Type 1 Diabetes

Question 1

What is the definition of type 1 diabetes?

Answer 1

A state of absolute insulin deficiency

Question 2

What is the diagnostic criteria for Diabetes ( type 1 and 2)

Answer 2

Fasting glucose > 7mmolL

Random glucose > 11.1mmolL

plus sypmtoms

Question 3

What is the percentage risk of a child having type 1 diabetes if both his parents have type 1 diabetes?

Answer 3

30%

Question 4

What is the percentage risk of a child developing type 1 diabetes if:

(a) Their father has type 1 diabetes
(b) Their mother has type 1 diabetes

Answer 4

(a) father:- 8%
(b) mother:- 3%

Both:- 30%

Question 5

Why are HLA genes important?

Answer 5

HLA genes represnt 50% of the familial risk of type 1 diabetes

Question 6

What percentage of patients with susceptible HLA genes develop diabetes?

Answer 6

10%

Question 7

What can trigger the onset of type 1 diabetes?

Answer 7

Viral infection

Maternal factors

Weight gain

Question 8

What season do has the highest rate of new diagnosis of type 1 diabetes?

Answer 8

Winter

Question 9

What is the management plan for a patient with newly diagnosed type 1 diabetes?

Answer 9

Blood glucose and ketone monitoring

Insulin

Carbohydrate estimation + dietician contact

Check Hba1c

Annual review assessments

Question 10

What would you include in the annual review assesment of a patient with type 1 diabetes?

Answer 10

Weight

Blood pressure

HbA1c

Renal Function

Retinal screening

Foot risk assessment

Question 11

What percentage of people with cystic fibrosis will also develop diabetes?

Answer 11

20%

Question 12

What are the two phases of insulin secretion in a normal response to a meal?

Answer 12

Rapid phase of preformed insulin 5-10mins

Slow phase over 1 to 2 hrs

Question 13

What vessle is insulin secereted in too?

Answer 13

Hepatic portal vein

Question 14

What is the base line rate of secretion of insulin?

Answer 14

0.25 to 1.5 units of insulin per hour

Question 15

In a patient with diabetes under the age of 6 months what type of diabetes should you be thinking off?

Answer 15

Neonatal diabetes

Question 16

What does LADA stand for ?

Answer 16

Latent onset diabetes of adulthood

LAtent Diabetes Adults

Question 17

What is LADA?

Answer 17

Presence of elevated pancreatic auto-antibodies in patients with recently diagnosed diabetes who do not initially require insulin.

Question 18

What is the usual age range for LADA?

Answer 18

25-40yrs

Question 19

What are the three aims of insulin therapy?

Answer 19

Prevent hyperglycaemia

Avoid Hypoglycaemia

Reduce Chronic Complications

Question 20

What is normal insulin secreted in to ?

Answer 20

Portal vein

Question 21

Would you find Ketones in a diabetic urine?

Answer 21

Only in type 1 diabetes , not in type 2

Question 22

What would you find in h C peptide levels of diabetic patients?

Answer 22

It would be low in type 1 diabetes and high in type 2 diabetics

Question 23

What are the four common devices for administering insulin?

Answer 23

Syringe

Disposable pen

Re-usable cartridge pen

Insulin pump

Question 24

What is the normal insulin secretion rate ?

Answer 24

Normal low basal rate with post-prandial insulin secreated post meal

Question 25

What is the go to standard insulin regiem ?

Answer 25

Basal Bolous regiem

Question 26

What are the blood glucose targets before and 1-2 hours after a meal in type 1 diabetes?

Answer 26

Target before 3.9 - 7.2 mmol/L pre meal

After meal less than 10 mmol/L

Question 27

How long do insulin analogues take to start working?

Answer 27

10 - 15 minutes

Question 28

How long does soluble insulin take to start working?

Answer 28

30 - 60 minutes

Question 29

What is the insulin to carbohydrate ratio?

Answer 29

1 unit of insulin per 10g of Carbohydrate

Question 30

What is the target HbA1c in people with type 1 diabetes?

Answer 30

48 mmol/mol