(Peri-Op & Anaesthesia) (GP)

Overview

• Type 1 → autoimmune response that trigers the destruction of insulin-producing beta cells in the pancreas leading to an absolute insulin deficiency (⇒ lipolysis and ketogenesis). Commonly manifests in childhood. Associated with HLA DR3/4. May be FH of autoimmune disease.
• Type 2 → strong genetic component (strong family component) aswell as significant association with obesity and a sedentary lifestyle. Characterised by insulin resistance (decreased insulin sensitivity) and relative insulin deficiency (insulin prodction reduces over time). Risk Factors ⇒ obestiy, HTN, south asian/afro-carribean ethnicity.
  • MODY ⇒ onset of T2DM <25yrs old. Autosomal dominant inheritance. Family history of early onset diabetes is often present.
• Amboss T1DM vs T2DM

Making Diagnosis

Clinical Features:

• Polyuria and Polydipsia
• Polyphagia (Excessive Appetite)
• Unexplained Weight Loss
• Fatigue
• Increased Susceptibility to Infections
• Acanthosis Nigracans (hyperpigementation) → T2DM
• T1DM → DKA is first manifestation in around 1/3 of cases. N&V, abdominal pain, kussmaul breathing, sweet smelling breath.
• T2DM → many patients are asymptomatic. Some may present with HHS.