Diabetes mellitus type 1 overview: Difference between revisions
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==Overview== | ==Overview== | ||
Diabetes mellitus type 1 (Type 1 diabetes, Type I diabetes, T1D, IDDM) is a form of [[diabetes mellitus]]. Type 1 diabetes is an [[autoimmune]] disease that results in the permanent destruction of [[insulin]] producing [[beta cells]] of the pancreas. Type 1 is lethal unless treatment with exogenous insulin via [[injections]] replaces the missing [[hormone]]. Type 1 diabetes (formerly known as "childhood", "juvenile" or "insulin-dependent" diabetes) is not exclusively a childhood problem: the adult incidence of Type 1 is significant — many adults who contract Type 1 diabetes are misdiagnosed with [[Diabetes mellitus type 2|Type 2]] due to the misconception of Type 1 as a disease of children — and since there is no cure, Type 1 diabetic children will grow up to be Type 1 diabetic adults. The principal treatment of type 1 diabetes, even from the earliest stages, is replacement of insulin combined with careful monitoring of blood glucose levels using blood testing monitors. Without insulin, [[diabetic ketoacidosis]] can develop and may result in coma or death. Emphasis is also placed on lifestyle adjustments (diet and exercise) though these can do absolutely nothing to reverse the loss. Apart from the common [[subcutaneous]] injections, it is also possible to deliver insulin by a [[insulin pump|pump]], which allows continuous infusion of insulin 24 hours a day at preset levels, and the ability to program doses (a [[Bolus (medicine)|bolus]]) of insulin as needed at meal times. An inhaled form of insulin, [[Exubera]], was approved by the FDA in January 2006, although Pfizer discontinued Exubera in October 2007. <ref>{{cite web |url=http://www.fda.gov/bbs/topics/news/2006/NEW01304.html |title=FDA Approves First Ever Inhaled Insulin Combination Product for Treatment of Diabetes |accessdate=2007-09-09 |format= |work=}}</ref> Type 1 treatment must be continued indefinitely. Treatment does not significantly impair normal activities, if sufficient patient training, awareness, appropriate care, discipline in testing and dosing of insulin is taken. However, treatment is burdensome for patients, chronic and insulin is replaced in a non-physiological manner, and is therefore is far from ideal. The average glucose level for the type 1 patient should be as close to normal (80–120 mg/dl, 4–6 mmol/l) as is ''safely'' possible. Some physicians suggest up to 140–150 mg/dl (7-7.5 mmol/l) for those having trouble with lower values, such as frequent hypoglycemic events. Values above 200 mg/dl (10 mmol/l) is sometimes accompanied by discomfort and frequent urination leading to [[dehydration]]. Values above 300 mg/dl (15 mmol/l) usually require treatment and may lead to [[ketoacidosis]], although is not immediately life-threatening. However, low levels of blood glucose, called [[hypoglycemia]], may lead to seizures or episodes of unconsciousness and absolutely must be treated immediately. | Diabetes mellitus type 1 (Type 1 diabetes, Type I diabetes, T1D, IDDM) is a form of [[diabetes mellitus]]. Type 1 diabetes is an [[autoimmune]] disease that results in the permanent destruction of [[insulin]] producing [[beta cells]] of the pancreas. Type 1 is lethal unless treatment with exogenous insulin via [[injections]] replaces the missing [[hormone]]. Type 1 diabetes (formerly known as "childhood", "juvenile" or "insulin-dependent" diabetes) is not exclusively a childhood problem: the adult incidence of Type 1 is significant — many adults who contract Type 1 diabetes are misdiagnosed with [[Diabetes mellitus type 2|Type 2]] due to the misconception of Type 1 as a disease of children — and since there is no cure, Type 1 diabetic children will grow up to be Type 1 diabetic adults. The principal treatment of type 1 diabetes, even from the earliest stages, is replacement of insulin combined with careful monitoring of blood glucose levels using blood testing monitors. Without insulin, [[diabetic ketoacidosis]] can develop and may result in coma or death. Emphasis is also placed on lifestyle adjustments (diet and exercise) though these can do absolutely nothing to reverse the loss. Apart from the common [[subcutaneous]] injections, it is also possible to deliver insulin by a [[insulin pump|pump]], which allows continuous infusion of insulin 24 hours a day at preset levels, and the ability to program doses (a [[Bolus (medicine)|bolus]]) of insulin as needed at meal times. An inhaled form of insulin, [[Exubera]], was approved by the FDA in January 2006, although Pfizer discontinued Exubera in October 2007. <ref>{{cite web |url=http://www.fda.gov/bbs/topics/news/2006/NEW01304.html |title=FDA Approves First Ever Inhaled Insulin Combination Product for Treatment of Diabetes |accessdate=2007-09-09 |format= |work=}}</ref> Type 1 treatment must be continued indefinitely. Treatment does not significantly impair normal activities, if sufficient patient training, awareness, appropriate care, discipline in testing and dosing of insulin is taken. However, treatment is burdensome for patients, chronic and insulin is replaced in a non-physiological manner, and is therefore is far from ideal. The average glucose level for the type 1 patient should be as close to normal (80–120 mg/dl, 4–6 mmol/l) as is ''safely'' possible. Some physicians suggest up to 140–150 mg/dl (7-7.5 mmol/l) for those having trouble with lower values, such as frequent hypoglycemic events. Values above 200 mg/dl (10 mmol/l) is sometimes accompanied by discomfort and frequent urination leading to [[dehydration]]. Values above 300 mg/dl (15 mmol/l) usually require treatment and may lead to [[ketoacidosis]], although is not immediately life-threatening. However, low levels of blood glucose, called [[hypoglycemia]], may lead to seizures or episodes of unconsciousness and absolutely must be treated immediately. | ||
==Historical Perspective== | |||
==Classification== | |||
==Pathophysiology== | |||
==Causes== | |||
==Differentiating Diabetes Mellitus Type 1 from other Diseases== | |||
==Epidemiology and Demographics== | |||
==Risk Factors== | |||
==Screening== | |||
==Natural History, Complications and Prognosis== | |||
==Diagnosis== | |||
===History and Symptoms=== | |||
===Physical Examination=== | |||
===Laboratory Findings=== | |||
===Electrocardiogram=== | |||
===Chest X Ray=== | |||
===CT=== | |||
===MRI=== | |||
===Echocardiography or Ultrasound=== | |||
===Other Imaging Findings=== | |||
===Other Diagnostic Studies=== | |||
==Treatment== | |||
===Medical Therapy=== | |||
===Surgery=== | |||
===Primary Prevention=== | |||
===Secondary Prevention=== | |||
===Cost-Effectiveness of Therapy=== | |||
===Future or Investigational Therapies=== | |||
==Case Studies== | |||
===Case #1=== | |||
==References== | ==References== | ||
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[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Primary care]] | [[Category:Primary care]] | ||
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{{WS}} | |||
Revision as of 15:06, 7 July 2016
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Diabetes mellitus type 1 Microchapters |
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Differentiating Diabetes mellitus type 1 from other Diseases |
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Case Studies |
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Diabetes mellitus Main page |
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Patient Information |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]
Overview
Diabetes mellitus type 1 (Type 1 diabetes, Type I diabetes, T1D, IDDM) is a form of diabetes mellitus. Type 1 diabetes is an autoimmune disease that results in the permanent destruction of insulin producing beta cells of the pancreas. Type 1 is lethal unless treatment with exogenous insulin via injections replaces the missing hormone. Type 1 diabetes (formerly known as "childhood", "juvenile" or "insulin-dependent" diabetes) is not exclusively a childhood problem: the adult incidence of Type 1 is significant — many adults who contract Type 1 diabetes are misdiagnosed with Type 2 due to the misconception of Type 1 as a disease of children — and since there is no cure, Type 1 diabetic children will grow up to be Type 1 diabetic adults. The principal treatment of type 1 diabetes, even from the earliest stages, is replacement of insulin combined with careful monitoring of blood glucose levels using blood testing monitors. Without insulin, diabetic ketoacidosis can develop and may result in coma or death. Emphasis is also placed on lifestyle adjustments (diet and exercise) though these can do absolutely nothing to reverse the loss. Apart from the common subcutaneous injections, it is also possible to deliver insulin by a pump, which allows continuous infusion of insulin 24 hours a day at preset levels, and the ability to program doses (a bolus) of insulin as needed at meal times. An inhaled form of insulin, Exubera, was approved by the FDA in January 2006, although Pfizer discontinued Exubera in October 2007. [1] Type 1 treatment must be continued indefinitely. Treatment does not significantly impair normal activities, if sufficient patient training, awareness, appropriate care, discipline in testing and dosing of insulin is taken. However, treatment is burdensome for patients, chronic and insulin is replaced in a non-physiological manner, and is therefore is far from ideal. The average glucose level for the type 1 patient should be as close to normal (80–120 mg/dl, 4–6 mmol/l) as is safely possible. Some physicians suggest up to 140–150 mg/dl (7-7.5 mmol/l) for those having trouble with lower values, such as frequent hypoglycemic events. Values above 200 mg/dl (10 mmol/l) is sometimes accompanied by discomfort and frequent urination leading to dehydration. Values above 300 mg/dl (15 mmol/l) usually require treatment and may lead to ketoacidosis, although is not immediately life-threatening. However, low levels of blood glucose, called hypoglycemia, may lead to seizures or episodes of unconsciousness and absolutely must be treated immediately.
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Diabetes Mellitus Type 1 from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
References
- ↑ "FDA Approves First Ever Inhaled Insulin Combination Product for Treatment of Diabetes". Retrieved 2007-09-09.