Diabetes Type 1 Disease Summary

Questions and Answers

What is the primary characteristic of Type 1 Diabetes Mellitus?

Hyperinsulinemia and polyphagia

Hypoglycemia and polydipsia

Autoimmune destruction of pancreatic beta cells (correct)

Insulin resistance and obesity

What is the most common age of onset for Type 1 Diabetes?

4-6 years and 11-13 years (correct)

1-3 years and 17-19 years

7-10 years and 14-16 years

20-25 years and 30-35 years

What is the risk of developing Type 1 Diabetes in the general population?

1 in 500

1 in 1000

1 in 100

1 in 300 (correct)

What is the most common complication of Type 1 Diabetes?

Ketoacidosis Signup and view all the answers

Which of the following racial groups has the highest reported incidence of Type 1 Diabetes?

Caucasians Signup and view all the answers

What is the term for the symptom of burning or tingling sensations in the extremities in diabetes?

Paresthesias Signup and view all the answers

Approximately how many new cases of Type 1 Diabetes are diagnosed annually in the US?

10,000 Signup and view all the answers

What is the name of the condition resulting from the increase in plasma keto acids that lowers blood pH?

Diabetic ketoacidosis Signup and view all the answers

What is a common characteristic of patients with type 1 diabetes?

They are prone to multiple infections Signup and view all the answers

What is a distinguishing feature of diabetes type 1 from diabetes type 2?

Presence of ketones in urinalysis Signup and view all the answers

What is a serious acute complication of type 1 diabetes?

Ketoacids Signup and view all the answers

What is a common chronic complication of type 1 diabetes?

Hypertension Signup and view all the answers

What is a major cause of death in patients with type 1 diabetes?

Complications from ESRD Signup and view all the answers

What is a factor that can affect pancreatic B-cell function?

Environmental factors such as viruses Signup and view all the answers

What is the name of the genes that are thought to predispose individuals to a destructive autoimmune process?

HLA immune response genes Signup and view all the answers

What is a possible outcome of poor glycemic control during pregnancy in women with type 1 diabetes?

All of the above Signup and view all the answers

Which of the following is a characteristic of type 1 DM?

Absolute insulin deficiency Signup and view all the answers

What is the primary cause of hyperglycemia in type 1 DM?

Unopposed glucose production by the liver Signup and view all the answers

What is the underlying mechanism of ketoacidosis in type 1 DM?

Increased fatty acid conversion to keto acids in the liver Signup and view all the answers

What is the primary cause of peripheral vascular disease in diabetes?

Occlusive vascular disease Signup and view all the answers

What is the underlying mechanism of neuropathy in diabetes?

All of the above Signup and view all the answers

What is the critical blood glucose level above which leukocyte function is impaired?

250 mg/dL Signup and view all the answers

What is the primary cause of microalbuminuria in diabetes?

Intraglomerular pressure increase Signup and view all the answers

What is the definition of microalbuminuria?

Urinary excretion of small amounts of albumin Signup and view all the answers

What is the primary characteristic of a patient with type 1 diabetes?

Young and lean Signup and view all the answers

What is the term for a relatively mild and slowly progressive form of immune-mediated type 1A diabetes?

LADA Signup and view all the answers

What is the primary cause of early symptoms of type 1 diabetes?

Elevated blood glucose levels Signup and view all the answers

What is the primary purpose of periodically testing for HbA1C?

To monitor glycemic control over time Signup and view all the answers

What is the recommended HbA1C level according to the American Diabetes Association?

Below 7.0% Signup and view all the answers

What is the significance of an elevated HbA1C?

It suggests a persistently elevated plasma glucose concentration Signup and view all the answers

What is the similarity between HbA1C and fructosamine?

Both are used to monitor glycemic control over time Signup and view all the answers

What is the predictive value of an elevated HbA1C?

It is highly predictive of diabetic microvascular complications Signup and view all the answers

What is the significance of subnormal plasma insulin and/or C-peptide concentrations in diabetes?

It suggests type 1 diabetes Signup and view all the answers

What is the purpose of measuring glutamic acid decarboxylase antibodies in diabetes?

To distinguish type 1 from type 2 diabetes Signup and view all the answers

What is the significance of islet cell and anti-insulin antibodies in type 1 diabetes?

They are only present in the early stages of the disease Signup and view all the answers

What is the most common complication of type 1 diabetes that can result in amputation of the lower extremity?

Staphylococcal or streptococcal infection of the feet Signup and view all the answers

What is the most common procedure performed in conjunction with pancreatic transplantation in individuals with type 1 diabetes?

Kidney transplantation Signup and view all the answers

What is the probability of pancreatic graft survival after 1 year in patients undergoing simultaneous pancreas and kidney transplantation?

85% Signup and view all the answers

What is the potential hazard of using potent immunosuppressive drugs in patients undergoing pancreatic transplantation?

Increased risk of infection Signup and view all the answers

What is the potential benefit of using stem cells from the patient's own blood in the treatment of type 1 diabetes?

Ability to stop using insulin Signup and view all the answers

Study Notes

Diabetes Type 1

Diabetes mellitus is a catabolic endocrine disease characterized by hyperglycemia (elevated plasma glucose concentrations) and polyuria (frequent urination).
Type 1 DM is an autoimmune process in which pancreatic islet beta cells are targeted and destroyed by cells of the immune system.
Circulating insulin is virtually absent, and carbohydrate, lipid, and protein metabolism is abnormal.
Patients are susceptible to weight loss and life-threatening ketoacidosis (increase in plasma keto acids that lowers blood pH).

Prevalence

Type 1 DM is the most common metabolic disease of childhood.
The overall incidence of type 1 diabetes in the US is 15 new cases per 100,000 people younger than age 18 per year.
The risk in the general population for developing type 1 diabetes is 1 in 300, but increases 15-20 times among people with first-degree relatives with the condition.
Caucasians have the highest reported incidence of type 1 DM.

Significance

The significance of Type 1 DM lies in its chronic and progressive course, multiple clinical manifestations, and many potential life-threatening acute and chronic complications.
Symptoms include frequent urination and nocturnal enuresis, constant thirst and hunger, blurred vision, weight loss, pruritus, weakness, fatigue, and paresthesias.
Patients are prone to multiple infections, especially foot infections that may progress to gangrene and require limb amputation.

Causes and Risk Factors

Type 1 DM is considered a multifactorial disorder in which both environmental factors and heredity play critical roles.
Environmental factors that may affect pancreatic B function include mumps, rubella, coxsackie B4 viruses, and toxic chemical agents.
Specific human leukocyte antigen (HLA) immune response genes on chromosome 6 are thought to predispose individuals to a destructive autoimmune process.

Pathophysiology

Type 1 DM is characterized by an absolute insulin deficiency.
Tissues dependent on insulin for glucose transport do not have glucose available as a substrate for the generation of energy.
Production of glucose by the liver is not opposed by insulin and overproduction of glucagon by pancreatic a cells stimulates glycogenolysis and gluconeogenesis.
Plasma glucose levels rise and hyperglycemia results.

Clinical Manifestations and Lab Tests

The patient with type 1 diabetes is typically young, lean, and has a parent or sibling with DM.
Early symptoms of type 1 DM are related to elevated blood glucose levels and a significant loss of water through the urinary tract.
Major symptoms include increased thirst, increased urination, weight loss despite an increased appetite, fatigue, nausea, and vomiting.
HbA1c is used to monitor glycemic control over the preceding 3 months.
An elevated HbA1c is highly predictive of DM-induced microvascular complications.

Serious Complications and Prognosis

The most serious acute complications of type 1 DM include ketoacidosis, hypoglycemic coma, dehydration, infections, and amputation of the lower extremity.
Pancreatic transplantation has been performed in individuals with diabetes since 1966 and has resulted in consistent improvement in patient outcomes.

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Description

Learn about Diabetes Type 1, a chronic disease characterized by hyperglycemia and polyuria, with multiple complications. Understand the autoimmune process that targets pancreatic islet Beta cells.