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Type 1 diabetes - Symptom

Alternative Names

Insulin-dependent diabetes; Juvenile onset diabetes; Diabetes - type 1

Symptoms:

These symptoms may be the first signs of type 1 diabetes, or may occur when the blood sugar is high:

Being very thirsty
Feeling hungry
Feeling tired or fatigued
Having blurry eyesight
Losing the feeling or feeling tingling in your feet
Losing weight without trying
Urinating more often

For other people, these warning symptoms may be the first signs of type 1 diabetes, or they may happen when the blood sugar is very high (see: diabetic ketoacidosis):

Deep, rapid breathing
Dry skin and mouth
Flushed face
Fruity breath odor
Nausea or vomiting, inability to keep down fluids
Stomach pain

Low blood sugar (hypoglycemia) can develop quickly in people with diabetes who are taking insulin. Symptoms usually appear when the blood sugar level falls below 70 mg/dL. Watch for:

Headache
Hunger
Nervousness
Rapid heartbeat (palpitations)
Shaking
Sweating
Weakness

Signs and tests:

Diabetes is diagnosed with the following blood tests:

Fasting blood glucose level -- diabetes is diagnosed if it is higher than 126 mg/dL two times
Random (nonfasting) blood glucose level -- you may have diabetes if it is higher than 200 mg/dL, and you have symptoms such as increased thirst, urination, and fatigue (this must be confirmed with a fasting test)
Oral glucose tolerance test -- diabetes is diagnosed if the glucose level is higher than 200 mg/dL after 2 hours
Hemoglobin A1c test
- Normal: Less than 5.7%
- Pre-diabetes: Between 5.7% and 6.4%
- Diabetes: 6.5% or higher

Ketone testing is also sometimes used. The ketone test is done using a urine sample or blood sample. Ketone testing may be done:

When the blood sugar is higher than 240 mg/dL
During an illness such as pneumonia, heart attack, or stroke
When nausea or vomiting occur
During pregnancy

The following tests or exams will help you and your doctor monitor your diabetes and prevent problems caused by diabetes:

Check the skin and bones on your feet and legs.
Check to see if your feet are getting numb.
Have your blood pressure checked at least every year (blood pressure goal should be 130/80 mm/Hg or lower).
Have your hemoglobin A1c test (HbA1c) done every 6 months if your diabetes is well controlled; otherwise, every 3 months.
Have your cholesterol and triglyceride levels checked yearly (aim for LDL cholesterol levels below 70-100 mg/dL).
Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine).
Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease.
See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.

Monitor blood glucose - series

Reviewed last on: 6/28/2011
Ari S. Eckman, MD, Division of Endocrinology, Diabetes and Metabolism, Trinitas Regional Medical Center, Elizabeth, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Alemzadeh R, Ali O. Diabetes Mellitus. In: Kliegman RM, ed. Kliegman: Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders; 2011:chap 583.

American Diabetes Association. Standards of medical care in diabetes -- 2011. Diabetes Care. 2011. 34 Suppl 1:S11-S61.

Eisenbarth GS, Polonsky KS, Buse JB. Type 1 diabetes mellitus. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Kronenberg: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 31.

Pignone M, Alberts MJ, Colwell JA, Cushman M, Inzucchi SE, Mukherjee D, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, and an expert consensus document of the American College of Cardiology Foundation. Circulation. 2010. 121:2694-2701.

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