Type 1 Diabetes

Question 1

What is the typical history associated with type 1 diabetes?

Answer 1

Polyuria, polydipsia, polyphagia. Unexplained weight loss. Fatigue, blurred vision. Family history of autoimmune diseases.

Question 2

What are the key physical examination findings in type 1 diabetes?

Answer 2

Signs of dehydration. Weight loss. Possible diabetic ketoacidosis: fruity breath odor, deep rapid breathing (Kussmaul respiration).

Question 3

What investigations are necessary for diagnosing type 1 diabetes?

Answer 3

Fasting blood glucose ?126 mg/dL. HbA1c ?6.5%. Random blood glucose ?200 mg/dL with symptoms. Positive autoantibodies (GAD, IA-2, insulin).

Question 4

What are the non-pharmacological management strategies for type 1 diabetes?

Answer 4

Patient education on carbohydrate counting, blood glucose monitoring. Regular physical activity. Psychological support and counseling.

Question 5

What are the pharmacological management options for type 1 diabetes?

Answer 5

Insulin therapy (basal and bolus). Continuous glucose monitoring (CGM). Pramlintide as an adjunct in some patients.

Question 6

What are the red flags to look for in type 1 diabetes patients?

Answer 6

Signs of diabetic ketoacidosis: vomiting, abdominal pain, confusion. Hypoglycemia: shakiness, sweating, loss of consciousness. Persistent hyperglycemia despite treatment.

Question 7

When should a patient with type 1 diabetes be referred to a specialist?

Answer 7

Newly diagnosed diabetes for insulin initiation. Poor glycemic control despite treatment. Complications: retinopathy, nephropathy, neuropathy. Psychological support for adjustment to diagnosis.

Question 8

What is one key piece of pathophysiology related to type 1 diabetes?

Answer 8

Autoimmune destruction of pancreatic beta cells. Leads to absolute insulin deficiency. Requires lifelong insulin therapy.