Type 1 Diabetes Mellitus Flashcards
what is the pathogenesis of type 1 DM?
destruction of insulin producing cells in the islet of Langerhans (Beta cells)
type 1 DM can either be due to _____ or _______ destruction
autoimmune
non-autoimmune
genetically susceptible subjects, triggered by at least 1 environmental agents that progresses over months/years, but subject is asymptomatic and euglycemic.
autoimmune type 1 DM
at what point are genetic markers present in type 1 DM?
at birth
at what point are immune markers detectable in type 1 DM?
after the onset of the autoimmune process
at what point are metabolic markers detected in type 1 DM?
when enough beta cell damage has occurred but before symptoms
type 1 DM is one of the most common _____ diseases in _____
chronic
childhood
what age are most type 1 DM cases diagnosed in the US?
19 or younger
___% of patients are diagnosed with type 1 DM before age _____
45
10
what will the presentation of type 1 DM present without?
without acidosis
what are the top 3 clinical presentations of type 1 DM?
polydipsia
polyuria
weight loss
what symptom will be present if they have type 1 DM that causes a yeast infection that grows with glucose?
perineal candidiasis
what symptom will be present if hyperglycemia is longstanding?
cataracts
with insufficient insulin, type 1 DM will lead to _____ or _____
ketonemia
ketonuria
similar symptoms as the classic presentation, but more severe
diabetic ketoacidosis
what are 3 symptoms that will be present in DKA?
fruity smelling breath
drowsiness/lethargy
nausea/vomiting
what 2 criteria help distinguish type 1 DM vs type 2 DM?
type 1:
body habitus (thin)
not a strong family history
what are 3 lab results that will present in type 1 DM?
pancreatic autoantibodies
low insulin
low C-peptide
if a patient presents with classic symptoms of hyperglycemia, what random plasma glucose value will diagnose them with type 1 DM?
200 or higher
for an asymptomatic patient, what should labs/other results be to diagnose them with type 1 DM? (3)
fasting plasma glucose: over 126
OR
post-OGTT: over 200
OR
Hbg A1c: over 6.5%
what is the management for a patient with type 1 DM?
coordinate meals + activity with insulin replacement
what is the glucose monitoring rule?
at least 4 times a day
OR
continuous glucose monitoring
what is the standard glycemic target of HbA1C?
less than 7%
what is the glycemic target of HbA1c for older patients, comorbidities, or limited life expectancy?
less than 8%
what is the glycemic target of HbA1c during pregnancy?
less than 6%
at minimum, how often should young patients with type 1 DM be seen?
every 3 months
what should we watch for in patients with type 1 DM? (2)
hypoglycemia
weight gain
what is available for emergency use in a patient with type 1 DM if they experience hypoglycemia?
glucagon injection
