T1DM Flashcards
1
Q
Definition and complications
A
Definition: pancreas produces insufficient insulin
Complications: CVD, nephropathy, neuropathy
2
Q
Evolutionary background
A
- Incidence has been increasing over the years
- Autoimmune disease
- Train immune system in early life
- Diet and microbiota guide immune system maturation
3
Q
gut microbiota
A
- Toll like receptors detect microbial molecules and activate response
- Bacteria presented by dendritic cells to touch epithelial cells
- Alter intestinal permeability to make epithelium leaky
4
Q
diet and immunity
A
- Dietary antigens can cause immune system to attack self early on like proteins and fats in bovine milk increase risk of Beta cell autoimmunity
- Breastfeeding transfers maternal sIgA to infant which decreases chance of bacterial translocation
- Early high gluten diets contribute to T1DM
5
Q
Genetic underpinnings: HLA and non-HLA
A
- HLA: biggest risk factors accounts for 40-50% familial aggregation of T1DM
- Non HLA: genetic predispositions but need to be triggered to get T1DM
6
Q
current treatments
A
Insulin pens/pumps, glucose sensors, closed loop systems
7
Q
future treatments
A
- Transplanting stem cell derived Beta cells
- Immune therapies targeting T cells, B cells, cytokines
- Pancreatic islet transplants and stem cell therapy
8
Q
Clinical implications of EM
A
Continuous glucose monitoring
