Endocrine System >
Type I Diabetes

“Complex metabolic disorder characterised by persistent hyperglycaemia (insulin deficiency)”

Risk Factors
  • Family history of type 1 diabetes (strong genetic component)
Aetiology
  • Absolute deficiency of insulin
Pathophysiology
  • Autoimmune destruction of beta cells → absolute deficiency of insulin
    • Increased hepatic glucose output
    • Decreased glucose uptake into adipocytes
    • Decreased glucose uptake in skeletal muscle
    • Decreased glycogenesis in liver and skeletal muscle
Clinical Presentation
  • Onset is usually adolescent but can occur at any age
  • Presentation includes:
    • Polyuria
    • Polydipsia
    • Age of onset younger than 50 years
    • Rapid weight loss
    • BMI below 25 kg/m2
Investigations
  • Bloods:
    • Main test – HbA1c > 48 mmol/mol
    • Others:
      • Random plasma glucose > 11 mmol/L
      • Fasting plasma glucose > 7 mmol/L
      • Oral glucose tolerance test 2h > 11 mmol/L
      • Only measure diabetes-specific autoantibodies if patient had atypical features that don’t fit the usual presentation (e.g. >50 years old, BMI 25 kg/m2 or above)
  • Imaging: n/a
  • Special: n/a
Management
  • Insulin therapy
Complications
  • Diabetic ketoacidosis
  • Diabetic foot
  • Macrovascular complications:
    • Increased risk of stroke
    • Myocardial Infarction
    • Peripheral vascular disease
  • Microvascular complications:
    • Diabetic retinopathy
    • Diabetic nephropathy
    • Diabetic neuropathy
    • Erectile dysfunction

Leave a Reply

Search Our Notes

Get Updates

Get updates direct to your inbox as we post more notes!

Our Latest Notes