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General Medicine

Diabetes Mellitus, Type 1

Irfan Siddiqui, MD and Armand Krikorian, MD, FACE Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Type 1 diabetes mellitus (T1DM) is a chronic disease caused by pancreatic insufficiency (deficiency) of insulin production.

  • Results in hyperglycemia and end-organ complications (e.g.,...

DIAGNOSIS

DIFFERENTIAL DIAGNOSIS

  • Benign renal glycosuria

  • Glucose intolerance

  • Type 2 diabetes

  • Consider monogenic diabetes if

    • Diabetes diagnosed before 6 months of age

    • Strong family history of diabetes with...

TREATMENT

GENERAL MEASURES

  • Overall control of carbohydrate metabolism for all pediatric age ranges (1)[C]

  • Education regarding matching of mealtime insulin dose to carbohydrate intake, premeal blood gluc...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Normal; full participation in sports activities

  • Regular aerobic exercise is recommended.

Patient Monitoring

  • Blood pressure (BP) checks at every routine visit with a ...

REFERENCES

1
American Diabetes Association. Standards of medical care in diabetes—2016: summary of revisions. Diabetes Care.  2016;39(Suppl 1):S4–S104. [View Abstract on OvidMedline]
2
Atkinson MA,...

SEE ALSO

Diabetes Mellitus, Type 2; Diabetic Ketoacidosis 

CODES

ICD10

  • E10.9 Type 1 diabetes mellitus without complications

  • E10.8 Type 1 diabetes mellitus with unspecified complications

  • E10.69 Type 1 diabetes mellitus with other specified complication

  • E10.29 Type...

CLINICAL PEARLS

  • Polyuria may present as nocturia, bedwetting, or incontinence in a previously continent child.

  • Young children are more likely to present in DKA because they may not express thirst or ob...

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Related Images
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Homeless diabetic man with painful foot showing gangrene and dystrophic nails
Homeless diabetic man with painful foot showing gangrene and dystrophic nails
Figure 14.60. Pretibial diabetic skin changes: necrobiosis lipoidica diabeticorum.
Figure 14.60. Pretibial diabetic skin changes: necrobiosis lipoidica diabeticorum.
FIG. 11 Diabetic patient with acute spontaneous onset of low back pain and fever. A,B: Dramatic elements of two-level spondylodiscitis, L3-5, with secondary communicating psoas abscess component.
FIG. 11 Diabetic patient with acute spontaneous onset of low back pain and fever. A,B: Dramatic elements of two-level spondylodiscitis, L3-...
Figure 11.93. Neuropathic (Charcot) joints in two diabetic patients. A. Radiographs of both feet show bilateral neuropathic joints at the first metatarsophalangeal joints (arrows). On the left there is periarticular osteopenia, indicating superimposed infection. Frontal (B) and lateral (C) knee radiographs of another patient show disintegration of the knee joint with considerable bony debris (" bag of bones") and a large joint effusion. In the past, involvement o...
Figure 11.93. Neuropathic (Charcot) joints in two diabetic patients. A. Radiographs of both feet show bilateral neuropathic joints at the f...
Necrobiosis lipoidica diabeticorum. Atrophic patch present x 6 mo.
Necrobiosis lipoidica diabeticorum. Atrophic patch present x 6 mo.
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