Diabetes mellitus type 1 natural history, complications, and prognosis: Difference between revisions

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Case #1

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Revision as of 06:15, 30 August 2020

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

Overview

If left untreated, patients with [type 1 DM] may progress to develop complications of the hyperglycemia state, which commonly include diabetes ketoacidosis and hyperglycemia hyperosmolar state. Prognosis is generally good with compliance with medications.

Natural History

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. Without treatment, the patient will develop complications of type 1 diabetes.^[1]

Complications

Complications for type 1 diabetes include:^[2]^[3]^[4]^[5]

Complications of Diabetes
Acute Complications due to hyperglycemia	Diabetes ketoacidosis Hyperglycemic hyperosmolar state
Microvascular complications	Eye disease Retinopathy (nonproliferative/proliferative) Macular edema 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

In a control study patients with type 1 diabetes had significantly lower total body bone mineral density (BMD) z-score values. Lower levels of osteocalcin, C-terminal telopeptide, calcium, phosphorus, and magnesium have been found in patients with type 1 diabetes compared to control group.^[6]
A study demonstrated that children with 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. ^[7]
Based on a systematic review, type 1 diabetic patients have worse executive function performance, working memory and task switching, compared to the control group.^[8]
The followings are some related dermatological consequences of type 1 diabetes:^[9]
- Scleroderma-like skin changes: Pathogenesis is not fully understood, nevertheless advanced glycosylation end products and sugar 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

Necrobiosis Lipoidica in type 1 diabetes, Case courtesy by Nandini Chatterjee^[10]

- Bullosis diabeticorum
- Xerosis
- Eruptive xanthomas: Although xanthomas are routinely related to hypertriglyceridemia, type 1 diabetic patients may develop eruptive xanthomas with normal levels of triglyceride. Prevelance of Eruptive xanthomas in type 1 diabetes is approximately 1%.

Prognosis

Diabetes is a lifelong disease and there is no cure. Tight control of blood glucose can prevent or delay diabetes complications. But these problems can occur, even in people with good diabetes control.^[11]

References

↑ Achenbach P, Bonifacio E, Koczwara K, Ziegler AG (2005). "Natural history of type 1 diabetes". Diabetes. 54 Suppl 2: S25–31. PMID 16306336.
↑ "ADA".
↑ 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
↑ 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
↑ 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.
↑ 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.
↑ 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.
↑ 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.
↑ Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K; et al. (2000). "Endotext". PMID 29465926.
↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987274/. Missing or empty |title= (help)
↑ "Diabetes in control".

Template:WH Template:WS

[pmid16306336-1] 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

[TengTian2017-5] 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.

[LeãoFritz2020-6] 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.

[JabbourHenderson2016-7] 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.

[BroadleyWhite2017-8] 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.

[pmid29465926-9] Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K; et al. (2000). "Endotext". PMID 29465926.

[10] ttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987274/. Missing or empty |title= (help)

[11] "Diabetes in control".

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[5]

[6]

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@@ Line 76: / Line 76: @@
 * 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]] 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>
-* The followings are some related [[dermatology|dermatological]] consequences of [[Diabetes mellitus type 1|type 1 diabetes]]:
+* 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]] alcohols buildup in the upper [[dermis]] is believed to effect the strengthening of [[collagen]].
+** [[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]]
+** [[Necrobiosis lipoidica]]
-[[File:Necrobiosis Lipoidica .png|alt=Necrobiosis Lipoidica |center|thumb|600x600px|Necrobiosis Lipoidica in 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>]]
+[[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>]]
-** Bullosis Diabeticorum
+** Bullosis diabeticorum
-**
+** [[Xerosis]]
+** Eruptive [[xanthoma|xanthomas]]: Although [[xanthoma|xanthomas]] are routinely related to hypertriglyceridemia, [[Diabetes mellitus type 1|type 1 diabetic]] 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%.