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Diabetes Mellitus, Type 1

David T. Broome, MD, Vicente T. San Martin, MD and Betul A. Hatipoglu, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

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

  • Results in hyperglycemia and end-organ complications

  • Features include:

    • Us...

DIAGNOSIS

HISTORY

  • New-onset polyuria and polydipsia (1)[C]

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

    • Polyuria may be difficult to appreciate in diape...

TREATMENT

GENERAL MEASURES

  • Insulin is the mainstay of therapy (1).

  • Education regarding matching of mealtime insulin dose to carbohydrate intake, premeal blood glucose level, and anticipated activity (1)

    • ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Regular aerobic exercise with care to avoid hypoglycemia 

Patient Monitoring

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

REFERENCES

1
American Diabetes Association. 8. Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes—2018. Diabetes Care.  2018;41(Suppl 1):S73–S85. [View Abstract ...

ADDITIONAL READING

  • Mayer-Davis EJ, Lawrence JM, Dabelea D, et al; and SEARCH for Diabetes in Youth Study. Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012. N Engl J Med.  20...

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 (early puberty).

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

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