Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 2 Medicine > Type 1 Diabetes Mellitus > Flashcards

Type 1 Diabetes Mellitus Flashcards

1
Q

Epidemiology of Diabetes:

  • Is the prevalence of all types of diabetes in the UK increasing?
  • Adults > 16 years of age 2009 vs 2016/2017 % with diabetes
A
  • Is the prevalence of diabetes in the UK increasing - yes
  • Adults > 16 years of age 2009 - 5.1% vs 2016/2017 6.7% with diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Epidemiology of Type 1 Diabetes:

  • Prevalence is about …%
  • Peak onset at …
  • More common in men or women?
  • White vs BAME - more common in who?
  • … variability
  • More prevalent … latitudes
A
  • Prevalence is about 0.5%
  • Peak onset at adolescence (youngest 6 months to 80+)
  • M=F
  • White>Bame
  • Seasonal variability
  • More prevalent Northern latitudes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is this figure representing?

A

Age and gender of patients with Type 1 diabetes in England and Wales, 2016-17

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is this showing?

A

Diabetes - geographical incidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Genetic Predisposition to Type 1 Diabetes

  • …% background risk
  • 1-2% if … affected
  • 3-6% if … has affected
  • 6% if … has affected
  • 36% if … affected
A
  • 0.5% background risk
  • 1-2% if mother affected
  • 3-6% if father has affected
  • 6% if sibling has affected
  • 36% if monozygotic twin affected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Genetic Predisposition

  • Association with … antigens
    • two in particular: these are…
    • …% of Scandinavians with type 1 diabetes positive for 1 or both
A
  • Association with HLA antigens
    • HLA DR3-DQ2 and DR4-DQ8 predispose
    • 90% of Scandinavians with type 1 diabetes positive for 1 or both
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is this showing (diabetes)

A
  • How well Genetic risk score (GRS2) discriminates those with T1D diabetes from T2 diabetes
  • The more one has of those predisposing genotypes the more likely that the person has T1 vs T2 diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pathophysiology of Type 1 Diabetes

  • …-cell events trigger … response
  • antibodies to … or … generally appear first
  • Other …-cell antibodies follow:
    • 1A2, Xn2+ transporter 8
  • Selective immune …-cell destruction
    • The … antibodies you get, the more likely you are to develop type 1 diabetes
A
  • beta-cell events trigger autoimmune response
  • antibodies to insulin or GAD generally appear first
  • Other beta-cell antibodies follow:
    • 1A2, Xn2+ transporter 8
  • Selective immune beta-cell destruction
  • The more antibodies you get, the more likely you are to develop type 1 diabetes (shown in graph)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is shown on this slide?

A

Normal pancreatic islet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is shown on this slide?

A

Pancreatic islets are destroyed (autoimmune destruction insulitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is this showing?

  • Schematic evolution of ….
A
  • type 1 diabetes
  • Genetic predisposition, environmental trigger leading to an inflammatory process, beta cells destroyed - mass down - pre diabetes -> diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Autoimmune triggers for Type 1 Diabetes may be … (3)

​

A
  • Viral infection (Coxackie)
  • Endoreticular stress
  • Cytokines release - destruction of beta cell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Autoimmune diseases associated with T1 diabetes

  • … disease
  • …thyroidism
  • … disease
  • … disease
  • Hypo…
  • … anaemia
  • Vi…
  • Autoimmune … syndromes
A
  • Coeliac disease
  • Hypothyroidism
  • Grave’s disease
  • Addison’s disease
  • Hypogonadism
  • Pernicious anaemia
  • Vitiligo
  • Autoimmune polyglandular syndromes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Symptoms associated with T1 diabetes

  • 4 T’s - what are they?
  • Other symptoms include:
    • Problem with Vision - what is this?
    • What kind of infections?
    • Keto…
    • Diabetic KA
    • (Death…)
A
  • Thirsty, going to toilet, tired, becoming thinner (polydipsia, poluria, lethargy, weight loss)
  • Other symptoms include:
    • Problem with Vision - what is this - blurred vision
    • What kind of infections - candida infections
    • ketosis / ketoacidosis
    • Diabetic KA
    • (Death…)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are Ketone bodies?

A

Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat instead of the sugar glucose for energy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 3 ketone bodies?

A

The ketone bodies – acetone, acetoacetate, and beta-hydroxybutyrate – are toxic acidic chemicals.

17
Q

How are ketone bodies excreted?

A

They build up in the blood and then spill over into the urine. The body can also rid itself of acetone through the lungs. This gives the breath a fruity odor.

18
Q

People with diabetic ketoacidosis can be detected on their breath, how?

A

Breath smells like pear drops - due to acetone

19
Q

Is there a clear test for T1 Diabetes?

20
Q

Diagnosis of T1 Diabetes (specifically T1)

  • Is age relevant?
  • Onset?
  • Phenotype
  • What histories do we check?
  • Weight …
  • Keto..
  • What antibodies do we check for?
  • What do we use to check if the person is actually making insulin?
A
  • Yes - typically see younger people with T1 over T2 diabetes
  • Yes - rapidity of onset is a clue
  • Phenotype
  • Past medical history, Family History
  • Weight loss
  • Ketosis
  • GAD/IA2/Zinc transporter 8 antibody positive
  • C-peptide to check if person is making insulin
21
Q

C-peptide is produced in what molar ratio with insulin?

A

1:1 molar ratio

22
Q

If you are unsure whether someone has T1 or T2 diabetes, what can you measure?

A
  • C-peptide
  • Need adequate stimulus for secretion
23
Q

Insulin and T1 Diabetes

  • Necessary for …
  • Peptide hormone needs to be given …
    • The most common route is …
    • Also can be … or through the …
  • Various types:
    • Primary … (animal, human, analogue)
    • Duration of … (addition of protamine, altered solubility, fatty acid chain)
    • … : (100, 200, 300, 500 units/ml)
A
  • Necessary for survival
  • Peptide hormone needs to be given parenterally
    • Most common - Subcutaneously
    • Inhaled
    • Mucous membranes
  • Various types:
    • Primary structure (animal, human, analogue)
    • Duration of action (addition of protamine, altered solubility, fatty acid chain)
    • Strength: (100, 200, 300, 500 units/ml)
24
Q

What is the device shown for?

A
  • Giving insulin (pen device)
  • Small fine needle on one end
  • Dose up insulin in units (amount of insulin)
  • Given subcutaneously - soft tissue areas
25
Injection sits for insulin - where are they?
Soft tissue sites - given subcutaenously
26
_Physiological Insulin Secretion_ * When does the body secrete insulin? * When does insulin spike? * People with T1 diabetes should administer insulin when?
* Body usually **constantly** secretes low level of insulin * When we **eat** - increase saliva - release of insulin * people with T1 diabetes should give a background level of insulin (long slow acting) and then injections before each meal (change amount according to what you are eating)
27
_Typical Insulin Regime_ * (1) ... (2)... regimen * Rapid acting insulin pre-meal (2) * Long acting background insulin (1) * ... regimen * Rapid acting insulin reflects ... intake
* **Basal** **bolus** regimen * Rapid acting insulin pre-meal (**bolus**) * Long acting background insulin (**basal**) * **Balanced** regimen * Rapid acting insulin reflects **CHO** intake
28
_Factors Affecting Blood Glucose_ * 8 factors - list
1. Diet 2. Injection site 3. Temperature 4. Exercise 5. Illness 6. Stress 7. Alcohol 8. Menstrual Cycle
29
_Hypoglycaemia - symptoms_ * Autonomic symptoms include ... (3) * Neuroglycopaenic symptom ... (1) * Can be ... or ... * ... hypoglycaemia is inevitable with good control * Loss of warning signs
* Autonomic symptoms include * **palpitation**, **sweating**, **tremor** * Neuroglycopaenic symptom ... (1) * **confusion** * Can be **mild** or **se****vere**
30
What is this showing?
**Subcutaneous insulin pump** * **expensive, hard to learn how to use** * **can use it more physiologically - alter basal insulin if sick/exercise etc**
31
_Transplantation_ * ... transplant * almost always SPK (...) or PAK (...) * ... ... therapy * Edmonton protocol * UK programme * Which is less invasive?
* **Pancreas** * almost always SPK (**simultaneous pancreas kidney**) or PAK (**p****ancreas after kidney**) * **Islet Cell** therapy * Edmonton protocol * UK islet cell programme * **Islet less invasive**
32
_Monitoring T1 Diabetes_ * Glucose monitoring at least ... times a day * Test also in 3 scenarios/conditions - what are they?
* Glucose monitoring at least **4** times a day * Test also in 3 scenarios/conditions - what are they? * **Driving** * **Unwell** * **Hypoglycaemic**
33
What is this test?
Finger prick test - glucose monitoring
34
What are ways of monitoring blood glucose levels? (2)
* Finger prick test * Continuous glucose monitoring system - CGMS
35
What is this showing?
Flash Continuous blood glucose monitor
36
What is this showing?
Ambulatory glucose profile - trend for glucose range
37
What is 'time in range' monitoring? (for T1 diabetes)
Time in Range (TIR) ​​indicates the percentage of how long your glucose value was within the target range during a defined period
38
_Ketone monitoring_ * Acetoacetate can be found in the ... * Beta-hydroxybutyrate can be found in the ...
* Acetoacetate can be found in the **urine** * Beta-hydroxybutyrate can be found in the **blood**
39
_Monitoring - as a clinician (T1 Diabetes)_ * Clinicians will monitor how sugary someones ... are at least ... a year * This is known as someones ... (glycated ...) * Reflects glucose over last ... months * Weighted towards last ... weeks * Affected by lifespan of ...
* Clinicians will monitor how sugary someones **red blood cells** are at least **twice** a year * This is known as someones **HbA1c** (glycated haemoglobin) * Reflects glucose over last **3** months * Weighted towards last **6** weeks * Affected by lifespan of **red cell**

Year 2 Medicine (162 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions