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Endocrine > Type 1 Diabetes > Flashcards

Type 1 Diabetes Flashcards

1
Q

What are possible environmental triggers for type 1 diabetes?

A

viral infection; maternal factors; weight gain; vitamin D deficiency; dietary factors; environmental toxins

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2
Q

What antigens with which auto-antibodies are formed against in type 1?

A

glutamine acid decaroxylase
islet-antigen 2
insulin
ZnT8 transporter

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3
Q

What are the auto-antibodies in type 1?

A

GAD65Ab
IA-2Ab
IAA
ZnT8Ab

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4
Q

What are the accelerating factors for diabetes?

A

infection; insulin resistance; puberty; diet/weight; stress

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5
Q

What are the features of type 1 diabetes?

A

raised glucose; ketones; decreased insulin; decreased beta cell mass; decreased C-peptide

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6
Q

What are the typical presenting symptoms of type 1 diabetes?

A

polyuria (enuresis in children); polydipsia; weight loss; fatigue and somnelence; blurred vision; candidal infection

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7
Q

What is the ideal range of HbA1c?

A

48 to 58 mmol/mol

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8
Q

What are the two phases of insulin secretion?

A

rapid phase of pre-formed insulin and slow phase over 1 to 2 hours

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9
Q

What vessel is insulin secreted into?

A

portal vein

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10
Q

What type of diabetes should you suspectin a patient under the age of 6?

A

monogenic diabetes

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11
Q

What is LADA?

A

latent onset diabetes of adulthood

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12
Q

How is a diagnosis of LADA made?

A

the presence of elevated levels of pancreatic auto-antibodies in patients who do not initially require insulin

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13
Q

Who gets LADA?

A

young adults 25-40; male; usually non-obese

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14
Q

How many patients with CF get diabetes?

A

more than 25% will have a 20 years

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15
Q

What is Wolfram syndrome?

A 
DIDMOAD
Diabetes Insipidus
Diabetes MEllitus
Optic Atrophy
Deafness
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16
Q

What are the features of bardet-beidl syndrome?

A

very obese; polydactyly; hypogonadal; visual impairment; hearing impairment; mental retardation; diabetes

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17
Q

What are the associated auto-immune conditions with type 1?

A

thyroid disease; coeliac disease; pernicious anaemia; addisons disease; IgA deficiency

18
Q

How is coeliac disease diagnosed?

A

anti-TTG antibodies; duodenal biopsy

19
Q

What are the symtoms of thyroid disease?

A

wegith change; deterioration in HbA1c; hypoglycasemia

20
Q

What is polyglandular endocrinopathy?

A

The polyglandular autoimmune syndromes (PAS) form
different clusters of autoimmune disorders and are
rare endocrinopathies characterized by the coexistence
of at least two glandular autoimmune mediated
diseases

21
Q

What are the symptoms of hypoglycaemia?

A

pallor; sweating; tremor; palpitations; confusion; nausea; hunger

22
Q

What are the symtpoms of hyperglycaemia?

A

thrist; tiredness; blurred vision; weight loss; polyuria; nocturia; fungal infections

23
Q

What percentage of insulin produced does the basal rate of insulin account for?

A

50%

24
Q

Give examples of rapid-acting analogues?

A

humalog; novorapid; apidra

25
Q

Give examples of long acting analogues?

A

lantus; levemir

26
Q

How should most people with type 1 diabetes be treated?

A

with MDI or CSII

27
Q

What is the initial amount of insulin given to a patient?

A

0.3units/kg of body weight

28
Q

What is the target for blood glucose before a meal?

A

3.9-7.2

29
Q

What is the blood glucose target 1-2 hours after beginning of meal?

A

<10mmol/l

30
Q

How long do insulin analogues take to act?

A

10-15 minutes

31
Q

What is onset of action of soluble insulin?

A

30-60 minutes

32
Q

What is advanced carbohydrate counting?

A

synchronising the amount of insulin to amount of carbohydrate consumed

33
Q

What do insulin pumps deliver?

A

continuous administration of short acting insulin subcutaenously

34
Q

How is glycated haemoglobin formed?

A

by non-enzymatic glycation of haemoglobin on exposure to glucose

35
Q

What factors can affect insulin absorption/action?

A

tempreature; injection site; injection depth; exercise

36
Q

Do you stop insulin if patient has a hypo?

A

No- treat hypo and administer insulin as normal

37
Q

What should also be given with IV insulin infusions?

A

glucose

38
Q

Who is given IV insulin?

A

DKA; in hyperosmolar hyperglycaemic state; acute illness; fasting patients who are unable to tolerate oral intake

39
Q

What is the blood glucose level aimed for with IV insulin?

A

5-12 mmol

40
Q

How often should patients on IV insulin have their blood glucose checked?

A

hourly

Endocrine (27 decks)

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