Type I Diabetes Mellitus

Question 1

Subtypes

Answer 1

Type 1A: Immune-mediated B-cell destruction

Type 1B: Idiopathic (15%)

Question 2

Age presentations DM TI

Answer 2

4-6 years of age and 10-14 years of age

Question 3

DMTI Most common presentation

Answer 3

1st: New onset of chronic polydipsia, polyuria, and weight loss with hyperglycemia and ketonemia or ketonuria
2nd: DKA

Question 4

Diagnostic Criteria

Answer 4

• Fasting plasma glucose ≥126 mg/dLon at least two occasions OR
• Symptoms of hyperglycemia and a plasma glucose ≥200 mg/dL OR
• Plasma glucose ≥200 mg/dL measured two hours after a standard glucose load in an oral glucose tolerance test (OGTT)

Question 5

Type I Treatment regimen

Answer 5

Includes long-acting basal insulin with pre-meal and pre-snack boluses of rapid-acting insulin

Question 6

Clinically important hypoglycemia

Answer 6

<54 mg/dl

Question 7

Whipples Triad

Answer 7

Symptoms consistent with hypoglycemia
Low plasma glucose concentration
Relief of symptoms after plasma glucose level is raised.

Question 8

Rule of 15

Answer 8

Check blood sugar
Give 15 grams of simple carbohydrate by mouth
Re-check blood sugar in 15 minutes
Repeat until blood sugar is above 100mg/dl

Question 9

IV Glucose follow-up

Answer 9

50% solution followed by dextrose

Question 10

Hypoglycemic coma

Answer 10

• BG <30 mg/dl
• Normal pH
• Neg Glucosuria
• normal ketones
• Normal osmolality
• CNS S/S

Question 11

Hyperosmolar Hyperglycemic State (HHS)

Answer 11

• Serum glucose 1000
• mild or absent ketosis
• INC Plasma osmolality > 320
• CNS S/S
• Minimal acidosis venous pH
• insidous development; Signs of volume depletion

Question 12

DKA Tx

Answer 12

• ABCs - Airway, Breathing, circulation
• Fluid + Electrolytes (Esp K+)
• Administer Insulin after potassium > 3.3
• Glucose goal is 150-250