Type 1 Diabetes Mellitus Essay
Type 1 diabetes mellitus is an autoimmune disease that results in insulin dependence due to failure of secretion of the hormone insulin by beta cells in the pancreas. Type 1 diabetes usually manifests in childhood, < 20 years of age – the reason for which it was formerly termed juvenile diabetes, and is more prevalent in Caucasians then in any other ethnicity (Diabetes Basics, n.d.). The key to proper management is early detection, patient education, and most importantly patient compliance.
The patient will commonly present with multiple symptoms, the most common are the 3 P’s – polyuria, polydipsia, and polyphagia. However, subjective symptoms may include reports of fatigue, abdominal pain, nocturnal enuresis, weight loss, changes in mood, and blurred vision. Objectively the signs will be hyperglycemia, confirmation of weight loss, abnormal lab values such as an elevated hemoglobin A1c (HbA1c) level, and abnormal urine results.
Upon assessment of a patient with, or suspected of, type 1 diabetes ask about recent infections, including yeast, and/or illnesses. Assess whether they have had injuries become more easily infected or take longer to heal. Also ask if they have had any changes in vision or sense of touch (Ignatavicius, 2012, p. 1418).
Diagnosis of Type 1 Diabetes in a child, or adolescent, is usually straightforward and generally requires little diagnostic testing. A good indication of diabetes is an abnormal, or hyperglycemic, blood glucose test: casual glucose test (anytime) ≥ 200mg/dl or fasting glucose test (8 hours after eating) ≥ 126 mg/dl. The HbA1c measures the glycated hemoglobin in the blood to identify the average plasma glucose concentration over a 2 – 3 month period, a result of 6.5% - average blood glucose of 139 mg/dl - or higher indicates diabetes (A1c calculator, n.d.). Glucose permanently binds to hemoglobin, therefore the higher the serum blood glucose the more glycosylated hemoglobin becomes, making the measurement of glycated hemoglobin a reliable – realistic, indicator of diabetes (Ignatavicius, 20120 p. 1420). Urine results for diabetics may also show high levels of glucose – usually negative in a non-diabetic, and ketones. The presence of ketones in the urine is very common in newly diagnosed diabetics; however, ketones may be a sign of diabetic ketoacidosis – an emergent situation.
Diabetic ketoacidosis (DKA), a form of metabolic acidosis, is a life threatening emergency that requires immediate medical intervention. DKA manifests when the body cannot use glucose for energy - generally due to absence of insulin, and uses fat in substitute. Ketones are the byproduct of fat breakdown and can build-up in the body, causing acidosis. The signs and symptoms of DKA are consistent hyperglycemia, thirst, confusion, ketones in the urine, nausea, and vomiting.
The etiology of Type 1 Diabetes is the destruction of the insulin secreting beta cells in the pancreas in a genetically susceptible person (Ignatavicius,...
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Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesn’t make enough—or any—insulin or doesn’t use insulin well. Glucose then stays in your blood and doesn’t reach your cells.
Over time, having too much glucose in your blood can cause health problems. Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy.
Sometimes people call diabetes “a touch of sugar” or “borderline diabetes.” These terms suggest that someone doesn’t really have diabetes or has a less serious case, but every case of diabetes is serious.
What are the different types of diabetes?
The most common types of diabetes are type 1, type 2, and gestational diabetes.
Type 1 diabetes
If you have type 1 diabetes, your body does not make insulin. Your immune system attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age. People with type 1 diabetes need to take insulin every day to stay alive.
Type 2 diabetes
If you have type 2 diabetes, your body does not make or use insulin well. You can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes occurs most often in middle-aged and older people. Type 2 is the most common type of diabetes.
Gestational diabetes develops in some women when they are pregnant. Most of the time, this type of diabetes goes away after the baby is born. However, if you’ve had gestational diabetes, you have a greater chance of developing type 2 diabetes later in life. Sometimes diabetes diagnosed during pregnancy is actually type 2 diabetes.
Other types of diabetes
Less common types include monogenic diabetes, which is an inherited form of diabetes, and cystic fibrosis-related diabetes.
How common is diabetes?
As of 2015, 30.3 million people in the United States, or 9.4 percent of the population, had diabetes. More than 1 in 4 of them didn’t know they had the disease. Diabetes affects 1 in 4 people over the age of 65. About 90-95 percent of cases in adults are type 2 diabetes.1
Who is more likely to develop type 2 diabetes?
You are more likely to develop type 2 diabetes if you are age 45 or older, have a family history of diabetes, or are overweight. Physical inactivity, race, and certain health problems such as high blood pressure also affect your chance of developing type 2 diabetes. You are also more likely to develop type 2 diabetes if you have prediabetes or had gestational diabetes when you were pregnant. Learn more about risk factors for type 2 diabetes.
What health problems can people with diabetes develop?
Over time, high blood glucose leads to problems such as
- heart disease
- kidney disease
- eye problems
- dental disease
- nerve damage
- foot problems
You can take steps to lower your chances of developing these diabetes-related health problems.
 Centers for Disease Control and Prevention. National diabetes statistics report, 2017. Centers for Disease Control and Prevention website. www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf(PDF, 1.3 MB). Updated July, 18 2017. Accessed August 1, 2017.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.