T1DM

Question 1

Self tolerance: process of selecting T cells that

Answer 1

express MHC and can bind appropriately
do not recognize self antigens

Question 2

self tolerance: process of deleting cells that

Answer 2

don’t bind to MHC
recognize self

Question 3

naive T cells are moved where to await exposure to antigens

Answer 3

peripheral lymph nodes

Question 4

genetic markers present at birth in T1DM

Answer 4

DR3-DQ2 or DR4-DQ8

Question 5

immune markers (antibodies) are present

Answer 5

AFTER onset of autoimmune process

Question 6

metabolic markers present at what point in T1DM

Answer 6

once enough beta cell damage occurs (before symptomatic)

Question 7

examples of metabolic markers for T1DM

Answer 7

A1C, blood glucose, C peptide

Question 8

associated autoimmune diseases for T1DM

Answer 8

addison’s disease
graves/hashimotos
celiac disease
gonadal insufficiency

Question 9

basal insulin alone is only used in

Answer 9

T2DM patients

Question 10

Total daily dose =

Answer 10

basal insulin + bolus insulin

Question 11

insulin needs for children

Answer 11

more insulin sensitive; lower dose needed

Question 12

insulin needs for ESRD

Answer 12

insulin cleared by kidneys; lower kidney clearance = lower insulin needed

Question 13

insulin needs for T2DM

Answer 13

more insulin resistance = higher dose needed

Question 14

insulin needs in elderly

Answer 14

high risk for hypoglycemia; lower insulin dose

Question 15

correction factor

Answer 15

amount blood glucose will drop with 1 unit of insulin

Question 16

what T cells cause direct destruction in T1DM

Answer 16

CD8

Question 17

What T cells create antibodies in T1DM

Answer 17

CD4

Question 18

Other genetic alternations/mutations that increase risk of T1DM

Answer 18

polymorphisms on promoter of insulin gene
T helper cells that are interferon gamma positive and secrete IL-8 and IL-12

Question 19

autoimmune antibodies in T1DM

Answer 19

islet cell antibodies
antibodies to glutamic acid decarboxylase
Insulin autoantibodies
IA-2A
Autoantigen ZnT8

Question 20

after exogenous insulin administration, patients can develop which antibodies

Answer 20

insulin autoantibodies

Question 21

Criteria to consider testing for antibodies in an adult patient who is newly diagnosed with diabetes

Answer 21

Two or more of the following:
Age of onset < 50Y
Acute symptoms
BMI < 25
Personal or FHx of autoimmune disease

Question 22

All T1DM patients will be treated with

Answer 22

insulin

Question 23

basal dose is what percent of TDD

Answer 23

40-50%

Question 24

bolus insulin is what percent of TDD

Answer 24

50-60%

Question 25

Calculation for correction factor (CF)

Answer 25

1800/TDD

Question 26

carbohydrate: insulin ratio

Answer 26

number of carbs covered by 1 unit of insulin

Question 27

calculating carbohydrate: insulin ratio

Answer 27

500/TDD

Question 28

calculating bolus on board

Answer 28

insulin taken - insulin taken x (hours since last bolus/active insulin time)