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