Trigger 5: T1 diabetes

Question 1

T1 diabetes is

Answer 1

on the rise

Question 2

how much of diabetes is t1

Answer 2

8-10%

Question 3

why is the rise of T1DM not due to genetics

Answer 3

due to the rate that T1DM it cannot be attributed to change in genetics of populations and must be attributed to environmental factors

Question 4

cause of t1DM- simple

Answer 4

triggering of autoimmune response again beta cells which causes beta cell destruction and impaired insulin secretion

Question 5

strategies to prevent or reverse diabetes

Answer 5

beta-cell protection

regeneration

replacement

Question 6

very little is know about the

Answer 6

aetiology of the disease- making designing therapies hard

Question 7

how many people have t1DM

Answer 7

422million

Question 8

how much spent on t1DM a day

Answer 8

£22m

Question 9

how much of NHS budget spent on diabetes

Answer 9

10% (although 90% are T2)

Question 10

symptoms of T1DM

Answer 10

Thirst
Thin
Tired
Tilet

Question 11

how quickly is T1Dm increased

Answer 11

at a rate of 4%/year

Question 12

what has been implicated as responsible for the onset of t1DM

Answer 12

virus

Question 13

why have virus been hypothesised as causing T1DM- simple

Answer 13

due to seasonal pattern of onset- specifically entervorisuses

Question 14

which type of virus’ have been implicated

Answer 14

enterovirus’

Question 15

animal models and virus

Answer 15

in animal models enterovirus have been found to accelerate the disease

Question 16

example of enterovirus

Answer 16

Cocksaxie

Question 17

virus- other argument

Answer 17

♣ under certain conditions they were also able to protect against disease

Question 18

Blood tests used to research/ monitorT1DM

Answer 18

• genetic variants
• autoantibodies
• c-peptide
• immune cell subsets
• cytokine response

Question 19

why are blood tests not very practical

Answer 19

most patients are children, limited by the frequency of withdrawals- children don’t like needles

Question 20

research on the pancreas is

Answer 20

rare- major obstical for diabetic research

Question 21

how many pancreas’ have been studies

Answer 21

150

Question 22

why have so few pancreas’ been studies

Answer 22

• verry inaccessible
• not routinely biopsied
• risky procdure

Question 23

the pancreas produces

Answer 23

digestive enzymes and hormones

Question 24

how much of the pancreas produces digestive enzymes

Answer 24

98%

Question 25

how much produces hormones

Answer 25

2%

Question 26

which hormones does the pancreas produce

Answer 26

glucagon and insulin

Question 27

what ca be used to visualise the islets of langerhans e.g. detecting glucagon and insulin

Answer 27

immunostaining

Question 28

what does immunostaining show

Answer 28

that in T1DM B cells are selectively targeted

Question 29

in non diabetic immunostaining shows

Answer 29

that most cells make insulin, only a few make glucagon

Question 30

in diabetic immunostaining shows

Answer 30

no insulin production

glucagon cells still work and are functional

Question 31

progression fo T1 throughout life

Answer 31

individuals start with some B cells. however at some point overt diabetes ensures due to not having enough b cells

Question 32

potential for an intervention if

Answer 32

individuals at risk of T1DM are identified

Question 33

what is the main animal model for T1D

Answer 33

NOD mice

Question 34

NOD mice

Answer 34

non-obese diabetes mice

Question 35

NODs are used to

Answer 35

study autoimmune diseases such as T1D

- mice spontaneously develop autoimmune diabetes

Question 36

strengths of NOD mouse

Answer 36

• existence of spontaneous autoimmunity and T1D
• similar to human condition e.g. producing autoantibodies and increase in circulating auto reactive T cels prior to onset of T1D

Question 37

weaknesses of NOD mouse

Answer 37

• different pathogenic process to humans
• therefore therapeutics may not be relevant to humans
• difference in appearance of insulitis