Condition Info - BotMed Application

ConditionName

Diabetes mellitus (DM) type 1

ConditionDescription

Symptoms

Autoimmune;
Abrupt onset;
Weigh loss;
Possible DKA

PhysicalFindings

ClinicalTests

Ab tests: IAA, ICA, GAD, IA-2;
Glucosuria;
Serum and urine ketones.

2 times fasting glucose >125
Or one random  >=200 with symptoms

MOST accurate: oral glucose tolerance test (2 H after sugar intake)

H1C >= 6.5% - one test is enough

RiskFactors

Onset in childhood (before 20);
HLA-DR3;
HLA-DR4;
HLA-DQ;
History of Rubella, Coxsackie, Mumps.

IsRedFlag

IsNPLEX

Consequence

Vascular disease; 
Not typical presentation of ischemic dz , may be presented only with pressure over the chest. CAD, MI.

Send to eye doctor after 5 years.
Most common cause of blindness <55;
Non-proliferative retinopathy – control glucose level;
Proliferative retinopathy – laser photocoagulation.
Cataract; Glaucoma;

Neuropathy – feet;

Nephrotic syndrome.
Osteomyelitis;

ProgressionFromCondition

TreatmentOptions

Diet helps to control blood sugar.

Monitoring Complications

Neuropaty: Assess loss of sensation at great toe. After 5 years duration in post pubertal, then annually.

Retinopathy: Exam by experienced professional. Annually 5 years after onset of diabetes in those ≥ 15 years old.
				
Nephropathy: Random urine ACR & random urine dipstick. After 5 years duration in post pubertal, then annually.

Dyslipidemia: Fasting lipid profile. At diagnosis & every 1-3 years. Targets:
Moderate risk: LDL-C < 3.5 mmol/L; TC:HDL-C < 5.0
High risk: LDL-C < 2.5 mmol/L; TC:HDL-C < 4.0

Hypertension: Measured at every visit, target 130/80 mm Hg

PharmOptions

Insulin – must!
Pancreatic cells transplantation

WebLink

https://www.merckmanuals.com/en-ca/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/diabetes-mellitus-dm