25 Questions
What percentage of diabetes mellitus is accounted for by Type 1 DM?
5-10%
What is another name for Type 1 DM?
Insulin-dependent diabetes
At what stage of life does Type 1 DM typically present?
At any stage of life
What is the prevalence of Type 1 DM in the USA?
0.12%
How would you describe the onset of Type 1 DM?
Either rapid or slow in onset
What type of defects can lead to insulin action DM?
Genetic
What pancreatic disease can cause DM?
Pancreatitis
What is an example of a genetic disease that can cause DM?
Cystic fibrosis
What type of neoplasia can cause DM?
Cancer of the pancreas
What is a disease of the pancreas that can cause DM?
Pancreatitis
What is the primary goal of administering insulin?
To stop ketosis
What is the condition required to change to 5% dextrose with 0.45% sodium chloride solution?
Serum glucose is less than 200 mg/dL
What is the primary indication for administering 5% dextrose with 0.45% sodium chloride solution?
To treat hypoglycemia
What is the concentration of sodium chloride in the solution administered when serum glucose is less than 200 mg/dL?
0.45% sodium chloride
What is the concentration of dextrose in the solution administered when serum glucose is less than 200 mg/dL?
5% dextrose
What is the formula for calculating the glucose lowering effect per unit of rapid-acting insulin?
1800/TDI = # mg/dL of glucose lowering per 1 unit of rapid-acting insulin
What is the glucose lowering effect per unit of rapid-acting insulin if the TDI is 45 units?
40 mg/dL
What is the purpose of the 1800 rule?
To calculate the glucose lowering effect per unit of rapid-acting insulin
If the TDI is increased, what happens to the glucose lowering effect per unit of rapid-acting insulin?
It decreases
What unit of measurement is used to express the glucose lowering effect in the 1800 rule?
Milligrams per deciliter
What is the association of TSH levels above 10 mIU/L with?
Increased risk of coronary heart disease
What is the controversy surrounding the treatment of TSH levels above 10 mIU/L?
The use of levothyroxine in older patients
In which age group has the use of levothyroxine been shown to reduce heart disease?
Patients between 40-70 years of age
What is the effect of levothyroxine on heart disease in older patients?
Has no effect on heart disease risk
What is the goal of treating TSH levels above 10 mIU/L with levothyroxine?
To reduce the risk of coronary heart disease
Study Notes
Type 1 Diabetes Mellitus (DM)
- Cellular-mediated beta-cell destruction leads to insulin deficiency, requiring insulin for survival.
- Accounts for 5-10% of DM cases.
- Also known as insulin-dependent diabetes.
- Prevalence in the USA is approximately 0.12% (around 340,000 individuals).
- Presents in childhood, early adulthood, or any stage of life.
- Typically symptomatic with a rapid onset in childhood, but can have a slower onset in older adults.
Other DM Types
- Genetic defects in beta-cell function or insulin action.
- Diseases of the pancreas, such as pancreatitis, neoplasia, or cystic fibrosis.
Insulin Therapy
- "1800 Rule" formula: 1800/TDI = # mg/dL of glucose lowering per 1 unit of rapid-acting insulin.
- Example: TDI 60 units → 1800/60 = 30 mg/dL reduction in blood glucose concentration per 1 unit of rapid-acting insulin.
- Switch to 5% dextrose with 0.45% sodium chloride when serum glucose is less than 200 mg/dL.
- Goal of insulin therapy is to stop ketosis, not to normalize glucose concentration.
Thyroid-Stimulating Hormone (TSH) and Coronary Heart Disease
- TSH > 10 mIU/L associated with increased risk of coronary heart disease.
- Treatment: Controversial, but may involve using levothyroxine and potentially reducing heart disease in younger patients (40-70 years old), although not in older patients (>70 years old).
This quiz covers the characteristics and prevalence of Type 1 Diabetes Mellitus, including its causes, symptoms, and diagnosis. It is also known as insulin-dependent diabetes.
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