-Scale (Avoid)

Question 14

Effects of Intensive Glycemic Control over long periods of time

Answer 14

Reduces microvascular complications
Increases risk of hypoglycemia