Type 1 Diabetes Flashcards
Normal glucose levels
4.4 - 6.1
Insulting reduces blood glucose by transporting it to which two organs
Muscle/liver —> glycogen storage
What cells in the pancreatic isle of Langerhans produce insulin
B cells
How does glucagon increase blood glucose levels
- glycogen breakdown
- inhibit glycogen synthesis
- gluconeogenesis
What cells in pacnreatic IoL produce glucagon
Alpha cells
Cause of gestational diabetes
Hormonal interference
Type of diabetes that is drug-induced
Drug resistant
Type of hypersensitivity in type 1 diabetes
Type 4 (T cells attacking IoL B cells)
When is diagnosis for T1DM made
Early age
Two genes on chromosome 6 associated with T1DM
- HLA DR3
- HLA DR4
Presentation of T1DM
- weight loss
- polydipsia
- glucosria
- polyuria
- polyphagia
Explain the polyuria in T1DM
Glucosuria —> ++ osmotic pressure
Hrs of fasting before a fasting blood glucose test
8
Prediabetic blood levels in fasting blood glucose
100-125 mg/dl
Diabetic blood levels in fasting blood glucose
> 126 mg/dl
Diabetic blood glucose in random glucose blood test
> 200
Definition of HbA1C
Glycated Hb in RBCs
HbA1C in pre-diabetics
5.7-6.4%
HbA1C in diabetics
> 6.5%
Source of C-peptide
By product of insulin production
When does ketogenesis take place
Insufficient glucose/glycogen
Where does ketogenesis take place
Liver (fatty acids —> ketones)
Is BBB permeable to ketones
Yes
When does DKA happen
Hyperglycaemic ketosis —> metabolic acidosis
How is DKA compensated for initially
Renal compensation, bircarbs used up over time
Explain the dehydration in DKA
Hyperglycaemia —> glycouria —> +osmotic pressure —> osmotic diuresis —> polyuria —> polydipsia
Which pump stops working in the absence of insulin in T1DM which leads to potassium imbalance in the body
Na/K pump
What might compensate for [K] initially
Kidneys
DKA symptoms (all together)
- hyperglycaemia (diagnosis)
- dehydration (diagnosis)
- ketosis (diagnosis)
- metabolic acidosis (diagnosis)
- K imbalance
- polyuria
- polydipsia
- N/V
- acetone smell
- dehydration
- altered consciouesness
Tx DKA (FIG PICK)
- fluids
- insulin infusion
- glucose
- potassium
- infection
- chart
- ketones
Maximum dose of K to be given at once
> 10 mmol/hr
Tx options for T1DM hypoglycaemia
- IV dextrose
- IM glucagon
Microvascular complications due to hyperglycaemia
- CAD
- peripheral ischaemia
- stroke
- hptn
Microvascular complications due to hyperglycaemia
- peripheral neuropathy
- retinopathy
- nephropathy
Infection-related complications due to hyperglycaemia
- UTI
- pneumonia
- fungal
DKA clinical triad
- CBG>11mol/L
- capillary ketones >3mmol/L or ketonuria >3+
- venous pH <7.3 or venous bicarbonate <15mmol/L
