Type 1 Diabetes Flashcards
What causes T1DM?
Beta cell destruction leading to absolute insulin deficiency
What is required for diagnosis of T1DM?
Acute onset of hyperglycaemia symptoms with ketoacidosis and BSL >11.1
Which autoantibodies are involved in T1DM?
Anti GAD65, anti IAA, anti IA-2 and IA-2B and anti ZnT8
Which HLAs confer risk for T1DM?
HLA-DR3 and HLA-DR4
Which HLAs confer protection for T1DM?
HLA-DR2
What is the average lifetime risk of developing T1DM in the general population?
0.4%
What is the risk of developing T1DM if your mother or father has it?
Mother: 2-4%
Father: 5-8%
Both: 30%
What is the risk of developing T1DM if your sibling has it?
Non twin: 5%
Dizygotic twin: 8%
Monozygotic twin: 50%
What is the diagnostic criteria for LADA?
Age of onset > 30
Positive titre for at least one autoantibody
Not treated with insulin within first 6 months after diagnosis
What is idiopathic type 1 diabetes?
Accounts for 5% of T1DM
Permanent insulinopenia and ketoacidosis prone but no evidence of B cell autoimmunity
Which other autoimmune diseases are associated with T1DM?
Thyroid disease, addison’s disease, coeliac disease, vitiligo, autoimmune hepatitis, myasthenia gravis and autoimmune gastritis
Which autoimmune diseases should patients with T1DM be regularly screened for?
Thyroid disease, coeliac disease and autoimmune gastritis
What is type II autoimmune polyendocrine syndrome?
Characterised by the presence of addison’s with autoimmune thyroid disease and/or T1DM
What is type I autoimmune polyendocrine syndrome?
Candidiasis, hypoparathyroidism, addison’s disease
Which gene is involved in type I autoimmune polyendocrine syndrome?
AIRE
What is X linked polyendocrinopathy, immune dysfunction and diarrhoea?
A rare syndrome involving neonatal diabetes and malabsorption
What gene is involved in X linked polyendocrinopathy, immune dysfunction and diarrhoea?
FOXP3
What is the typical starting insulin regimen for T1DM?
0.5 units/kg/day with half as basal
What is the benefit of using U-300 vs U-100 insulins?
Has a more stable, predictable and prolonged activity profile to reduce hypoglycaemia risk
What is degludec?
An ultra long acting basal insulin analogue with a half life of 25 hours
What are the benefits of CSII vs MDI?
Reduces HbA1c by 0.3% and reduces risk of severe hypoglycaemia
What is the insulin carbohydrate ratio (ICR)?
Represents how many grams of carbohydrate are disposed of by 1 unit of insulin
What is the insulin sensitivity factor (ISF)?
Represents how much 1 unit of rapid acting insulin will lower the blood glucose over 2-4 hours
What surgical treatments are available for T1DM?
Whole pancreas transplantation or islet transplantation
