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{{Diabetes mellitus type 1}}
{{Diabetes mellitus type 1}}
{{Diabetes mellitus}}
{{Diabetes mellitus}}
{{CMG}}{{AE}}{{VD}}{{Anahita}}


== Natural History ==
==Overview==
===Hypoglycemia, Hyperglycemia, and a High Risk for Diabetic Comas===
The [[symptom|symptoms]] of [[Diabetes mellitus type 1|type 1 diabetes]] usually develop in the first decade of life, and start with non-specific [[symptom|symptoms]] of classic new onset [[Diabetes mellitus type 1|type 1 diabetes]] or acute [[symptom|symptoms]] with [[diabetic ketoacidosis]]. If left untreated, [[patient|patients]] with [[diabetes mellitus|type 1 DM]] may develop acute [[Complication (medicine)|complications]] of the [[hyperglycemia]] state, such as [[diabetes ketoacidosis]] and [[hyperglycemia hyperosmolar state]]. In addition other [[Complication (medicine)|complications]] related to microvascular or macrovascular changes, such as [[retinopathy]], autonomic [[neuropathy]], [[dermatology]] diseases, [[coronary heart disease]], [[peripheral arterial disease]] and [[macular edema]]. [[Prognosis]] is generally good with compliance with [[medication|medications]].
Hypoglycemia, low blood glucose (sugar), sometimes called an insulin reaction, can happen even during those times when you're doing all you can to manage your diabetes. So, although many times you can't prevent it from happening, hypoglycemia can be treated before it gets worse. The symptoms of hypoglycemia include:
*Shakiness
*[[Dizziness]]  
*[[Sweating]]  
*[[Hunger]]  
*[[Headache]]  
*Pale skin color
*Sudden moodiness or behavior changes, such as crying for no apparent reason
*Clumsy or jerky movements
*[[Seizure]]  
*Difficulty paying attention, or [[confusion]]  
*Tingling sensations around the mouth
The quickest way to raise your blood glucose and treat hypoglycemia is with some form of sugar, such as 3 glucose tablets (you can buy these at the drug store), 1/2 cup of fruit juice, or 5-6 pieces of hard candy. Ask your health care professional or dietitian to list foods that you can use to treat low blood glucose. Good diabetes control is the best way we know to prevent [[hypoglycemia]].


[[Hyperglycemia]] is the technical term for high blood glucose (sugar). High blood glucose happens when the body has too little, or not enough, [[insulin]] or when the body can't use insulin properly. If you have type 1 diabetes, your body does not make enough insulin. It could be that you ate more than planned or exercised less than planned. The stress of an illness, such as a cold or [[flu]], could also be the cause. Other stresses, such as family conflicts or school or dating problems, could also cause [[hyperglycemia]]. The signs and symptoms include: high blood glucose, high levels of sugar in the urine, [[frequent urination]], and increased [[thirst]]. It's important to treat hyperglycemia as soon as you detect it. If you fail to treat [[hyperglycemia]], a condition called [[ketoacidosis]] ([[diabetic coma]]) could occur. Ketoacidosis develops when your body doesn't have enough insulin.
==Natural History, Complications, and Prognosis==
Often, you can lower your blood glucose level by exercising. Cutting down on the amount of food you eat might also help. Your best bet to prevent hyperglycemia is to practice good diabetes management. Ketoacidosis is life-threatening and needs immediate treatment. It can occur when a case of hyperglycemia gets out of control. Symptoms include:
*[[Shortness of breath]]
*Breath that smells fruity
*[[Nausea]] and [[vomiting]]
*Very dry mouth
== Complications ==
===Heart Disease and Stroke===
People with diabetes have extra reason to be mindful of heart and blood vessel disease. Diabetes carries an increased risk for [[heart attack]], [[stroke]], and [[complication]]s related to poor circulation. 2 out of 3 people with diabetes die from [[heart disease]] or [[stroke]]. Diabetes management is more than control of blood glucose. People with diabetes must also manage [[blood pressure]] and [[cholesterol]] and talk to their health provider to learn about other ways to reduce their chance for heart attacks and stroke. Again, lifestyle changes, such as choosing foods wisely and being physically active, as well as taking medication can help. Many people find that changing what they eat can make a big difference in their blood glucose, blood pressure, and cholesterol levels.


===Kidney Disease===
===Natural History===
Diabetes can damage the [[kidney]]s, which not only can cause them to fail, but can also make them lose their ability to filter out waste products. Diabetes can damage the filtering ability of kidneys. High levels of blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak. Useful protein is lost in the urine. Having small amounts of protein in the urine is called [[microalbuminuria]]. When kidney disease is diagnosed early, (during [[microalbuminuria]]), several treatments may keep kidney disease from getting worse. Having larger amounts is called macroalbuminuria. When kidney disease is caught later (during macroalbuminuria), [[end-stage renal disease]], or ESRD, usually follows.In time, the stress of overwork causes the kidneys to lose their filtering ability. Waste products then start to build up in the blood. Finally, the kidneys fail. This failure, ESRD, is very serious. A person with ESRD needs to have a kidney transplant or to have the blood filtered by machine ([[dialysis]]). Diabetic kidney disease can be prevented by keeping blood sugar in your target range.


===Eye Complications===
* The [[symptom|symptoms]] of [[Diabetes mellitus type 1|type 1 diabetes]] usually develop in the first decade of life, and start with non-specific [[symptom|symptoms]] of classic new onset [[Diabetes mellitus type 1|type 1 diabetes]] or acute [[symptom|symptoms]] with [[diabetic ketoacidosis]]. Without [[treatment]], the [[patient]] will develop [[Complication (medicine)|complications]] of [[Diabetes mellitus type 1|type 1 diabetes]].<ref name="pmid16306336">{{cite journal| author=Achenbach P, Bonifacio E, Koczwara K, Ziegler AG| title=Natural history of type 1 diabetes. | journal=Diabetes | year= 2005 | volume= 54 Suppl 2 | issue=  | pages= S25-31 | pmid=16306336 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16306336  }}</ref>
People with diabetes are 40% more likely to suffer from [[glaucoma]] than people without diabetes. The longer someone has had diabetes, the more common glaucoma is. Risk also increases with age. Glaucoma occurs when pressure builds up in the eye, and vision is gradually lost because the [[retina]] and [[nerve]] are damaged. Many people without diabetes get [[cataracts]], but people with diabetes are 60% more likely to develop this eye condition. People with diabetes also tend to get cataracts at a younger age and have them progress faster. With cataracts, the eye's clear lens clouds, blocking light. [[Diabetic retinopathy]] is a general term for all disorders of the retina caused by diabetes. In nonproliferative retinopathy, capillaries in the back of the eye balloon and form pouches. Nonproliferative retinopathy can move through three stages (mild, moderate, and severe), as more and more blood vessels become blocked. In some people, retinopathy progresses after several years to a more serious form called proliferative retinopathy which can lead to blindness caused by [[retinal detachment]].
People who keep their blood sugar levels closer to normal are less likely to have retinopathy or to have milder forms.


===Diabetic Neuropathy and Nerve Damage===
=== Complications ===
One of the most common complications of diabetes is [[diabetic neuropathy]]. Neuropathy means damage to the nerves that run throughout the body, connecting the spinal cord to muscles, skin, blood vessels, and other organs. There are two common types of nerve damage. The first is sensorimotor neuropathy, also known as [[peripheral neuropathy]]. This can cause [[tingling]], [[pain]], [[numbness]], or [[weakness]] in your feet and hands. The second is called [[autonomic neuropathy]]. This type can lead to:
*Digestive problems such as feeling full, [[nausea]],
*[[Vomiting]], [[diarrhea]], or [[constipation]]
*Problems with how well your bladder works
*Problems having sex
*[[Dizziness]] or [[faintness]]
*Loss of the typical warning signs of a [[heart attack]]
*Loss of the warning signs of low blood glucose
*Increased or decreased [[sweating]]
*Changes in how your eyes react to light and dark
People with diabetes can also have what is called focal neuropathy. In this kind of nerve damage, a nerve or a group of nerves is affected, causing sudden weakness or [[pain]]. It can lead to double vision, a paralysis on one side of the face called [[Bell's palsy]], or pain in the front of the thigh or other parts of the body. People with diabetes also are at risk for compressed nerves. Something in the body presses against a nerve preventing it from sending a signal. Carpal tunnel syndrome is a common cause of [[numbness]] and [[tingling]] in the fingers and can lead to muscle pain and weakness as well. Keeping your blood glucose levels in the target range can prevent or delay further damage and may lessen your symptoms.


===Foot Complications===
* [[Complication (medicine)|Complications]] of [[Diabetes mellitus type 1|type 1 diabetes]] include:<ref>{{Cite web|url=http://www.diabetes.org/diabetes-basics/statistics/|title=ADA|last=|first=|date=|website=|publisher=|access-date=}}</ref><ref>Type 1 Diabetes mellitus "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 27th,2016</ref><ref>Type 1 Diabetes mellitus "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 27th,2016</ref><ref name="TengTian2017">{{cite journal|last1=Teng|first1=Zhi-Pan|last2=Tian|first2=Rui|last3=Xing|first3=Fen-Li|last4=Tang|first4=Hui|last5=Xu|first5=Jin-Jing|last6=Zhang|first6=Bing-Wen|last7=Qi|first7=Jian-Wei|title=An association of type 1 diabetes mellitus with auditory dysfunction: A systematic review and meta-analysis|journal=The Laryngoscope|volume=127|issue=7|year=2017|pages=1689–1697|issn=0023852X|doi=10.1002/lary.26346}}</ref>
Although it can hurt, diabetic nerve damage can also lessen your ability to feel [[pain]], heat, and cold. Loss of feeling often means you may not feel a foot injury. You might not notice a foot injury until the skin breaks down and becomes infected. Nerve damage can also lead to changes in the shape of your feet and toes. [[Ulcer]]s occur most often on the ball of the foot or on the bottom of the big toe. Neglecting ulcers can result in infections, which in turn can lead to loss of a limb. Poor circulation (blood flow) can make your foot less able to fight infection and to heal. Diabetes causes blood vessels of the foot and leg to narrow and harden. You can control some of the things that cause poor blood flow. Don't smoke - smoking makes arteries harden faster. People with diabetes are far more likely to have a foot or leg amputated than other people. The problem? Many people with diabetes have artery disease, which reduces blood flow to the feet. Also, many people with diabetes have nerve disease, which reduces sensation. Together, these problems make it easy to get ulcers and infections that may lead to amputation. One of the biggest threats to your feet is smoking. Smoking affects small blood vessels. It can cause decreased blood flow to the feet and make wounds heal slowly. A lot of people with diabetes who need amputations are smokers.
{| class="wikitable"
! colspan="2" |[[Complication (medicine)|Complications]] of [[Diabetes]]
|-
|Acute [[Complication (medicine)|Complications]] due to [[hyperglycemia]]
|
* [[DKA|Diabetes ketoacidosis]]
* [[Hyperosmolar hyperglycemic state|Hyperglycemic hyperosmolar state]]
|-
|Microvascular [[Complication (medicine)|complications]]
|Eye disease &nbsp;
* [[Retinopathy]] (nonproliferative/proliferative)
* [[Macular edema]]
[[Diabetic neuropathy|Neuropathy]] &nbsp;Sensory and motor (mono- and polyneuropathy) &nbsp;


===Gastroparesis===
and Autonomic [[neuropathy]]  
Gastroparesis is a disorder affecting people with both type 1 and type 2 diabetes, where the stomach takes too long to empty its contents. It happens when nerves to the stomach are damaged or stop working. The vagus nerve controls the movement of food through the digestive tract. If the vagus nerve is damaged, the muscles of the [[stomach]] and [[intestine]]s do not work normally, and the movement of food is slowed or stopped. Gastroparesis can make diabetes worse by making it more difficult to manage blood glucose.  When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. If food stays too long in the stomach, it can cause problems like bacterial overgrowth because the food has fermented. Also, the food can harden into solid masses called bezoars that may cause [[nausea]], [[vomiting]], and [[obstruction]] in the stomach. [[Bezoar]]s can be dangerous if they block the passage of food into the [[small intestine]].


=== Possible complications ===
[[Diabetic nephropathy|Nephropathy]] ([[albuminuria]] and declining renal function)
After many years, diabetes can lead to serious problems with your eyes, kidneys, nerves, heart, blood vessels, and other areas in your body.
|-
|Macrovascular [[Complication (medicine)|complications]]
|[[Coronary heart disease]]
[[Peripheral arterial disease]]


If you have diabetes, your risk of a heart attack is the same as someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the typical signs of a heart attack.
[[Stroke|Cerebrovascular disease]]
|-
|Other
|Gastrointestinal ([[gastroparesis]], [[diarrhea]])
[https://www.niddk.nih.gov/health-information/diabetes/preventing-diabetes-problems/sexual-urologic-problems Genitourinary (uropathy/sexual dysfunction)]


In general, complications include:
[http://www.idb.hr/diabetologia/02no3-2.pdf Dermatological complications]


*Cataracts
[http://www.diapedia.org/acute-and-chronic-complications-of-diabetes/71040851487/diabetes-mellitus-and-infection Infectious complications]
*Damage to the blood vessels that supply the legs and feet (peripheral vascular disease)
*Foot sores or ulcers, which can result in amputation
*Glaucoma
*High blood pressure
*High cholesterol
*Kidney disease and kidney failure (diabetic nephropathy)
*Macular edema
*Nerve damage, which causes pain and numbness in the feet, as well as a number of other problems with the stomach and intestines, heart, and other body organs (diabetic neuropathy)
*Stroke
*Worsening of eyesight or blindness due to diabetic retinopathy (eye disease)


Other complications include:
[[Cataracts]]
*Erection problems
 
*Infections of the skin, female genital tract, and urinary tract
[[Glaucoma]]
 
Cheiroarthropathy (thickened skin and reduced [[joint]] mobility)
 
[[Periodontitis|Periodontal disease]]
 
[[Hearing loss]]
 
[[Depression]]
 
[[Obstructive sleep apnea]]
 
[[Fatty liver]] disease
 
[[Hip fracture]]
 
[[Osteoporosis]]
 
[[Cognitive impairment]] 
 
[[Dementia]]
 
Low [[testosterone]] in men
 
[[Dead-in-bed syndrome]]
|}
 
* In a [[control study]] [[patient|patients]] with [[Diabetes mellitus type 1|type 1 diabetes]] had significantly lower total body [[bone mineral density]] ([[bone mineral density|BMD]]) z-score values. Lower levels of [[osteocalcin]], [[C-terminus|C-terminal]] telopeptide, [[calcium]], [[phosphorus]], and [[magnesium]] have been found in [[patient|patients]] with [[Diabetes mellitus type 1|type 1 diabetes]], compared to [[Scientific control|control group]].<ref name="LeãoFritz2020">{{cite journal|last1=Leão|first1=Andreia Araújo Porchat|last2=Fritz|first2=Camilla Kapp|last3=Dias|first3=Marcia Regina Messaggi Gomes|last4=Carvalho|first4=Julienne Angela Ramires|last5=Mascarenhas|first5=Luis Paulo Gomes|last6=Cat|first6=Mônica Nunes Lima|last7=Radominski|first7=Rosana|last8=Nesi-França|first8=Suzana|title=Bone mass and dietary intake in children and adolescents with type 1 diabetes mellitus|journal=Journal of Diabetes and its Complications|volume=34|issue=6|year=2020|pages=107573|issn=10568727|doi=10.1016/j.jdiacomp.2020.107573}}</ref>
* A study demonstrated that children with [[Diabetes mellitus type 1|type 1 diabetes]] mentioned barriers for physical activity (eg, fear of [[hypoglycemia]], loss of control of [[diabetes]] and low fitness). This study report significant improvement with parental support. <ref name="JabbourHenderson2016">{{cite journal|last1=Jabbour|first1=Georges|last2=Henderson|first2=Mélanie|last3=Mathieu|first3=Marie-Eve|title=Barriers to Active Lifestyles in Children with Type 1 Diabetes|journal=Canadian Journal of Diabetes|volume=40|issue=2|year=2016|pages=170–172|issn=14992671|doi=10.1016/j.jcjd.2015.12.001}}</ref>
* Based on a [[systematic review]], [[Diabetes mellitus type 1|type 1 diabetic]] [[patient|patients]] have worse [[Executive system|executive function]] performance, working [[memory]] and task switching, compared to the [[Scientific control|control group]].<ref name="BroadleyWhite2017">{{cite journal|last1=Broadley|first1=Melanie M.|last2=White|first2=Melanie J.|last3=Andrew|first3=Brooke|title=A Systematic Review and Meta-analysis of Executive Function Performance in Type 1 Diabetes Mellitus|journal=Psychosomatic Medicine|volume=79|issue=6|year=2017|pages=684–696|issn=0033-3174|doi=10.1097/PSY.0000000000000460}}</ref>
* There have been a reported association between early childhood onset of [[type 1 diabetes mellitus]] and mild [[cerebral atrophy]] and reduced intellectual performance in adulthood.<ref name="FergusonBlane2005">{{cite journal|last1=Ferguson|first1=S. C.|last2=Blane|first2=A.|last3=Wardlaw|first3=J.|last4=Frier|first4=B. M.|last5=Perros|first5=P.|last6=McCrimmon|first6=R. J.|last7=Deary|first7=I. J.|title=Influence of an Early-Onset Age of Type 1 Diabetes on Cerebral Structure and Cognitive Function|journal=Diabetes Care|volume=28|issue=6|year=2005|pages=1431–1437|issn=0149-5992|doi=10.2337/diacare.28.6.1431}}</ref>
* The followings are some related [[dermatology|dermatological]] consequences of [[Diabetes mellitus type 1|type 1 diabetes]]:<ref name="pmid29465926">{{cite journal| author=Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K | display-authors=etal| title=Endotext | journal= | year= 2000 | volume=  | issue=  | pages=  | pmid=29465926 | doi= | pmc= | url= }} </ref>
** [[Scleroderma]]-like [[skin]] changes: [[Pathogenesis]] is not fully understood, nevertheless advanced glycosylation end products and [[sugar]] [[alcohol|alcohols]] buildup in the upper [[dermis]] is believed to effect the strengthening of [[collagen]]. 
** Cheiroarthropathy (thickened skin and reduced [[joint]] mobility)
** Scleredema diabeticorum
** [[Necrobiosis lipoidica]]
** Bullosis diabeticorum
** [[Xerosis]]
** Eruptive [[xanthoma|xanthomas]]: Although [[xanthoma|xanthomas]] are routinely related to [[Hyperlipoproteinemia|hypertriglyceridemia]], [[Diabetes mellitus type 1|type 1 diabetic]] [[patient|patients]] may develop eruptive [[xanthoma|xanthomas]] with normal levels of [[triglyceride]]. [[Prevelance]] of Eruptive [[xanthoma|xanthomas]] in [[Diabetes mellitus type 1|type 1 diabetes]] is approximately 1%.
[[File:Necrobiosis Lipoidica .png|alt=Necrobiosis Lipoidica |center|thumb|600x600px|Necrobiosis Lipoidica in [[Diabetes mellitus type 1|type 1 diabetes]], Case courtesy by Nandini Chatterjee<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987274/|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>]] 
 
 
===Prognosis===
 
* [[Diabetes]] is a lifelong [[disease]] and there is no cure. Tight control of [[Blood sugar|blood glucose]] can prevent or delay [[diabetes]] [[Complication (medicine)|complications]]. But these problems can occur, even in people with good [[diabetes]] control.<ref>{{Cite web|url=http://www.diabetesincontrol.com/life-expectancy-for-type-1-diabetes/|title=Diabetes in control|last=|first=|date=|website=|publisher=|access-date=}}</ref>
* When [[Diabetes mellitus type 1|type 1 diabetes mellitus]] left untreated it can be fatal due to [[Complication (medicine)|complications]] like [[diabetic ketoacidosis]].
* [[Prognosis]] of [[Diabetes mellitus type 1|type 1 diabetes mellitus]] is effected by factors such as [[Blood sugar|blood glucose]] concentration, [[Glycosylated hemoglobin|hemoglobin A1c]] ([[Glycosylated hemoglobin|HbA1c), [[lipid|lipids]], [[blood pressure]], and weight.
* There is a direct relationship between [[Glycosylated hemoglobin|hemoglobin A1c]] level and long-term [[Cognition|cognitive]] decline.<ref name="ZhengYan2018">{{cite journal|last1=Zheng|first1=Fanfan|last2=Yan|first2=Li|last3=Yang|first3=Zhenchun|last4=Zhong|first4=Baoliang|last5=Xie|first5=Wuxiang|title=HbA1c, diabetes and cognitive decline: the English Longitudinal Study of Ageing|journal=Diabetologia|volume=61|issue=4|year=2018|pages=839–848|issn=0012-186X|doi=10.1007/s00125-017-4541-7}}</ref>
* The most common cause of death among [[type 1 diabetes mellitus]] [[patient|patients]] under 30 years old is acute [[Metabolism|metabolic]] [[Complication (medicine)|complications]], based on a study done on Norwegian [[patient|patients]] who were diagnosed between 1973 and 1982.<ref name="SkrivarhaugBangstad2005">{{cite journal|last1=Skrivarhaug|first1=T.|last2=Bangstad|first2=H.-J.|last3=Stene|first3=L. C.|last4=Sandvik|first4=L.|last5=Hanssen|first5=K. F.|last6=Joner|first6=G.|title=Long-term mortality in a nationwide cohort of childhood-onset type 1 diabetic patients in Norway|journal=Diabetologia|volume=49|issue=2|year=2005|pages=298–305|issn=0012-186X|doi=10.1007/s00125-005-0082-6}}</ref>
* The following factors have been related to longer [[life expectancy]] in [[patient|patients]] with [[Diabetes mellitus type 1|type 1 diabetes]]:<ref name="pmid24936249">{{cite journal| author=Distiller LA| title=Why do some patients with type 1 diabetes live so long? | journal=World J Diabetes | year= 2014 | volume= 5 | issue= 3 | pages= 282-7 | pmid=24936249 | doi=10.4239/wjd.v5.i3.282 | pmc=4058732 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24936249  }} </ref>
** Proper (not necessarily optimal) glycaemic control
** High [[High density lipoprotein|HDL-cholesterol]] levels
** Low [[insulin]] requirements ([[insulin]] sensitive)
** Normal [[body mass index]] ([[Body mass index|BMI]])
** Proper [[blood pressure]] control
** [[patient|Patients]] who do not [[Smoking|smoke]]
** Absence of [[Albuminuria|microalbuminuria]] after 15-20 years of [[Diabetes mellitus type 1|type 1 diabetes]] onset
** [[family history|Familial history]] of long life 


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


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Latest revision as of 20:10, 11 September 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vishal Devarkonda, M.B.B.S[2]Anahita Deylamsalehi, M.D.[3]

Overview

The symptoms of type 1 diabetes usually develop in the first decade of life, and start with non-specific symptoms of classic new onset type 1 diabetes or acute symptoms with diabetic ketoacidosis. If left untreated, patients with type 1 DM may develop acute complications of the hyperglycemia state, such as diabetes ketoacidosis and hyperglycemia hyperosmolar state. In addition other complications related to microvascular or macrovascular changes, such as retinopathy, autonomic neuropathy, dermatology diseases, coronary heart disease, peripheral arterial disease and macular edema. Prognosis is generally good with compliance with medications.

Natural History, Complications, and Prognosis

Natural History

Complications

Complications of Diabetes
Acute Complications due to hyperglycemia
Microvascular complications Eye disease  

Neuropathy  Sensory and motor (mono- and polyneuropathy)  

and Autonomic neuropathy

Nephropathy (albuminuria and declining renal function)

Macrovascular complications Coronary heart disease

Peripheral arterial disease

Cerebrovascular disease

Other Gastrointestinal (gastroparesis, diarrhea)

Genitourinary (uropathy/sexual dysfunction)

Dermatological complications

Infectious complications

Cataracts

Glaucoma

Cheiroarthropathy (thickened skin and reduced joint mobility)

Periodontal disease

Hearing loss

Depression

Obstructive sleep apnea

Fatty liver disease

Hip fracture

Osteoporosis

Cognitive impairment

Dementia

Low testosterone in men

Dead-in-bed syndrome

Necrobiosis Lipoidica
Necrobiosis Lipoidica in type 1 diabetes, Case courtesy by Nandini Chatterjee[11]


Prognosis

References

  1. ↑ Achenbach P, Bonifacio E, Koczwara K, Ziegler AG (2005). "Natural history of type 1 diabetes". Diabetes. 54 Suppl 2: S25–31. PMID 16306336.
  2. ↑ "ADA".
  3. ↑ Type 1 Diabetes mellitus "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 27th,2016
  4. ↑ Type 1 Diabetes mellitus "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 27th,2016
  5. ↑ Teng, Zhi-Pan; Tian, Rui; Xing, Fen-Li; Tang, Hui; Xu, Jin-Jing; Zhang, Bing-Wen; Qi, Jian-Wei (2017). "An association of type 1 diabetes mellitus with auditory dysfunction: A systematic review and meta-analysis". The Laryngoscope. 127 (7): 1689–1697. doi:10.1002/lary.26346. ISSN 0023-852X.
  6. ↑ Leão, Andreia Araújo Porchat; Fritz, Camilla Kapp; Dias, Marcia Regina Messaggi Gomes; Carvalho, Julienne Angela Ramires; Mascarenhas, Luis Paulo Gomes; Cat, Mônica Nunes Lima; Radominski, Rosana; Nesi-França, Suzana (2020). "Bone mass and dietary intake in children and adolescents with type 1 diabetes mellitus". Journal of Diabetes and its Complications. 34 (6): 107573. doi:10.1016/j.jdiacomp.2020.107573. ISSN 1056-8727.
  7. ↑ Jabbour, Georges; Henderson, Mélanie; Mathieu, Marie-Eve (2016). "Barriers to Active Lifestyles in Children with Type 1 Diabetes". Canadian Journal of Diabetes. 40 (2): 170–172. doi:10.1016/j.jcjd.2015.12.001. ISSN 1499-2671.
  8. ↑ Broadley, Melanie M.; White, Melanie J.; Andrew, Brooke (2017). "A Systematic Review and Meta-analysis of Executive Function Performance in Type 1 Diabetes Mellitus". Psychosomatic Medicine. 79 (6): 684–696. doi:10.1097/PSY.0000000000000460. ISSN 0033-3174.
  9. ↑ Ferguson, S. C.; Blane, A.; Wardlaw, J.; Frier, B. M.; Perros, P.; McCrimmon, R. J.; Deary, I. J. (2005). "Influence of an Early-Onset Age of Type 1 Diabetes on Cerebral Structure and Cognitive Function". Diabetes Care. 28 (6): 1431–1437. doi:10.2337/diacare.28.6.1431. ISSN 0149-5992.
  10. ↑ Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K; et al. (2000). "Endotext". PMID 29465926.
  11. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987274/. Missing or empty |title= (help)
  12. ↑ "Diabetes in control".
  13. ↑ Zheng, Fanfan; Yan, Li; Yang, Zhenchun; Zhong, Baoliang; Xie, Wuxiang (2018). "HbA1c, diabetes and cognitive decline: the English Longitudinal Study of Ageing". Diabetologia. 61 (4): 839–848. doi:10.1007/s00125-017-4541-7. ISSN 0012-186X.
  14. ↑ Skrivarhaug, T.; Bangstad, H.-J.; Stene, L. C.; Sandvik, L.; Hanssen, K. F.; Joner, G. (2005). "Long-term mortality in a nationwide cohort of childhood-onset type 1 diabetic patients in Norway". Diabetologia. 49 (2): 298–305. doi:10.1007/s00125-005-0082-6. ISSN 0012-186X.
  15. ↑ Distiller LA (2014). "Why do some patients with type 1 diabetes live so long?". World J Diabetes. 5 (3): 282–7. doi:10.4239/wjd.v5.i3.282. PMC 4058732. PMID 24936249.

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