Treatment of Type 1 diabetes

Question 1

Useful discriminatory tests for T1DM?

Answer 1

GAD/anti-islet cell anitbodies
Ketones
C-peptide

Question 2

C-peptide is usually found in the same concentration as…

Answer 2

Insulin

Question 3

Trial which showed inverse relationship between HbA1c and risk of hypoglycaemic events?

Answer 3

DCCT

Question 4

Hyperglycemia symptoms

Answer 4

Thirst, tiredness, blurred vision, weight loss, polyuria, nocturia, fungal infections
Cognitive, mood state, information processing, working memory
Potential risk of diabetic ketoacidosis (“DKA”)

Question 5

Hypoglycemia symptoms

Answer 5

Pallor, sweating, tremor, palpitations, confusion, nausea, hunger.
Cognitive: tense-tiredness, information processing, working memory, coma

Question 6

Starting dose for insulin for T1DM?

Answer 6

0. 3 units/kg body weight

- divide around 50% prandial and 50% basal

Question 7

Short acting insulin

• onset
• peak
• how long they last

Answer 7

Onset: 30-60 mins
Peak: 2-4 hours
Last:s 5-8 hours

Question 8

Rapid acting insulin

• onset
• peak of action
• duration

Answer 8

Onset: 10-15 mins
Peak action: 60-90 mins
Duration: 4-5 hours

Question 9

How much insulin per 10g carbs?

Answer 9

1 unit of insulin per 10g CHO

Question 10

What type of insulin in a pump?

Answer 10

Short-acting

Question 11

Limitations of insulin injection/pump

Answer 11

• into subcutaneous tissue
  peak too slow to prevent post-meal
  hyperglycaemic spike
  -slow clearance

Question 12

Non-insulin adjunct therapy in type 1 diabetes

Answer 12

Metformin
Leptin
GLP-1
?SGLT2
Anti-CD3 monoclonal antibody