Type 1 Diabetes

Question 1

Define Type 1 diabetes

Answer 1

autoimmune disorder whereby the pancreatic beta cells are unable to produce insulin.

Question 2

Describe some factors that can contribute towards the development of Type 1 diabetes

Answer 2

genetic factors
environmental factors
immunological factors

Question 3

What are the 4 different types of insulin?

Answer 3

long acting
short acting
rapid acting
intermediate acting

Question 4

Why are there various different kinds of insulin?

Answer 4

each is suited for a different purpose
e.g., rapid acting insulin is useful in emergency situation
long acting insulin is useful for providing a blanket of insulin

Question 5

What are the 2 different administration methods

Answer 5

conventional insulin therapy

intensive insulin therapy

Question 6

Describe conventional insulin therapy

Answer 6

two injections of rapid or intermediate acting insulin just before breakfast and dinner.

this provides a peak of insulin at these times and a relatively high background insulin throughout the day.

Doesn’t mimic the healthy pancreas.

Question 7

Describe a strength and limitation of conventional insulin therapy

Answer 7

Strength:
unobtrusive

Limitation:
difficult to achieve glycemic control

Question 8

Describe intensive insulin therapy

What are the two kinds of intensive insulin therapy?

Answer 8

• Multiple daily injections

- Continuous subcutaneous insulin infusion

Question 9

Describe multiple daily injections

Answer 9

Patients follow a basal/bolus scheme - bolus insulin is quick acting, basal insulin is long acting.

more accurately mimics the healthy pancreas as well as providing a blanket of insulin.

Question 10

What are some strengths and limitations of multiple daily injections?

Answer 10

strength - better glycemic control

limitation - more injections so more intrusive/difficult to go about normal life

Question 11

Describe the CSII method

Answer 11

insulin pump therapy
pump that continuously administers rapid acting insulin
small device that attached to the diabetic via a small cannula

Question 12

What is the diagnostic criteria to get an insulin pump?

Answer 12

HbA1c of 8.5%

disabling hypoglycaemia despite a high quality of care

Question 13

What are some strengths and limitations of CSII (insulin pump therapy)?

Answer 13

strengths:

• overall reduction in insulin requirement (up to 26%)
• reduction in incidence of hypoglycaemia
• reduction in dawn phenomenon (high glucose in morning)

limitations:

• rapid acting insulin can deplete very quickly
• risk of malfunction/breakage
• still need to carry a back up insulin pen
• impractical wearing a pump e.g., clothing or sports
• have to change cannula every few days
• still required to check blood glucose multiple times a day

Question 14

What are some symptoms of diabetes?

Answer 14

• tiredness
• frequent urination
• tiredness
• blurred vision
• hunger
• weight loss
• wounds not healing
• sexual problems e.g., erectile dysfunction

Question 15

What are some consequences of untreated diabetes (high blood glucose).

Answer 15

macrovascular diseases:

• stroke
• heart attack
• peripheral vascular disease

microvascular diseases:

• diabetic retinopathy
• renal disease
• peripheral/autonomic vascular disease
• amputation due to infection