T1DM

Question 1

Define T1DM

Answer 1

T1DM is a autoimmune condition where the pancreas stops being able to produce adequate insulin

Question 2

What hypersensitivity is T1DM

Answer 2

Type 4

cell-mediated

Question 3

T1DM Sx

Answer 3

• Polyphagia
• WL
• Glycouria
• Polyuria
• Polydipsia

Question 4

WL pathopysiology in T1DM

Answer 4

Cells starved of glucose
- lipolysis - adipose fat breaking down
- Muscle breaking down protein

Question 5

T1DM serious complication

Answer 5

Diebetic Ketoaciosis (DKA)

Question 6

DKA pathophysiology

Answer 6

1. Lipolysis: Fat –> free FAs
2. Liver turn FFAs –> ketone bodies
3. Ketone raised acid in the body

Question 7

DKA pathophysiology

Answer 7

1. Ketone raised acid in the body (Kussmaul resp blow out CO2)
2. Serum H+ exachange with cellular K+ / NO insulin to pushes K+ into cells resulting (Hyperkalaemia)
3. High Anion gap

Question 8

DKA Sx

Answer 8

• Polyuria
• Polydipsia
• Abdo pain
• N+V
• Fatigue

Question 9

DKA Dx criteria

Answer 9

1. Glucose >11 mmol/L
2. Ketone >3 mmol/L or 2+ on dip
3. HCO3 < 18
4. pH < 7.3

Question 10

How to characterised DKA

Answer 10

1. Hyperglycaemia
2. Ketosis
3. Acidosis

Question 11

Define Euglycaemic DKA

Answer 11

Normal glucose level but with ketosis / acidosis

Question 12

what meds can cause euglycaemic DKA

Answer 12

SGLT-2 inhibitors

Question 13

DKA clinical signs

Answer 13

• Dry mucous membranes
• Hypotension
• Tachycardia
• Altered mental state (drowsiness, confusion, coma)
• Kussmaul’s breathing (deep, sighing breathing to compensate for metabolic acidosis by blowing off carbon dioxide)
• Fruit-like smelling breath (due to ketosis)

Question 14

DKA initial Mx when K+ level is 3.5-5.5

Answer 14

IV 0.9% saline + K+ 40mmol

Question 15

Fixed Rate Insulin infusion (FRII) given rate

Answer 15

0.1 Units/kg/hour

Question 16

DKA MX for SBP < 90

Answer 16

Bolus IV saline 0.9