Diabetes Type 1 Diabetes 2 — Questions and Answers
Question 1: Which autoantibody is most commonly tested to confirm autoimmune destruction of beta cells in Type 1 diabetes?
- Anti-insulin antibody (IAA)
- GAD65 antibody (Correct answer)
- Anti-thyroid peroxidase
- Anti-nuclear antibody
Correct answer: GAD65 antibody
GAD65 (glutamic acid decarboxylase) antibodies are the most commonly detected autoantibodies in Type 1 diabetes and are used to confirm autoimmune beta-cell destruction.
Question 2: A child with Type 1 diabetes has a blood glucose of 55 mg/dL and is conscious. What is the first action?
- Give IV dextrose immediately
- Administer glucagon injection
- Give 15g of fast-acting carbohydrates orally (Correct answer)
- Call emergency services
Correct answer: Give 15g of fast-acting carbohydrates orally
The 15-15 rule states: give 15g of fast-acting carbs, wait 15 minutes, recheck; oral treatment is first-line for a conscious patient.
Question 3: What is the target HbA1c level recommended by the ADA for most non-pregnant adults with Type 1 diabetes?
- Below 6.0%
- Below 7.0% (Correct answer)
- Below 8.0%
- Below 9.0%
Correct answer: Below 7.0%
The ADA recommends an HbA1c below 7.0% for most non-pregnant adults with Type 1 diabetes to reduce microvascular complications.
Question 4: Which type of insulin is typically used as the basal component in a basal-bolus regimen for Type 1 diabetes?
- Regular insulin
- Insulin lispro
- Insulin glargine (Correct answer)
- Insulin aspart
Correct answer: Insulin glargine
Insulin glargine is a long-acting insulin analog with a flat, peakless profile used as basal coverage in Type 1 diabetes management.
Question 5: The Somogyi effect in Type 1 diabetes refers to what phenomenon?
- Dawn phenomenon causing morning hyperglycemia
- Rebound hyperglycemia following nocturnal hypoglycemia (Correct answer)
- Insulin resistance caused by stress hormones
- Hyperglycemia from excessive carbohydrate intake
Correct answer: Rebound hyperglycemia following nocturnal hypoglycemia
The Somogyi effect is rebound hyperglycemia that occurs in the morning as a counter-regulatory response to nocturnal hypoglycemia.
Question 6: Which HLA haplotypes are most strongly associated with genetic susceptibility to Type 1 diabetes?
- HLA-A3 and HLA-B27
- HLA-DR3 and HLA-DR4 (Correct answer)
- HLA-DQ6 and HLA-DR2
- HLA-B8 and HLA-A2
Correct answer: HLA-DR3 and HLA-DR4
HLA-DR3 and HLA-DR4 (particularly DR3/DR4 heterozygosity) confer the highest genetic risk for developing Type 1 diabetes.
Question 7: What is diabetic ketoacidosis (DKA) precipitation most commonly triggered by in a known Type 1 diabetic?
- Eating too many carbohydrates
- Insulin omission or infection (Correct answer)
- Excessive exercise
- Dehydration alone
Correct answer: Insulin omission or infection
The most common triggers for DKA in known Type 1 diabetics are insulin omission (including pump failure) and concurrent infections that increase insulin resistance.
Diabetes Type 1 Diabetes 2
Which autoantibody is most commonly tested to confirm autoimmune destruction of beta cells in Type 1 diabetes?