T1DM

Question 1

What is the pathogenesis of T1DM?

Answer 1

Auto-immune destruction of beta cells in the pancreas leads to absolute insulin deficiency, usually developing in childhood/adolescence

Question 2

What are the symptoms of T1DM?

Answer 2

• Polyuria
  
  • Hyperglycaemia leads to osmotic diuresis
• Polydipsia
  
  • Due to loss of fluid and electrolytes
• Weight loss
  
  • Breakdown of fat & muscle secondary to insulin deficiency

Question 3

What are complications of T1DM?

Answer 3

• Microvascular complications
  
  • Nephropathy
  • Retinopathy
  • Neuropathy
• Macrovascular complication
  
  • IHD
  • Stroke
• DKA

Question 4

What is the management of T1DM?

Answer 4

Insulin

Question 5

What are the different types of insulin?

Answer 5

1. Rapid acting
2. Fast acting
3. Intermediate acting
4. Long acting

Question 6

What is the target BP for patients with type 1 DM?

Answer 6

T1DM & no albuminuria:

< 135/85 mmHg

T1DM w/ albuminuria or 2+ features of metabolic syndrome:

< 130/80 mmHg

Question 7

What are the blood glucose targets for patients with T1DM?

Answer 7

In type 1 diabetics, blood glucose targets:

• 5-7 mmol/l on waking
• 4-7 mmol/l before meals at other times of the day