Type 1 Diabetes Flashcards
list Clinical features of newly diagnosed Type 1 diabetes
- Short history (weeks) of severe symptoms
- Moderate or large urinary ketones
- Weight loss
what is the commonist age for type 1 diabetes diagnosis
5-15
if a mother has T1Diabetes , the risk of developing it is about _%
2
If a father has T1Diabetes, the risk of developing it is about _%
8
if both parents have T1Diabetes, the risk of developing it is up to __%
30
if a brother or sister develops T1D , the risk of developing it is __%
10
Offspring of affected ____ are more unwell than those of affected ____, with longer duration of symptoms, more than twice as likely to present in ketoacidosis.
Fathers
Mothers
Reduced insulin leads to ___ breakdown and formation of ______ (a gluconeogenic precursor) and free fatty acids (ffa)
- Fat
- Glycerol
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)
- glucose
- liver
- ketone
what is Ketoacidosis
- 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
Define diabetic ketoacidosis (DKA)
- Hyperglycaemia (plasma glucose usually <50 mmol/l)
- Raised plasma ketones (urine ketones > 2+)
- Metabolic acidosis – plasma bicarbonate < 15 mmol/l
What are the causes of DKA
- Intercurrent illness
- infection
-myocardial infarct - Treatment errors – stop/reduce insulin dose
- undiagnosed diabetes
What are the clinical features of DKA
Symptoms:
- polyuria and polydipsia
- nausea and vomiting
- weight loss
- weakness
- abdominal pain
- Drowsiness / confusion
Signs:
- hyperventilation (Kussmaul breathing)
- dehydration
- hypotension
- Tachycardia
- coma
How do you manage DKA
- Rehydration
- insulin
- replace electrolytes (k)
- treatment without delay
what are the complications of DKA
- cerebral
- adult respiratory distress syndrome
- thromboembolism – venous and arterial
- aspiration pneumonia (in drowsy/comatose patients)
- death