type 1 diabetes Flashcards
risk factors for type 1 diabetes
- age 10-14yrs is peak
- sex
- race
- genotype
- geographic location and seasonality
environmental triggers for diabetes
- viral infection
- maternal factors
- weight gain
- vitamin D
what are the characteristics and diagnostic criteria for stage 1
- autoimmunity
- normoglycemia
- presymptomatic
- multiple antibodies
- no IGT or IFG
what are the characteristics and diagnostic criteria for stage 2 diabetes
- autoimmunity
- dysglycemia
- presymptomatic
- multiple antibodies
- IFG and/or IGT
- FPG 100-125 mg/dL
- 2-h PG 140-199 mg/dL
characteristics and diagnostic criteria for stage 3
- new onset hyperglycemia
- symptomatic
- clinical symptoms
- diabetes by standard criteria
risk factors for pre-diabetes
- viral infection
- vit D deficiency
- diet
- environmental toxins
accelerating factors for clinical diabetes
- infection
- insulin resistance
- puberty
- weight
- stress
disease markers for pre-diabetes
-autoantibodies (GAD 65, IAA and IA2, Zn T8)
diabetic markers for clinical diabetes
- raised glucose
- ketones
- reduced insulin
- reduces beta cell mass
- reduced C-peptide
pathogenesis of type 1 diabetes
- interaction between genes and imparting susceptibility and resistance
- variable insulinitis
- beta-cell sensitivity to injury
- pre-diabetes
- overt diabetes
how is type 1 usually diagnosed by
history and presentation alone
type 1 diabetes clinical presentation
- pre school and peri-puberty
- small peak in late 30s
- usually lean
- acute onset
- severe symptoms
- severe weight loss
- ketonuria +/- metabolic acidosis
- no evidence of microvascular disease at diagnosis
- immediate and permanent requirement for insulin
what is LADA
late onset type 1 diabetes
does ketosis mean type 1 or 2
1
what do you do to find out which type of diabetes it is
antibody testing
signs that hospitalisation is required?
- DKA
- significant ketonaemia
- vomiting
signs of hypoglycaemia
- pallor
- sweating
- tremor
- palpitations
- confusion
- nausea
- hunger
what is basal insulin used for
once daily
what is bolus insulin used for
with meals
management of type 1
- blood glucose and ketone monitoring
- insulin
- carbohydrate estimation
- regular DSN and dietician contact
- appropriate medical clinic review
- education about self management
two types of prandial insulins
- insulin analogues
- soluble insulin
two types of basal insulin
- isophane insulins
- analogues insulins
what should most people with type 1 diabetes be treated with
MDI or CSII
conditions associated with type 1 diabetes
- cystic fibrosis
- wolfram syndrome
- barlet-biedl syndrome
associated auto-immune conditions
- thyroid disease
- coeliac disease
- pernicious anaemia
- Addison’s disease
- IgA deficiency
two types of pancreas transplantation
- kidney-pancreas autotransplantation
- islet autotransplantation
indications for a pancreas transplantation
- imminent or ESRD due to receive or with kidney transplant
- severe hypoglycemia/metabolic complications
- incapacitating clinical or emotional problems
what is a pancreatic islet transplant
-replace only the endocrine component of the pancreas with the aim of restoring physiological glucose homeostasis
what are the four steps of islet transformation
- pancreas donation and retrieval
- islet donation
- islet culture
- islet transplantation
