Type 1 Diabetes Flashcards

1
Q

list Clinical features of newly diagnosed Type 1 diabetes

A
  • Short history (weeks) of severe symptoms
  • Moderate or large urinary ketones
  • Weight loss
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2
Q

what is the commonist age for type 1 diabetes diagnosis

A

5-15

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3
Q

if a mother has T1Diabetes , the risk of developing it is about _%

A

2

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4
Q

If a father has T1Diabetes, the risk of developing it is about _%

A

8

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5
Q

if both parents have T1Diabetes, the risk of developing it is up to __%

A

30

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6
Q

if a brother or sister develops T1D , the risk of developing it is __%

A

10

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7
Q

Offspring of affected ____ are more unwell than those of affected ____, with longer duration of symptoms, more than twice as likely to present in ketoacidosis.

A

Fathers
Mothers

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8
Q

Reduced insulin leads to ___ breakdown and formation of ______ (a gluconeogenic precursor) and free fatty acids (ffa)

A
  • Fat
  • Glycerol
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9
Q

Free fatty acids (FFA)

  • Impair ________ uptake
  • Are transported to the ____, providing ‘energy’ for gluconeogensis
  • Are oxidised to form _____ bodies (beta hydroxy butyrate, acetoacetate and acetone)
A
  • glucose
  • liver
  • ketone
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10
Q

what is Ketoacidosis

A
  • Absence of insulin + rising counterregulatory hormones cause hyperglycaemia and rising ketones
  • Glucose and ketones escape in the urine but lead to osmotic diuresis and falling circulating blood vol
  • Ketones cause anorexia and vomiting
  • Vicious circle of increasing dehydration, hyperglycaemia and increasing acidosis eventually lead to circulatory collapse and death
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11
Q

Define diabetic ketoacidosis (DKA)

A
  • Hyperglycaemia (plasma glucose usually <50 mmol/l)
  • Raised plasma ketones (urine ketones > 2+)
  • Metabolic acidosis – plasma bicarbonate < 15 mmol/l
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12
Q

What are the causes of DKA

A
  • Intercurrent illness
  • infection
    -myocardial infarct
  • Treatment errors – stop/reduce insulin dose
  • undiagnosed diabetes
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13
Q

What are the clinical features of DKA

A

Symptoms:

  • polyuria and polydipsia
  • nausea and vomiting
  • weight loss
  • weakness
  • abdominal pain
  • Drowsiness / confusion

Signs:

  • hyperventilation (Kussmaul breathing)
  • dehydration
  • hypotension
  • Tachycardia
  • coma
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14
Q

How do you manage DKA

A
  • Rehydration
  • insulin
  • replace electrolytes (k)
  • treatment without delay
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15
Q

what are the complications of DKA

A
  • cerebral
  • adult respiratory distress syndrome
  • thromboembolism – venous and arterial
  • aspiration pneumonia (in drowsy/comatose patients)
  • death
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16
Q
A