Diabetes mellitus and its complications - type 1
Description
- T-cell mediated destruction of pancreatic beta cells -> absolute insulin deficiency, ketosis-prone
Staging - now the organising framework
| Stage | Antibodies | Glycaemia | Symptoms |
|---|---|---|---|
| 1 | >=2 islet autoantibodies | Normal | No |
| 2 | >=2 | Dysglycaemic | No |
| 3 | >=2 | Diabetic range | Yes |
| 4 | Established | Long-standing |
- Stage 1-2 are diagnosable disease, not risk - and now treatable
- Near-100% lifetime progression from stage 1 to clinical disease
Phases of clinical disease
- Preclinical autoimmunity -> clinical onset -> honeymoon remission (partial recovery of residual beta cells, months to ~2y) -> established
- Residual C-peptide, even tiny, means less hypoglycaemia and fewer complications - worth preserving
6 more sections, plus exam facts
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