Type 1 Diabetes Flashcards
Where is insulin produced?
Insulin is produced in the beta cells of the Islets of Langerhans in the pancreas
Where is glucagon produced?
Glucagon is produced in the alpha cells in the Islets of Langerhans in the pancreas
What are the symptoms in initial presentation of T1DM?
Polyuria
Polydipsia
Weight loss
When do the symptoms of T1DM typically present?
1 to 6 weeks before the onset of DKA
What investigations are performed in a newly diagnosed type 1 diabetic?
FBC
Renal profile
HbA1c
TFTs, TPO antibodies
Anti-TTG antibodies
Insulin antibodies, anti-GAD antibodies and islet cell antibodies
What is the criteria for diagnosis of type 1 diabetes?
One of the following is sufficient for diagnosis:
Random glucose > 11.1 or fasting plasma glucose > 7
2 hour glucose tolerance test > 11.1
HbA1c > 48
What type of regime is insulin typically administered using?
Basal-bolus regime
- Long acting insulin to give constant background insulin during the day
- Short acting insulin before meals
What are the blood glucose goals for before meals, and before bed?
Pre-meal blood glucose - 4-7 mmol/L
Bedtime blood glucose - 6-10 mmol/L
What are the long term macrovascular complications of T1DM?
Coronary artery disease
Peripheral ischaemia - diabetic foot
Stroke
Hypertension
What are the microvascular complications of T1DM?
Peripheral neuropathy
Retinopathy
Glomerulosclerosis
What are the infection related complications of T1DM?
UTIs
Pneumonia
Skin and soft tissue infections
Fungal infections - oral and vaginal candidiasis
How often is HbA1c monitored in T1DM patients?
Every 3 to 6 months
What are the sick day rules for type 1 diabetics?
Increase blood glucose monitoring to every 3-4 hours
Do not stop insulin treatment
Check ketone levels regularly (every 3-4 hours)
Maintain normal meal battern
If unable to eat, or vomiting, replace meals with carbohydrate containing drinks
