Type 1 ‘Betes

Major differences between type 1 and type 2 DM

Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Major differences between type 1 and type 2 DM
Type 1 DM
American Diabetes Association (ADA) classifications of diabetes

● type 1 diabetes (beta-cell destruction, usually leading to absolute insulin deficiency)

○ immune-mediated
■ reported to account for 5%-10% of diabetes
■ results from cellular-mediated autoimmune destruction of beta cells of
pancreas
○ idiopathic
■ minority of type 1 diabetes with no evidence of autoimmunity
■ strongly inherited, mostly in persons of African or Asian ancestry
■ may have permanent insulinopenia, or intermittent need for insulin
Type 1 Pathogenesis
Selective destruction of insulin-secreting pancreatic beta cells
○ likely due to defects in bone marrow, thymus, immune system, and beta cell
function
○ about 70% of pancreatic islets lack insulin at diagnosis of type 1 diabetes
Polygenic susceptibility
○ 40 genetic loci identified so far
Environmental exposure
○ environmental factors may precipitate onset in genetically susceptible
persons
○ proposed environmental triggers include diet, viruses, vitamin D, and others

Quick and Dirty Explanation

T cells target self beta cells of the pancreas for destruction
Effects of beta cell destruction
● Inadequate insulin secretion results in deficient action of insulin
on target tissues
● Deficient action of insulin on target tissues results in abnormal
carbohydrate, fat, and protein metabolism
● Abnormal metabolism results in hyperglycemia
● Acute hyperglycemia can cause metabolic emergencies such as
diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic
state
● Chronic hyperglycemia can cause vascular complications such as
nephropathy, retinopathy, and cardiovascular disease
Clinical Manifestation
Polyuria and nocturia

Enuresis

Lethargy, fatigue

Polydipsia

Polyphagia

Recent sudden weight loss

Abdominal Pain
Diabetic Ketoacidosis (DKA)
Signs of T1DM and…

Nausea and/or vomiting

Headache

Confusion

Lethargy
How to insulin
ADA Recommendations

- Multiple daily inj. (3-4 of

prandial and 1-2 basal
insulin) or Continuous
subQ. Infusion
- Matching prandial insulin
to carbohydrate intake
and physical activity

Glargine cannot be mixed with other forms of insulin