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Diabetes Mellitus, Type 1

David T. Broome, MD, Vicente T. San Martin, MD and Betul A. Hatipoglu, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Type 1 diabetes mellitus (T1DM) is a chronic disease caused by insulin deficiency following β-cell destruction.

  • Results in hyperglycemia and potential end-organ complications.

  • Features...

DIAGNOSIS

HISTORY

  • New-onset polyuria and polydipsia.

    • Polyuria may present as nocturia, bed-wetting, or incontinence in a previously continent child.

    • Polyuria may be difficult to appreciate in diaper-clad...

TREATMENT

GENERAL MEASURES

  • Insulin is the mainstay of therapy.

  • Education regarding matching of mealtime insulin dose to carbohydrate intake, premeal blood glucose level, and anticipated activity

    • Premeal ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Regular aerobic exercise with care to avoid hypoglycemia: 
  • To reduce hypoglycemia, patients should lower basal requirements (temporary basal rate if using an insul...

REFERENCES

1
American Diabetes Association. Standards of medical care in diabetes—2019. Diabetes Care.  2019;19(Suppl 1):S1–S204.
2
Felner EI, Klitz W, Ham M, et al. Genetic interaction among three ...

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

  • The age of presentation of T1DM is bimodal: one peak at 4 to 6 years of age and a second peak at 10 to 14 years of age.

  • At least one autoantibody is present in 85–90% of individuals whe...

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