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Type 1 Diabetes Mellitus Jason Cavolina BS, MS, PharmD Candidate Arnold & Marie Schwartz College of Pharmacy and Health Sciences Long Island University Ambulatory II Clerkship
Introduction ,[object Object],[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object]
Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Criteria for Screening ,[object Object],[object Object],[object Object],[object Object]
Diagnostic Elements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pharmacotherapeutic Goals Glycemic Control <180 mg/dL  Peak postprandial capillary plasma glucose 90-130 mg/dL  Pre-prandial capillary plasma glucose <7.0 – 6.5 % Hemoglobin A 1C
Desired Outcomes ,[object Object],[object Object],[object Object],[object Object]
Overview of DM Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Nutrition Therapy Adjust based on age, weight and height. Total calories < 300 mg/d (< 200 mg/d in dyslipidemia) Cholesterol Up to 20% of total cal. Monounsaturated fat ~10% of total cal. Polyunsaturated fat < 10% of total cal (< 7% in dyslipidemia) Saturated fat 25-35% of total cal. Total fat 15-20% of total cal. Protein ~50-60% of total calories Carbohydrate Recommended Intake Nutrient
Exercise Recommendation ,[object Object],[object Object],[object Object]
Pharmacotherapy in Type 1 DM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Insulin ,[object Object],[object Object],[object Object],[object Object]
Which one should be used? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Rapid-acting Insulin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rapid-acting Insulin ,[object Object],[object Object],[object Object],[object Object],[object Object]
Rapid-acting Insulin ,[object Object],[object Object],[object Object],[object Object],[object Object]
Short-acting Insulin ,[object Object],[object Object],[object Object],[object Object]
Short-acting Insulin ,[object Object],[object Object],[object Object],[object Object],[object Object]
Short-acting Insulin ,[object Object],[object Object],[object Object]
Intermediate-acting Insulin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Intermediate-acting Insulin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Long-acting Insulin ,[object Object],[object Object],[object Object],[object Object]
Long-acting Insulin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Premixed Insulin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Premixed Insulin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Insulin Regimens
Insulin Regimens
Symlin® (Pramlintide acetate)  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Insulin Adverse Reactions ,[object Object],[object Object],[object Object]
Insulin Adverse Reactions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Insulin Adverse Reactions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hypoglycemia ,[object Object],[object Object]
Insulin Adverse Reactions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diabetic Adverse Event ,[object Object],[object Object],[object Object],[object Object]
Diabetic Adverse Event ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Monitoring Diabetes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Counseling Points ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Counseling Points ,[object Object],[object Object],[object Object],[object Object],[object Object]
Counseling Points ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Insulin Administration   ,[object Object],[object Object]
Insulin  Delivery Devices ,[object Object],[object Object],[object Object],[object Object],[object Object]
Counseling Points ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Injection Site ,[object Object],[object Object],[object Object],[object Object],[object Object]
Preventing Painful Injections ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object]
Questions
References ,[object Object],[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object]

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Type 1 Diabetes Mellitus

  • 1. Type 1 Diabetes Mellitus Jason Cavolina BS, MS, PharmD Candidate Arnold & Marie Schwartz College of Pharmacy and Health Sciences Long Island University Ambulatory II Clerkship
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  • 11. Pharmacotherapeutic Goals Glycemic Control <180 mg/dL Peak postprandial capillary plasma glucose 90-130 mg/dL Pre-prandial capillary plasma glucose <7.0 – 6.5 % Hemoglobin A 1C
  • 12.
  • 13.
  • 14. Medical Nutrition Therapy Adjust based on age, weight and height. Total calories < 300 mg/d (< 200 mg/d in dyslipidemia) Cholesterol Up to 20% of total cal. Monounsaturated fat ~10% of total cal. Polyunsaturated fat < 10% of total cal (< 7% in dyslipidemia) Saturated fat 25-35% of total cal. Total fat 15-20% of total cal. Protein ~50-60% of total calories Carbohydrate Recommended Intake Nutrient
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