insulin deficiency results in: - decreased _______ uptake - increased _______ catabolism - increased _________

- decreased GLUCOSE uptake - increased PROTEIN catabolism - increased LIPOLYSIS

T1DM Flashcards by Matthew Turnbull

T1DM is associated with what other autoimmune diseases?

thyroid
coeliac
addison's
pernicious anaemia
vitiligo

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1 in 20 people with what have TIDM?

coeliac

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20% of all T2DM

Slowly-progressive disease onset

Non-obese

No FHx T2DM

Age >35 y at onset

Mild IR

Low c-peptide

HLA gene positive (GAD)

80% GAD+ -> insulin-dependence in 6 years

diagnosis?

LADA

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what does LADA stand for?

latent autoimmune diabetes of adulthood

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Addison’s disease
Hypothyroidism
Hypogonadism
Vitiligo
Coeliac disease

T1DM may be associated with all of the above in what?

polyglandular endocrinopathy type 2

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type 1 endocrinopaty is autosomal what?

autosomal recessive

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mild immune deficiency

mucocutaneous candidiasis and additionally alopecia, pernicious anaemia, hypoparathyroidism is seen in what?

type 1 endocrinopathy

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lymphocytes attacking islets is seen in what?

T1DM

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amyloid deposition is seen in what?

T2DM

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name the important islet autoantibodies

GAD
IA-2
IA-2beta
ZN-T8

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GAD is more associated with T_DM than T_DM

GAD is more associated with T1DM than T2DM

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what chromosome is important in T1DM?

chromosome 6

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what antigen is important in T1DM?

HLA

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insulin deficiency results in:

decreased _______ uptake
increased _______ catabolism
increased _________

decreased GLUCOSE uptake
increased PROTEIN catabolism
increased LIPOLYSIS

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state the classical symptoms fo T1DM

polyuria
polydipsia
weight loss
general malaise

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vomiting
abdominal pain
altered consciousness
acidotic breathing

diagnosis?

DKA

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Acute Onset
Presents with DKA or severe symptoms
Peak incidence pre-school and peri-puberty
Non-obese
Insulin dependent
Family history uncommon

diagnosis?

T1DM

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Slow onset – typically present for 6 to 10 years before presentation
Middle-aged /elderly
Obese &amp; Sedentary
Non-insulin dependent
Family history common

diagnosis?

T2DM

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diagnosis of T1DM is based on history and presentation (eg DKA) but ___________ and _-_______ may help

diagnosis of T1DM is based on history and presentation (eg DKA) but ANTIBODIES and C-PEPTIDE may help

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name the diet of dose adjustment for normal eating

DAFNE

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the benefits of good glucose control in diabetics are reduced ____________ and _____________ complications

the benefits of good glucose control in diabetics are reduced MICROVASCULAR and MACROVASCULAR complications

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HbA1c (mmol/mol):

normal -
prediabetes -
diabetes -

normal - <42
prediabetes - 42-47
diabetes - 48 or over

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HbA1c (%):

normal -
prediabetes -
diabetes -

normal - <6%
prediabetes - 6-6.4%
diabetes - 6.5% or over

name the 3 microvascular risks of diabetes

retinopathy
nephropathy
neuropathy

name 4 things that relate to glucose variability

injection tissue external factors carbohydrate delivery

insulin secretion in response to a meal is __phasic

insulin secretion in response to a meal is BIphasic

what is usually seen in the urine of a T1DM patient?

ketone bodies

c-peptide in a T1DM patient is usually high or low?

low

children diagnosed under the age of six months are much more likely to have _________ rather than T1DM

children diagnosed under the age of six months are much more likely to have MONOGENIC rather than T1DM

a diagnosis of what is established by the presence of elevated levels of pancreatic auto-antibodies in patients with ‘recently diagnosed’ diabetes who do not initially require insulin?

LADA

what does LADA stand for?

LAtent onset Diabetes of Adulthood a.k.a slowly progressive T1DM

occurs in young adults 25 to 40 male preponderance usually non-obese auto-antibody positive associated auto-immune conditions non-insulin requiring at diagnosis sub-optimal control on oral agents diagnosis?

LADA

people with what lung disease is diabetes common in?

cystic fibrosis

Diabetes Insipidus Diabetes Mellitus Optic Atrophy Deafness Neurological anomalies diagnosis?

DIDMOAD or Wolfram syndrome autosomal recessive

``` Often very obese Polydactyly Hypogonadal Visual impairment Hearing impairment Mental retardation Diabetes ``` diagnosis?

bardet-biedl syndrome

short/severe ketones in urine antibodies positive diagnosis?

T1DM

longer/variable ketones 0/++ antibodies positive insulin delayed diagnosis?

LADA

variable ketones 0/+ antibodies negative inheritance diagnosis?

MODY

long/mild ketones 0 antibodies negative overweight diagnosis?

T2DM

name some diseases associated with diabetes

``` thyroid coeliac pernicious anaemia Addison's disease IgA deficiency ``` rare: autoimmune polyglandular syndromes (T1 and T2) AIRE mutations IPEX syndrome

``` often asymptomatic bloating/diarrhoea malabsorption anaemia low albumin and calcium anti TTG antibodies IgA deficiency duodenal biopsy ``` diagnosis?

coeliac disease

``` Addisons disease vitiligo primary hypogonadism primary hypothyroidism coeliac disease ``` the above are all type _ polyglandular endocrinopathies

``` Addisons disease vitiligo primary hypogonadism primary hypothyroidism coeliac disease ``` the above are all type 2 polyglandular endocrinopathies

muck-cutaneous candidiasis primary hypoparathyroidism pernicious anaemia alopecia the above are all type _ polyglandular endocrinopathies

muck-cutaneous candidiasis primary hypoparathyroidism pernicious anaemia alopecia the above are all type 1 polyglandular endocrinopathies

1 in __ with thyroid disease have T1DM

1 in 20 with thyroid disease have T1DM

bardet-biedl syndrome is seen in _______________ parents

bardet-biedl syndrome is seen in CONSANGUINEOUS parents

what are lumps under the skin caused by accumulation of extra fat at the site of many subcutaneous injections of insulin. It may be unsightly, mildly painful, and may change the timing or completeness of insulin action

lipohypertrophy

too much insulin can result in what?

hypoglycaemia

who should receive IV insulin?

those with DKA or HHS or acute illness or fasting patients

the following are indications for what: Severe hypoglycemia/ metabolic complications Incapacitating clinical or emotional problems

pancreas transplant

replacing only the endocrine component of the pancreas is called what?

pancreatic islet transplantation

what should you be careful about in DKA treatment for under 18s?

fluid resuscitation

what is there the risk of in fluid resuscitation in DKA in under 18s?

cerebral oedema

what are you at risk of if your insulin pump breaks?

DKA

name the screening test performed in congenital thyroid disease

Guthrie test

hyperpigmentation of the scrotum and virtualised newborns are due to what condition?

congenital adrenal hyperplasia