type 1 diabetes

Question 1

risk factors for type 1 diabetes

Answer 1

• age 10-14yrs is peak
• sex
• race
• genotype
• geographic location and seasonality

Question 2

environmental triggers for diabetes

Answer 2

• viral infection
• maternal factors
• weight gain
• vitamin D

Question 3

what are the characteristics and diagnostic criteria for stage 1

Answer 3

• autoimmunity
• normoglycemia
• presymptomatic
• multiple antibodies
• no IGT or IFG

Question 4

what are the characteristics and diagnostic criteria for stage 2 diabetes

Answer 4

• autoimmunity
• dysglycemia
• presymptomatic
• multiple antibodies
• IFG and/or IGT
• FPG 100-125 mg/dL
• 2-h PG 140-199 mg/dL

Question 5

characteristics and diagnostic criteria for stage 3

Answer 5

• new onset hyperglycemia
• symptomatic
• clinical symptoms
• diabetes by standard criteria

Question 6

risk factors for pre-diabetes

Answer 6

• viral infection
• vit D deficiency
• diet
• environmental toxins

Question 7

accelerating factors for clinical diabetes

Answer 7

• infection
• insulin resistance
• puberty
• weight
• stress

Question 8

disease markers for pre-diabetes

Answer 8

-autoantibodies (GAD 65, IAA and IA2, Zn T8)

Question 9

diabetic markers for clinical diabetes

Answer 9

• raised glucose
• ketones
• reduced insulin
• reduces beta cell mass
• reduced C-peptide

Question 10

pathogenesis of type 1 diabetes

Answer 10

• interaction between genes and imparting susceptibility and resistance
• variable insulinitis
• beta-cell sensitivity to injury
• pre-diabetes
• overt diabetes

Question 11

how is type 1 usually diagnosed by

Answer 11

history and presentation alone

Question 12

type 1 diabetes clinical presentation

Answer 12

• pre school and peri-puberty
• small peak in late 30s
• usually lean
• acute onset
• severe symptoms
• severe weight loss
• ketonuria +/- metabolic acidosis
• no evidence of microvascular disease at diagnosis
• immediate and permanent requirement for insulin

Question 13

what is LADA

Answer 13

late onset type 1 diabetes

Question 14

does ketosis mean type 1 or 2

Answer 14

1

Question 15

what do you do to find out which type of diabetes it is

Answer 15

antibody testing

Question 16

signs that hospitalisation is required?

Answer 16

• DKA
• significant ketonaemia
• vomiting

Question 17

signs of hypoglycaemia

Answer 17

• pallor
• sweating
• tremor
• palpitations
• confusion
• nausea
• hunger

Question 18

what is basal insulin used for

Answer 18

once daily

Question 19

what is bolus insulin used for

Answer 19

with meals

Question 20

management of type 1

Answer 20

• blood glucose and ketone monitoring
• insulin
• carbohydrate estimation
• regular DSN and dietician contact
• appropriate medical clinic review
• education about self management

Question 21

two types of prandial insulins

Answer 21

• insulin analogues

- soluble insulin

Question 22

two types of basal insulin

Answer 22

• isophane insulins

- analogues insulins

Question 23

what should most people with type 1 diabetes be treated with

Answer 23

MDI or CSII

Question 24

conditions associated with type 1 diabetes

Answer 24

• cystic fibrosis
• wolfram syndrome
• barlet-biedl syndrome

Question 25

associated auto-immune conditions

Answer 25

- thyroid disease - coeliac disease - pernicious anaemia - Addison's disease - IgA deficiency

Question 26

two types of pancreas transplantation

Answer 26

- kidney-pancreas autotransplantation | - islet autotransplantation

Question 27

indications for a pancreas transplantation

Answer 27

- imminent or ESRD due to receive or with kidney transplant - severe hypoglycemia/metabolic complications - incapacitating clinical or emotional problems

Question 28

what is a pancreatic islet transplant

Answer 28

-replace only the endocrine component of the pancreas with the aim of restoring physiological glucose homeostasis

Question 29

what are the four steps of islet transformation

Answer 29

- pancreas donation and retrieval - islet donation - islet culture - islet transplantation