Type 1 Diabetes

Question 2

Define Type 1 Diabetes.

Answer 2

Question 3

What is the common age of a diagnosis of T1DM

Answer 3

<20yrs

Question 4

Of the entire population with DM, what percentage is T1DM?

Answer 4

10%

Question 5

What are some RFs for developing T1DM?

Answer 5

Question 6

Describe the pathophysiology of T1DM.
Mention all the antibodies

Answer 6

Question 7

What are the common symptoms of T1DM?

Answer 7

± DKA

Question 8

WHat are the common symptoms of DKA?

Answer 8

Question 9

What are the common signs of DKA?

Answer 9

Question 10

Define metabolic syndrome. What are the 5 common features?

Answer 10

Question 11

What are your ddx for T1DM?

Answer 11

Question 12

What is MODY? What population group should you suspect MODY in? What are the key features and are the immunological findings?

Answer 12

Question 13

What is LADA? What population group should you suspect LADA in? What are the key features and are the immunological findings?

Answer 13

Question 14

List the microvascular complications of T1DM?

Answer 14

retinopathy
nephropathy
neuropathy

Question 15

What are the features retinopathy as a result of T1DM?
What treatment options, other than glycemic control?

Answer 15

Question 16

What are the features Nephropathy as a result of T1DM?

Answer 16

Question 17

What are the features neuropathy as a result of T1DM?

Answer 17

Question 18

What are the cutaneous complications of T1DM?

Answer 18

Question 19

List the macrovascular complications of T1DM?

Answer 19

increased risk of CVD (MI, HTN, Hyperlipidemia), Vascular (PAD), CVA (TIA, stroke), embolic (PE,DVT)

Question 20

List the common emergency presentations of a patient with T1DM?

Answer 20

1. Hypoglycaemia
2. DKA
3. HHS

Question 21

Describe the emergency presentation and tx of a T1DM patient with hypoglycemia.

Answer 21

Question 22

What are the diagnostic parameters for DKA?

Answer 22

Question 23

Describe the emergency tx of DKA in a T1DM patient.

Answer 23

1) Fluid resuscitation: 1L 0.9% Stat (then over 1,2,4,6,8hrs) as per fluid status. Switch to 0.45% if hypernatremia (corrected sodium which is plasma sodium +1/4 glucose)
2) Insulin: IV 50 units Actrapid in 0.9%NaCl at 7*** units/hours then Dextrose (still with actrapid) when <12mmol (glucose)
3) K+: If K+ normal or low give K+ at a maximum of 10mmol/hr

Question 24

Describe the emergency presentation of HHS in a T1DM patient.

Answer 24

Question 25

Describe the emergency tx of HHS in a T1DM patient.

Answer 25

1) Fluid resuscitation: 1L 0.9% Stat (then over 1,2,4,6,8hrs) as per fluid status. Switch to 0.45% if hypernatremia (corrected sodium which is plasma sodium +1/4 glucose) 2) Insulin: IV 50 units Actrapid in 0.9%NaCl at 3 units/hours then Dextrose (still with actrapid) when <12mmol (glucose) 3) K+: If K+ normal or low give K+ at a maximum of 10mmol/hr

Question 26

Outline all the possible complications of T1DM including emergency complications.

Answer 26

Question 27

In what patient cohorts is HbA1C not accurate in?

Answer 27

Question 28

What serum antibodies can be detected in T1DM?

Answer 28

Question 29

What are the 3 diagnostic features of DKA?

Answer 29

Question 30

What is the normal, prediabetic and diabetic ranges for fasting glucose? What is the normal random glucose?

Answer 30

Question 31

What are the 3 diagnostic features of a hyperosmolar hyperglycemic state?

Answer 31

Question 32

You are investigating a patient with a suspected T1DM. You send off the routine bloods and the c peptide returns LOW. What does a LOW C-peptide indicate?

Answer 32

MODY or LADA

Question 33

What are the diagnostic investigations for T1DM?

Answer 33

Question 34

What are the non-diagnostic investigations for T1DM?

Answer 34

Question 35

What are ALL the investigations for T1DM?

Answer 35

Question 36

Describe the best diet plan for a T1DM patient. (ie - what would the dietician tell them)

Answer 36

Question 37

Outline the components of comprehensive diabetic care.

Answer 37

Question 38

How can patients monitor their glucose? Explain

Answer 38

Question 39

List the possible insulin regimens for a patient with T1DM.

Answer 39

1. basal-bolus 2. mixed insulin 3. continuous insulin / insulin pump 4. hybrid closed loop systems

Question 40

What is the first line insulin regimen for T1DM patients? Describe the regimen in terms of the drug actions.

Answer 40

Question 41

What is the best insulin regimen for those with a poor compliance under 12yoa? Describe this regimen.

Answer 41

Question 42

What is the best insulin regimen for those with a very poor compliance, OVER 12yoa with uncontrollable T1DM? Describe this regimen.

Answer 42

Question 43

Describe the hybrid closed loop system for insulin delivery in T1DM.

Answer 43

Question 44

Describe the long term management options for a patient with T1DM.

Answer 44

Question 45

Describe the secondary preventative measures involved in T1DM.

Answer 45

Question 46

Outline the full management of T1DM.

Answer 46