Type 1 Diabetes Flashcards
What are the criteria that indicate a child in DKA is ready to transition?
pH =/> 7.3
Bicarb =/> 15
Resolution of ketosis
What is the target HbA1C for children with T1DM?
<7.0% as per Mac
(or as per Diabetes Canada <7.5%)
What is the initial thyroid screening you should send in T1DM? How often should you screen?
Send TSH + TPO antibodies at diagnosis and every 2 years after.
Send q6-12 months if symptomatic (e.g. goiter)
Do not need to repeat TPO antibodies if previously positive.
What are the two indications to screen for primary adrenal insufficiency in T1DM? How do you screen?
Unexplained recurrent hypoglycemia
Decreasing insulin requirements
Send 8 am cortisol and serum lytes
When should you screen for celiac disease in T1DM?
If symptomatic - recurrent GI symptoms, poor growth, poor weight gain, fatigue, anemia, unexplained hypoglycemia, poor metabolic control
Send TTG + IgA
When do you start screening for nephropathy in T1DM? How do you screen?
Yearly screening at 12 years of age in those who have had T1DM for 5 years or more
First morning (preferred) or random ACR
When do you start screening for retinopathy in T1DM?
Yearly screening at 15 years of age in those who have had T1DM for 5 years or more.
Screening interval can increase to 2 years if good control, diabetes <10 years and no retinopathy at initial assessment
When do you start screening for neuropathy in T1DM? How do you screen?
Children 15 years or more with poor metabolic control should be screened yearly after 5 years of T1DM
Hx: paresthesia, numbness, pain, cramps
Exam: skin sensation, vibration, light, touch, reflexes
When do you start screening for dyslipidemia in T1DM?
Screen at 12 and 17 years of age (delay screening after diagnosis until metabolic control stabilized)
If <12 years: screen only those with BMI >97th percentile, family hx of hyperlipidemia or premature CVD
When do you start screening for hypertension in T1DM?
Screen at least twice/year from diagnosis
