T1DM Flashcards
Genetic associations and antibodies (4)
HLA-DR3/4
anti-GAD/insulin/islet cell
Presenation (8)
4-12 yrs polydipsia polyuria wt. loss /lethargy skin infections candidiasis DKA-pear breath, kussmaul's, shock, drowsiness, vomitting nocturnal enuresis
Dx of T1DM (3)
Sx+fasting>7 or random>11.1 (2 readings if no Sx)
OGTT rarely needed
at Dx test for thyroid disease and coeliac and yrly thereafter
Insulin doses (3)
aim for 0.5U/kg/d
half the dose as long acting in evening
half the dose as short acting before meals
HbA1c monitoring and control (3)
may be normal at Dx
monitor 3 times/yr
aim for 6.5-7.5%/48-58
Regimen options and monitoring (5)
check BM QDS, adjust dose accordingly periodic physician review basal bolus continuous SC infusion 2 dose regimen
Factors to review annually (8)
Eyes kidneys HbA1c BMI feet coeliac/thyroid Abs immunisations BP
Dietary advice in T1DM (3)
Low fat
high protein
more complex carbs
definition of hypoglycaemia
glucose <2.6
Presentation of hypoglycaemia (7)
sweating pallor headache CNS irritability vomitting seizures coma
Mx of conscious hypo patient
oral glucose gel
Mx of hypo coma
IV access
10%glucose IV+IM glucagon
if still unconscious: check BM, IV dexamethasone
(may be post-ictal from hypo seizure)
Features of MODY (3)
auto-D non-ketotic DM
due to islet cell dysfunction
onset between 12-18yrs
