Type 1 Diabetes Mellitus: The Daily PANCE Blueprint
A 14-year-old boy presents to your clinic complaining of having to eat, drink, and pee constantly. He says he just “doesn’t feel good” and has been having more fatigue as well. Labs reveal an elevated glucose level (BG 208 mg/dL) and an elevated A1c (7.0%). Which of the following is not a known complication the patient is at an increased risk for?
A. Myocardial infarction
B. Cerebrovascular complication
C. Peripheral neuropathy
D. Retinopathy
E. All of the above are complications
Answer and topic summary
The answer is E. All of the above are complications
The patient has type 1 diabetes, which is an autoimmune disease characterized by a severe deficiency of insulin due to the destruction of B-cells. It develops in genetically susceptible individuals who are exposed to some sort of environmental trigger that leads to this autoimmune response. Onset is typically in youth (but can occur at any age) and usually pretty sudden (patients may be in diabetic ketoacidosis). Clinical features include polyuria, polydipsia, fatigue, etc. Diagnosis is made by the ADA Criteria (A1C > 6.5% OR FPG > 126 mg/dL OR 2-hour plasma glucose >200mg/dL during OGTT OR random plasma glucose >200mg/dL with signs/symptoms. However, in the absence of clear hyperglycemia, the diagnosis requires 2 abnormal tests). The mainstay of treatment is insulin. Complications include diabetic retinopathy, nephropathy, neuropathy, limb amputations, myocardial infarctions/coronary artery disease (MCC of death in these patients), and cerebrovascular accidents.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Endocrinology ⇒ ⇒
Also covered as part of the HEREEOR, HEREEOR, and topic lists
