T1DM 1 Flashcards
T1DM
- Presentation
Polydipsia, Polyuria, Polyphagia
Weight Loss
Diabetic Ketoacidosis
Hyperglycemia (Little glucose is used for cellular energy)
What groups usually present with T1DM
75% will develop TD1M before 20 years of age
Diabetic Ketoacidosis
- Symptoms (7)
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
T1DM
- Risk Factors
Family History
Autoantibodies
- GADA, IA-2A, Insulin Antibodies
Genetic Markers
- Human Leukocyte Antigen (HLA DR/DQ Alleles)
Environmental Factors
T1DM
- Environmental Risk Factors
- Stress
- Cow’s Milk Protein
- Irregular Vaccination
- Fetal Injections
- Nitrosamine
T1DM
- Screening
Not recommended
T1DM
- Goals of Therapy
- Replace physiological insulin
- Reduce risk of microvascular and macrovascular complications
- Maintain Glycemic Control
T1DM (Glycemic Target for Most People)
- A1c
< 7.0%
T1DM (Glycemic Target for Children)
- A1c
< 7.5%
T1DM (Glycemic Target for Most People)
- Fasting and Pre-meal blood glucose
4-7 mmol/L
T1DM (Glycemic Target for Most People)
- Fasting and Pre-meal blood glucose
4-8 mmol/L
T1DM (Glycemic Target for Most People)
- 2-hour post prandial blood glucose
5-10 mmol/L
Hexamer vs Monomer
Hexamer is absorbed slowly
- Basal Dose
- Long acting
Monomer is absorbed quickly
- Bolus Dose
- Rapid Acting
Recommended Insulin Regimen
Basal-Bolus
- Basal = Long/Intermediate Acting Insulin
- Bolus = Rapid/Short Acting Insulin
Not Recommended Insulin Regimen
Split Mixed (Not preferred)
- Rapid/Short Insulin + Intermediate Insulin before breakfast and supper
Sliding-Scale (Avoid)
