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Pathology
Absolute lack of insulin secretion > impaired glucose metabolism
Autoimmune destruction of β pancreatic islet cells
Aetiology
Primary 90% associated with HLD-DR3/4, peak age of onset <25years
Secondary due to destruction of pancreas
Signs
Acute: Low BMI, dehydration, “pear drop”/fruity odour on breath
Chronic: peripheral neuropathy, decreased vision, lack of hypo awareness
Symptoms
Polyuria, polydipsia, weight loss, lethargy, blurred vision, thrush
Investigations
Bloods: Plasma glucose, serum ketones, anti-GAD and islet cell antibodies, c-
peptide –ve as no endogenous insulin production
Venous Blood Gas: pH and bicarbonate
Treatment
Insulin replacement
Patient education
Regular follow-ups.Prognosis
Depends on good control. Likely to limit life expectancy by 10-20 years.
DKA, retinopathy, nephropathy, neuropathy, PVD, Cardiovascular disease, Autonomic dysfunction (postural hypotension, gastroparesis)
Key Facts
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Key Images
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Key References
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