Type 1 Diabetes Flashcards

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1
Q

What is type 1 diabetes ?

A

This is a metabolic disorder that can cause hyperglycaemia, disturbances to carbohydrates and proteins and fat metabolisms, resulting from defects in insulin secretion and action

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2
Q

What is the peak age for diagnosis of T1DM ?

A

10-14 years old

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3
Q

What are the two types of T1DM ?

A

Autoimmune
And
Non-immune or idiopathic

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4
Q

What is autoimmune diabetes ?

A

Generic and environmental factors combines to trigger cells mediated destruction of beta cells of the pancreas

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5
Q

What is non-immune (idiopathic) diabetes ?

A

Rarer form
Occurs secondary to other conditions such as pancreatitis or cystic fibrosis

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6
Q

What is the genetic susceptibility of diabetes ?

A

Siblings with diabetes means that the other is 10% more likely to develop
10-19% non-identical twins
30-70% identical twins

Involves gene mutations of the histocompansatory complex within out DNA which pays a vital role in the coding proteins essential for adaptive immunity

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7
Q

What are the environmental factors for diabetes ?

A

Infections such as Entrovirus and Helicobacter pylori have been implicated
Exposure to cows milk proteins and lack of vitamin D has also been linked to

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8
Q

Describe and explain the pathophysiology of diabetes

A

Autoantigens are produced by beta cells in the blood stream and lymphatic system
The autoantigens are ingested by the antigen-presenting cells and activate the T helper lymphocytes
T helper lymphocytes active:
T cytotoxic lymphocytes specific to the autoantigens being produced b y the beta cells that attack the beta cells with toxins and granzymes
Marcrophages that release inflammatory cytokines causing further beta cell death
Blymphocytes that produce antibodies against the beta cells
All result in beta cell destruction and decrease the ability to produce insulin

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9
Q

Signs and symptoms of diabetes ?

A

Hyperglycaemia
Ketoneaemia
Dehydration
Weight loss
Fatigue

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10
Q

Describe hyperglycaemia

A

Insulin deficiency means there’s a decrease in transportation and use of glucose by the cells, so blood glucose levels rise. Now an imbalance between insulin and glucagon causing further breakdown of glycogen into glucose

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11
Q

Describe ketonaemia

A

Fat is metabolised into the liver to produce ketones for energy, too many ketones are produced than can be used by the liver

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12
Q

Describe dehydration with diabetes

A

Fluid loss through urine and high glucose levels draw water from cells (osmotic effect)

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13
Q

Describe weight loss with diabetes

A

Occurs due to fluid loss (osmotic diuresis) an because the cells are not able to use glucose for energy, start using body fats and proteins instead of

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14
Q

Describe fatigue with diabetes

A

Insulin deficiency mean that glucose cannot be used for energy causing a change in metabolic process. Causes poor use of food products so fatigue and lethargy is experienced. Sleep loss due to increase of urination during the night

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15
Q

Factors for diagnosing diabetes

A

Detailed family history
Urinalysis
Fasting blood glucose levels
Random blood glucose levels
Oral glucose tolerance test

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16
Q

What is the main aspect for diabetes management ?

A

To maintain enough insulin in the body to help control the blood glucose levels - maintaining a stable

17
Q

What is HbA1c ?

A

Important blood testing
Also referred to as Glycated haemoglobin, develop when haemoglobin and glucose bond, higher blood glucose levels = higher levels of glycated haemoglobin

18
Q

Why cant insulin be taken orally ?

A

It’s destroyed by the stomach

19
Q

What are the different forms of insulin ?

A

Human insulin
Analogue insulin
Animal insulin

20
Q

What are the speeds of insulin ?

A

Rapid acting
Short acting
Intermediate acting
Long acting

21
Q

Describe rapid acting insulin

A

Taken before or with meals (10-20mins)
Minimise blood sugars when eating
Lasts 2-5 hours

22
Q

Describe short acting insulin

A

Taken before meals
Doesn’t work quickly (20-60mins)
Up to 8 hours or 3-4 hours depending on brand

23
Q

Describe intermediate acting insulin

A

Usually taken in conjunction with short acting, starts acting 1 hour after and lasts up to 7 hours

24
Q

Describe long acting insulin

A

Can last up to 24 hours
No peak activity
Usually taken once or twice a day

25
Q

What are the symptoms of hyperglycaemia ?

A

Pallor
Sweating
Tremor
Blurred vision
Confusion
Slurred speech
Altered levels of consciousness

26
Q

How do you manage diabetic ketoacidosis (DKA) ?

A

IV fluids
Electrolytes
Insulin