T1DM

Question 1

RF

Answer 1

85% under 20s
peak 10-14
25% diagnosed as adults
M=F
HLA complex chromosome - HLA class II

Question 2

what is insulin secreted at

Answer 2

a low basal rate meaning a little bit is secreted into the bloodstream constantly throughout the day
accounts for 50%

Question 3

what does the other 50% of insuline intake come from

Answer 3

in response to food intake

Question 4

autoantibodies in type 1

Answer 4

islet cell antibdodies
glutamatic acid decarboxylase

Question 5

stage 1 of type 1 diabetes

Answer 5

autoimmunity
normoglycaemia
presymptomatic
multiple autoantibodies
no IGT/ IFG

Question 6

stage 2 characteristics

Answer 6

autoimmunity
dysglycaemia
presymptomatic
multiple autoantibodies
IFG and or IGT

Question 7

stage 3

Answer 7

new onset hyperglycaemia
symptomatic
clincial symptoms

Question 8

diagnosis

Answer 8

◼ Fasting glucose ≥ 7.0mmol/l
◼ Random blood glucose ≥ 11.1mmol/l
2-hour glucose tolerance ≥ 11.1mmol/l
HbA1C ≥ 48mmol/mol (6.5%)

Question 9

normal hba1c

Answer 9

41m and below

Question 10

impaired/ pre diabetes hba1c

Answer 10

42-47

Question 11

typical presenting symptoms

Answer 11

polyuria
polydipsia
Weight loss
 Fatigue and somnolence  Blurred vision
 Candidal infection
 Pruritis vulvae
 Balanitis
 In established keto-acidosis-10% adults higher in children

Question 12

classic presenting triad

Answer 12

excessive thirst
fatigue
frequent urination

Question 13

which diabetes is more genetic

Answer 13

type 2

Question 14

how should most people with T1DM be treated

Answer 14

with MDI - 3-4 injections per day or CSII- stuck on stomach

Question 15

targets of glucose

Answer 15

Target 4-7 mmol/l pre-meal
* Target <10 mol/l 2 hours after meals

Question 16

types of insulin

Answer 16

prandial- taken around meal time
basal

Question 17

onset of pradnial insulin

Answer 17

10-15 mins
peak- 60-90
duration 4-5 hours

Question 18

basal iisulin MOA

Answer 18

helps to work throughout day and night
long acting- 12 hours
provides steady low level release

Question 19

indications of pancreas transplant

Answer 19

– Imminent or ESRD due to receive or with kidney transplant
– Severe hypoglycemia/ metabolic complications
– Incapacitating clinical or emotional problems

Question 20

islet transplantation indications

Answer 20

Typically reserved for those with: → episodesofseverehypoglycaemia
→ Severe and progressive long-term complications despite maximal therapy
→ Uncontrolled diabetes despite maximal treatment
> to replace only the endocrine component of the pancreas