TYPE 1 DIABETES Flashcards
What is Type 1 diabetes mellitus?
Insulin deficiency - destroyed beta-cells in islets of Langerhans
When does Type 1 diabetes present?
Most commonly before adulthood
What are the typical features of Type 1 Diabetes?
- Hyperglycaemia (>11 mmol/L)
- Ketosis
- Rapid weight loss
- BMI < 25 kg/m2
- Age < 50 years
- Family history of autoimmune disease
Symptoms of diabetes
Toilet
Thirst
Tired
Thinner
4 T
If a child with suspected T1DM
presents with symptoms, What signs can be strong indicators of T2DM and require further investigations?
- Family history of Type 2
diabetes - Obese at presentation
- Black or Asian family origin
- Show evidence of insulin resistance (e.g. Acanthosis nigricans)
microvascular complications include
retinopathy
neuropathy
nephropathy
macrovascular complications include
premature CVD
peripheral arterial disease
MI, stroke
metabolic complications
DKA
hypoglycaemia
target HbA1c for T1D
48mmol/mol (6.5%) or lower
What are the HbA1c levels for normal, prediabetes and diabetes
Normal - Below 42 mmol/mol (6%)
Prediabetes - 42-47 mmol/mol (6-6.4%)
Diabetes - 48 mmol/mol (6.5% or more)
What are the blood pressure targets for a diabetic patient with and without complications→
140/80 mmHG or 130/80 mmHG (with complications)
What is the cholesterol target for a diabetic patient
Total cholesterol <4 mmol/L.
What is the diagnostic test for Type 1 diabetes
Random blood glucose test
What is the difference between the diagnostic test for Type 1 and Type 2
Type 2 is HbA1c and fasting blood glucose test
What is the diagnostic test for Gestational diabetes
Oral glucose tolerance test
Why is HbAlc useful in T1DM?
- It shows an average of glycaemic control in the past
2-3 months - It is a reliable predictor of microvascular and macrovascular complications
- Lower HbA1c = lower risk of
long-term vascular complications
How often should
HbA1c be measured in patients with type 1 diabetes?
3-6 m
Blood glucose monitoring
Targets
TARGETS:
* 5-7 mmol/L on waking (fasting)
* 4-7 mmol/L fasting BG before meals at other times of the day
* 5-9 mmol/L 90 minutes after eating
* >5 mmol/L when driving
waking (fasting)
5-7 mmol/L
fasting BG before meals at other times of the day
4-7 mmol/L
90 minutes after eating
5-9 mmol/L
when driving
> 5 mmol/L
How often should blood glucose be measured?
Monitored at least 4 x day
Before each meal and before bed
all patients will require therapy with
insulin
T1DM - first line treatment
Basal bolus regime
- Insulin determir bd
- Insulin aspart before meals
