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Diabetes - type 1 - Highlights

Description

An in-depth report on the causes, diagnosis, and treatment of type 1 diabetes.

Alternative Names

Type 1 diabetes; Insulin-dependent diabetes; Juvenile diabetes

Highlights:

Type 1 Diabetes

In type 1 diabetes, the pancreas does not produce insulin. Insulin is a hormone that is involved in regulating how the body converts sugar (glucose) into energy. People with type 1 diabetes need to take daily insulin shots and carefully monitor their blood glucose levels.

Type 1 diabetes is less common that type 2 diabetes. This type of diabetes can occur at any age, but usually first develops in childhood or adolescence. Type 1 diabetes accounts for 5 - 10% of all diabetes cases.

Symptoms of Diabetes

Symptoms of both type 1 and type 2 diabetes include:

Frequent urination
Excessive thirst
Extreme hunger
Sudden weight loss
Extreme fatigue
Irritability
Blurred vision

Warning Signs of Hypoglycemia

Hypoglycemia (low blood sugar) occurs when blood sugar (glucose) levels fall below normal. Patients with type 1 diabetes should be aware of these symptoms of hypoglycemia:

Sweating
Trembling
Hunger
Rapid heartbeat
Confusion

It is important to quickly treat hypoglycemia and raise blood sugar levels by eating sugar, sucking on hard candy, or drinking fruit juice. Patients who are at risk for hypoglycemia should carry some sugar product with them in case an attack occurs. In rare and worst cases, hypoglycemia can lead to coma and death. Regular blood sugar monitoring throughout the day can help you avoid hypoglycemia. Patients are also encouraged to wear a medical alert ID bracelet or necklace that states they have diabetes and that they take insulin.

Resources

www.diabetes.org -- American Diabetes Association
www.niddk.nih.gov -- National Institute of Diabetes and Digestive and Kidney Diseases
www.jdrf.org -- Juvenile Diabetes Research Foundation
www.nei.nih.gov -- National Eye Institute
www.eatright.org -- American Dietetic Association
www.kidney.org -- National Kidney Foundation
www.diabetestrialnet.org -- Type 1 Diabetes International Clinical Trial Net
www.medicalert.org -- Bracelets or neck chain emblems with personal medical information
www.childrenwithdiabetes.com -- Children with diabetes online community

References

Alemzadeh R and Wyatt DT. Diabetes mellitus. In: Kliegman RM, ed. Nelson Textbook of Pediatrics. 18th edition. Saunders; 2007:chap 590.

American Diabetes Association. Standards of medical care in diabetes -- 2009. Diabetes Care. 2009 Jan;32 Suppl 1:S13-61.

Bakris GL, Sowers JR; American Society of Hypertension Writing Group. ASH position paper: treatment of hypertension in patients with diabetes-an update. J Clin Hypertens (Greenwich). 2008 Sep;10(9):707-13; discussion 714-5.

Camilleri M. Clinical practice. Diabetic gastroparesis. N Engl J Med. 2007 Feb 22;356(8):820-9.

Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study Research Group, Jacobson AM, Musen G, Ryan CM, Silvers N, Cleary P, et al. Long-term effect of diabetes and its treatment on cognitive function. N Engl J Med. 2007 May 3;356(18):1842-52.

Farrar D, Tuffnell DJ, West J. Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD005542.

Fiorina P, Secchi A. Pancreatic islet cell transplant for treatment of diabetes. Endocrinol Metab Clin North Am. 2007 Dec;36(4):999-1013; ix.

Drueke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D, et al. Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med. 2006 Nov 16;355(20):2071-84.

Hunt D. Foot ulcers and amputations in diabetes. Clin Evid. 2006 Jun;(15):576-84.

Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group, Tamborlane WV, Beck RW, Bode BW, Buckingham B, Chase HP, et al. Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med. 2008 Oct 2;359(14):1464-76. Epub 2008 Sep 8.

Retnakaran R, Zinman B. Type 1 diabetes, hyperglycaemia, and the heart. Lancet. 2008 May 24;371(9626):1790-9.

SEARCH for Diabetes in Youth Study Group, Liese AD, D'Agostino RB, Hamman RF, Kilgo PD, Lawrence JM, et al. The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for Diabetes in Youth Study. Pediatrics. 2006 Oct;118(4):1510-8.

Shapiro AM, Ricordi C, Hering BJ, Auchincloss H, Lindblad R, Robertson RP, et al. International trial of the Edmonton protocol for islet transplantation. N Engl J Med. 2006 Sep 28;355(13):1318-30.

Skyler JS. Cellular therapy for type 1 diabetes: has the time come? JAMA. 2007 Apr 11;297(14):1599-600.

Vardi M, Nini A. Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus. Cochrane Database Syst Rev. 2007 Jan 24(1):CD002187.

Voltarelli JC, Couri CE, Stracieri AB, Oliveira MC, Moraes DA, Pieroni F, et al. Autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus. JAMA. 2007 Apr 11;297(14):1568-76.

Writing Group for the SEARCH for Diabetes in Youth Study Group , Dabelea D, Bell RA, D'Agostino RB, Imperatore G, Johansen JM, et al. Incidence of diabetes in youth in the United States. JAMA. 2007 Jun 27;297(24):2716-24.

Reviewed last on: 5/5/2009
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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