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Diabetes Mellitus, Type 1

Vicente T San Martin, MD and David T. Broome, MD Reviewed 06/2022
 


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 with education regarding matching of mealtime insulin dose to carbohydrate intake, premeal blood glucose level, and anticipated activity. 
  • P...

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-2020. Diabetes Care. 2020;43(Suppl 1):S1-S2.
2
Felner  EI, Klitz  W, Ham  M, et al. Genetic inter...

CODES

ICD10

  • E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema

  • E10.321 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular ede...

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.

  • Therapy with MDI or CSII and the use of a multidisciplinary team ...

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