Type 1 diabetes mellitus

Question 1

What is the cause of T1DM?

Answer 1

Autoimmune destruction of islets

Question 2

Recall 3 endocrine conditions that can rpesent with diabetes

Answer 2

Phaeocromocytoma
Cushing’s
Acromegaly

Question 3

What is a less common form of autoimmune diabetes?

Answer 3

LADA

Latent AI Diabetes in Adults

Question 4

Which haplotypes are implicated in T1DM?

Answer 4

DR3 and DR4

Question 5

Recall 3 osmotic symptoms of T1DM

Answer 5

1. Polyuria
2. Polydipsia
3. Nocturia

Question 6

Recall 4 non-osmotic symptoms of T1DM

Answer 6

1. Thrush
2. Blurred vision
3. Weight loss
4. Fatigue

Question 7

Recall 6 SIGNS of T1DM

Answer 7

Dehydration
Cachexia
Glycosuria
Ketonuria
Ketone smell
Hyperventillation

Question 8

Describe the hyperventillation experienced in T1DM

Answer 8

Due to metabolic acidosis - body is trying to get rid of CO2 = Kussmaul breathing

Question 9

What blood marker is used to measure insulin function?

Answer 9

C peptide

Question 10

What can me measured to confirm a T1DM diagnosis?

Answer 10

1. ICA (islet cell auto-Ab)

2. GADA (Glu Acid Decarb Auto-Ab)

Question 11

Recall the 2 types of insulin therapy and give an example of each

Answer 11

1. Short-acting with meals eg glispro

2. Long-acting eg glargine

Question 12

Recall 2 alternatives to insulin treatment that are used in more serious cases

Answer 12

1. Insulin pump

2. Islet cell transplant

Question 13

Recall 2 methods of measuring blood sugar

Answer 13

1. Capillary monitoring

2. HbA1C

Question 14

What is HbA1C and why is it useful?

Answer 14

Glycosylated Hb = gives an idea of blood sugar over last 120 days

Question 15

Recall 2 conditions in which HbA1C is less accurate than usual

Answer 15

1. Hbopathy

2. Renal failure

Question 16

What is the main acute complication of T1DM

Answer 16

Rapid decompensation

Question 17

What are the 2 main features of rapid decompensation in T1DM

Answer 17

1. Metabolic acidosis

2. Hyperglycaemia

Question 18

What are the 2 main effects of insulin deficiency on blood sugar

Answer 18

1. HGO cannot be suppressed after a meal so remains high

2. Uptake into muscles is impaired

Question 19

Recall the defining plasma glucose value of hypoglycaemia

Answer 19

<3.6mmol/L

Question 20

At what plasma glucose level is consciousness impaired?

Answer 20

<2mmol/L

Question 21

What are the 2 main risk factors for hypoglycaemia amongst diabetic patients?

Answer 21

1. Poor glycaemic control

2. Low HbA1c

Question 22

Recall and explain 5 clinical presentations of hypoglycaemia

Answer 22

1. Due to ANS activation:
Tachycardia
Tremor
Sweating
2. Due to impaired CNS function
Drowsiness
Confusion

Question 23

What is the best oral treatment solution to hypoglycaemia?

Answer 23

Rapid glucose solution compared with complex CHO to tackle short- and long-term needs

Question 24

If IV nutrition is required in hypoglycaemia, what solution should be administered

Answer 24

dextrose

Question 25

Describe the distribution of body potassium in Type 1 Diabetes

Answer 25

Total body deficiency with excess plasma K+