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brs2 > Type 1 Diabetes > Flashcards

Type 1 Diabetes Flashcards

1
Q

what is type 1 diabetes

A

autoimmune condition where beta cells are attacked and destroyed
= absolute insulin deficiency

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2
Q

what is the result of t1dm

A

hyperglycaemia

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3
Q

what is best treatment for t1dm

A

individualised to clinical status and preference

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4
Q

when does t1dm typically be diagnosed

A

in childhood

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5
Q

where is most genetic susceptibility of type 1 diabetes mediated

A

HLA area of gene

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6
Q

what are a few environmental factors though to contribute to t1dm

A

enteroviral infections E.g coxcasy virus
cows milk protein exposure
seasonal variation
changes in microbiota

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7
Q

what are the symptoms of T1DM

A 
excessive urination - polyuria
excessive thirst - polydipsia
nocturia
blurring of vision
recurrent infection e.g thrust
weight loss 
fatigue
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8
Q

what are the signs of T1DM

A 
dehydration
cachexia
hyperventilation
smell of ketones (pear drops)
glycosuria
ketonuria
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9
Q

how can we measure pancreatic auto antibodies

A

in sera of people
glutamic acid decarboxylase
insulinoma associated 2 antibodies

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10
Q

what happens if body is not making insulin

A

causes breakdown of muscle protein
increase glucose output from liver
break down fat cells = nefas and triglycerides - go to liver and make ketones

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11
Q

what are the aims of treatment in type 1 diabetes

A

maintain glucose levels without excessive hypoglycaemia
restore close to physiological insulin profile
prevent acute metabolic decomp
prevent micro and macro vascular complications

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12
Q

what are some complications of diabetes

A

hyperglycaemia:
acute = diabetic ketoacidosis
chronic =
macrovascular: ischaemic heart disease,cerebrovascular disease,peripheral vascular disease
microvascular = retinopathy,neuropathy, nephropathy

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13
Q

what are some of the ways to manage type 1 diabetes

A

insulin treatment
dietary support/ structured education
technology
transplantations

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14
Q

what is the insulin given with meals - quick acting

A

human insulin - exact molecular replicate

insulin analogue - lispro,aspart,glulisine

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15
Q

what is background insulin - long acting/basal

A 
bound to zinc/protamine (nph)
insulin analogues (glargine, determir, degludec)
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16
Q

what is insulin pump therapy

A

continous delivery of short acting insulin analogue e.g novorapid via pump
delivery of insulin into subcutaneous space
programme device to deliver fixed units
actively bolus for meals

17
Q

what other advice must be given to those with type 1 dm

A

dose adjustment for carbohydrate content
offered structured education programme - DAFNE
where possible sustitute refined carbohydrates with complex carbohydrates

18
Q

how can we get closed loop using artificial pancreas

A

it is a realtime continous glucose sensor

19
Q

how do islet cell transplant work

A

isolate islets from pancreas of deceased donor
transplant into hepatic portal vein
requires lifelong immunosuppression

20
Q

how does simultaneous pancreas and kidney transplant work

A

better survival of pancreas graft when transplanted with kidneys

21
Q

why is organ transplant not so common

A

requires lifelong immunosupression

availability of organs

22
Q

how do we monitor blood glucose levels

A

capillary finger prick - glucose monitoring

and continuous glucose monitoring

23
Q

what is a more useful way of measuring blood glucose over an extended period of time

A

glycated haemoglobin - hba1c

24
Q

what are some acute complications from type 1 diabetes

A

diabetic ketoacidosis
uncontrolled hyperglycaemia
hypoglycaemia

25
Q

what is diagnosis for diabetic ketoacidosis

A

ph <7.3

increased ketones in blood and urine

26
Q

what are some risks of hypoglycaemia

A 
seizure/coma/death
impacts on emotional wellbeing
impacts on driving
impacts on day to day function
impacts on cognition

brs2 (65 decks)

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