DIABETES MELLITUS-TYPE 1

SUMMARY

1. Marked by cell-mediated beta cell destruction causing absolute insulin deficiency. 90% of patients have autoantibodies against islet cells, insulin, glutamic acid decarboxylase, tyrosine phosphatase.

2. Patients are prone to ketosis.

3. Associated with other autoimmune diseases: thyroid, adrenal, celiac disease, vitiligo, B₁₂ deficiency, and myasthenia.

4. Treat with insulin, oral hypoglycemics are ineffective. Fixed daily doses of each type of insulin do not always
correct hyperglycemia, especially in patients whose intake of carbohydrates varies dramatically.

5. Use pre-established carbohydrate: insulin ratio to calculate the dose of patient's pre-meal short-acting insulin or a continuous, portable pump.

6. Nocturnal hypoglycemia is potentially lethal & episodes lead to feeling poorly the next day with marked fatigue and a measurable decrease in productivity.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].