Type 1 Diabetes Flashcards
What is type 1 diabetes ?
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
What is the peak age for diagnosis of T1DM ?
10-14 years old
What are the two types of T1DM ?
Autoimmune
And
Non-immune or idiopathic
What is autoimmune diabetes ?
Generic and environmental factors combines to trigger cells mediated destruction of beta cells of the pancreas
What is non-immune (idiopathic) diabetes ?
Rarer form
Occurs secondary to other conditions such as pancreatitis or cystic fibrosis
What is the genetic susceptibility of diabetes ?
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
What are the environmental factors for diabetes ?
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
Describe and explain the pathophysiology of diabetes
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
Signs and symptoms of diabetes ?
Hyperglycaemia
Ketoneaemia
Dehydration
Weight loss
Fatigue
Describe hyperglycaemia
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
Describe ketonaemia
Fat is metabolised into the liver to produce ketones for energy, too many ketones are produced than can be used by the liver
Describe dehydration with diabetes
Fluid loss through urine and high glucose levels draw water from cells (osmotic effect)
Describe weight loss with diabetes
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
Describe fatigue with diabetes
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
Factors for diagnosing diabetes
Detailed family history
Urinalysis
Fasting blood glucose levels
Random blood glucose levels
Oral glucose tolerance test
What is the main aspect for diabetes management ?
To maintain enough insulin in the body to help control the blood glucose levels - maintaining a stable
What is HbA1c ?
Important blood testing
Also referred to as Glycated haemoglobin, develop when haemoglobin and glucose bond, higher blood glucose levels = higher levels of glycated haemoglobin
Why cant insulin be taken orally ?
It’s destroyed by the stomach
What are the different forms of insulin ?
Human insulin
Analogue insulin
Animal insulin
What are the speeds of insulin ?
Rapid acting
Short acting
Intermediate acting
Long acting
Describe rapid acting insulin
Taken before or with meals (10-20mins)
Minimise blood sugars when eating
Lasts 2-5 hours
Describe short acting insulin
Taken before meals
Doesn’t work quickly (20-60mins)
Up to 8 hours or 3-4 hours depending on brand
Describe intermediate acting insulin
Usually taken in conjunction with short acting, starts acting 1 hour after and lasts up to 7 hours
Describe long acting insulin
Can last up to 24 hours
No peak activity
Usually taken once or twice a day
What are the symptoms of hyperglycaemia ?
Pallor
Sweating
Tremor
Blurred vision
Confusion
Slurred speech
Altered levels of consciousness
How do you manage diabetic ketoacidosis (DKA) ?
IV fluids
Electrolytes
Insulin
