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Diabetes Mellitus Type 1

Endocrine disorder characterized by hyperglycemia due to beta cell destruction in the pancreas, usually leading to absolute insulin deficiency

Also Called

Insulin-dependent diabetes mellitus
Juvenile onset diabetes mellitus

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

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Diabetes Mellitus Type 1

Other autoimmune disease:

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