Type 1 Diabetes Mellitus (1*)

Question 1

What occurs here?

How does it present?

Which investigations are done?

Answer 1

➊ Autoimmune destruction of pancreatic B-cells, resulting in little/no Insulin production = Hyperglycaemia

➋ • 25-50% present with DKA
• Classic triad of symptoms of Hyperglycaemia:
‣ Polyuria (due to osmotic diuresis)
‣ Polydipsia (due to dehydration)
‣ Weight loss (due to catabolism)

➌ • Exclude other associated pathologies
• Bloods - FBC, U&E, HbA1c, Glucose, TFTs, Anti-TTG

Question 2

What is the mainstay of its management?
→ What is the complication that occur with frequent injections in the same spot?

What else is part of its management?

Answer 2

➊ Insulin
• Long-acting given once a day, and Short-acting given 30 minutes before meals
• Insulin pump is another option – Insulin infused subcutaneously with cannula replaced every 2-3 days
→ Lipodystrophy

➋ • Monitoring dietary carbohydrate intake
• Monitoring blood sugar levels on waking, at each meal and before bed
• Monitoring and managing complications

Question 3

What are its short-term complications?

What are its long-term complications?

Answer 3

➊ • Hypoglycaemia
• DKA

➋ • Microvascular – Neuropathy, Retinopathy, Nephropathy (particularly glomerulosclerosis)
• Macrovascular – Coronary artery disease, Peripheral ischaemia (Poor healing, ulcers, diabetic foot), Stroke, HTN