Endocrine » Diabetes

Type I Diabetes

Type 1 diabetes mellitus can occur at any age and is characterized by the marked inability of the pancreas to secrete insulin because of autoimmune destruction of the beta cells. It commonly occurs in children, with a fairly abrupt onset; however, newer antibody tests have allowed for the identification of more people with the new-onset adult form of type 1 diabetes mellitus called latent autoimmune diabetes of the adult (LADA).The distinguishing characteristic of a patient with type 1 diabetes is that, if his or her insulin is withdrawn, ketosis and eventually ketoacidosis develop. Therefore, these patients are dependent on exogenous insulin. Autoantibodies to GAD may also be present in type 1 diabetes, especially in adults. In the Diabetes Control and Complications Trial (DCCT) it was demonstrated that chronic hyperglycaemia is associated with an increased risk of microvascular complications of diabetes. The goal is to lower blood glucose levels to the near-normal range (e.g., preprandial blood glucose levels of 90-130 mg/dL, HbA1C levels of < 7%) and to maintain them in this range throughout the patient's life. Self-monitoring of glucose levels Optimal diabetic control requires frequent self-monitoring of blood glucose levels. Most patients with type 1 diabetes require at least a split or mixed insulin regimen.

Complications
Hypoglycaemia, hyperglycaemia, increased risk of infections, microvascular retinopathy, nephropathy, neuropathic complications, Macrovascular disease. Diabetes is the major cause of blindness in adults aged 20-74 years. Diabetes is the leading cause of non traumatic lower-extremity amputation and ESRD.

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