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Causes
Immune-mediated Diabetes
- Classic symptoms
- Polyuria
- Nocturia
- Enuresis
- Lethargy, fatigue
- Polydipsia
- Polyphagia
- Recent sudden weight loss
- Abdominal pain
- Sudden recent weight loss
- If presenting in diabetic ketoacidosis
- Additional findings that may indicate cerebral edema include
- Persistent vomiting
- Headache
- Confusion
- Signs of dehydration such as tachycardia or hypotension
Making the diagnosis
Diagnosis is based on blood testing to establish Diabetes, and differentiation between types based on clinical characteristics and/or additional testing
Pathogenesis
Likely multifactorial, involving prolonged exposure to hyperglycemia combined with other risk factors such as genetic susceptibility, hypertension, and dyslipidemia
Complications
- Diabetic ketoacidosis
- Hypoglycemia
- Vulvovaginal candidiasis in children and adolescents
- Erectile dysfunction
Microvascular complications
- Retinopathy
- Nephropathy
- Neuropathy
-
Neuropathy may contribute to diabetic foot ulcer
- Macrovascular complications (atherosclerosis):
- Angina
- Myocardial infarction
- Stroke
- Lower extremity amputation
Associated conditions
Other autoimmune disease:
- Thyroid disease
- Graves disease
- Hashimoto thyroiditis
- Celiac disease
- Pernicious anemia
- Vitiligo
- Myasthenia gravis
- Autoimmune adrenal insufficiency (Addison disease)
Treatment overview
- All patients with type 1 Dibetes require insulin
-
Lifestyle interventions include
- Dietary management including individualized medical nutrition therapy
- Physical activity for ≥ 60 minutes/day in children (and ≥ 150 minutes/week in adults
- Diabetes self-management education
