What is type I diabetes?
Type I diabetes is a medical condition characterized by autoimmune destruction of beta islets cells in the pancreas, resulting in impaired insulin production and hyperglycemia. Patients often present for the first time to the emergency department with diabetic ketoacidosis – this potentially fatal condition is characterized by metabolic acidosis, ketoacids in the serum and urine, severe dehydration, cardiovascular instability, and respiratory distress. If left untreated, patients will typically die.
Type I diabetes is very difficult to control and typically requires the help of an Endocrinology specialist. Chronically poorly controlled diabetes is a leading cause of cardiovascular, kidney disease, …show more content…
Symptoms of type I diabetes often include:
• Excessive thirst & drinking – polydipsia
• Frequent urination - polyuria
• Increased appetite & food intake - polyphagia
The excessive hunger and appetite are a consequence of the fact that the body is in a state of starvation – even though glucose levels are elevated, the body cannot use it for energy. Frequent urination occur because of excessive spillage of glucose, sodium, and water into the urinary tract. This also is the cause of increased thirst and desire to drink. As opposed to type II diabetes, patients with type I diabetes are frequently thin or skinny – type II diabetics are generally overweight or obese.
Patients with diabetic ketoacidosis are typically very ill and often present acutely with:
• Confusion
• Respiratory distress
• Abdominal pain
• Nausea & …show more content…
If left untreated, diabetic ketoacidosis may lead to death.
Long-term complications of type I diabetes include:
• Cardiovascular disease – myocardial infarction (heart attack), coronary artery disease, heart failure, peripheral vascular disease
• Foot ulcers and infection
• Neurologic disease – stroke, peripheral neuropathy
• Renal disease – chronic kidney disease, diabetic nephropathy
• Gastrointestinal disease – gastroparesis, fatty liver disease
• Eye disease – retinopathy, glaucoma, blindness
• Death
How is type I diabetes diagnosed?
The diagnosis of type I diabetes is suggested based on symptoms and physical examination, but typically confirmed with laboratory studies. The diagnostic guidelines for type I diabetes are similar to type II diabetes and based on fasting glucose, random glucose, and hemoglobin A1C levels:
• Fasting plasma glucose ≥126 mg/dL on 2 occasions
• Plasma glucose ≥200 mg/dL with hyperglycemia symptoms
• Positive oral glucose tolerance test - plasma glucose ≥200 mg/dL 2 hours after a standard glucose load
• Hemoglobin A1C