Type 1 Diabetes

T1D: What is the pathophysiology?y

Destruction of the insulin-producing beta cells within the pancreas, leading to insulin deficiency.

T1D: What are the symptoms?

• Polyuria

• Polydipsia

• Weight loss

• In severe cases, patients may present with diabetic ketoacidosis(DKA) characterised by hyperglycemia, metabolic acidosis, and ketonemia.

T1D: What is the diagnostic criteria?

If symptomatic, one of the following results is sufficient for diagnosis:

• Random blood glucose > 11.1mmol/l or Fasting plasma glucose >7mmol/l

• 2-hour glucose tolerance > 11.1mmol/l

• HbA1C > 48mmol/mol (6.5%)

If the patient is asymptomatic, two results are required from different days.

T1D: What is the management?

• Short-acting insulin → after meals/snacks (3/5th of daily dose)

• Long-acting insulin→ at night

• IM glucagon and dextrose for unconscious individuals (2/5th of daily dose)

T1D: What is the initial management?

Basal-bolus insulin therapy or insulin pump

T1D: What are the target glucose leaves?

• Pre-meal blood glucose: 4-7 mmol/L (72-126 mg/dL)

• Bedtime blood glucose: 6-10 mmol/L (108-180 mg/dL)

• HbA1c: Less than 7%

T1D: Which condition is most commonly associated with T1D?

Hyperthyroidism → ensure patient goes for routine TFT

T1D/T2D: What is the classic feature of chronic diabetic sensory neuropathy?

Glove and stocking sensory loss

T1D/T2D: What does the glycaemic index represent?

A measure of how quickly carbs affect blood sugars