Type 1 Diabetes mellitus is a metabolic disorder characterized by persistent hyperglycaemia (random plasma glucose more than 11 mmol) with disturbances of carbohydrate, protein, and fat metabolism resulting from defects in insulin secretion, insulin action, or both.
Causes
Absolute insulin deficiency resulting from autoimmune destruction of the insulin - producing beta cells in the pancreas
Complications
Microvascular complications
Retinopathy
Nephropathy
Neuropathy
Macrovascular complications
Myocardial infarction
Stroke
Peripheral arterial disease
Metabolic complications
Diabetic ketoacidosis (DKA)
Hypoglycaemia
Psychological complications
Increased risk of developing other autoimmune conditions
Thyroid disease
Coeliac disease
Addison's disease
Pernicious anaemia
Reduced quality of life and life expectancy
Clinical signs
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Personal or family history of autoimmune disease
Body mass index (BMI) below 25kg/m2 (although type 1 diabetes should not be discounted if the person presents with a BMI of 25kg/m2 or above).
Hyperglycaemia
Age of onset younger than 50 years (Although should not be excluded if patient is over 50)
Rapid weight loss
Ketosis
Management in primary care
Referral to diabetes specialist team
Education for pt and family/carer
Lifestyle
Insulin treatment
Managing hypoglycaemia
'Sick day rules'
Identifying and managing acute complications of diabetes such as DKA
Minimizing the risk of long-term complications
Cardiovascular disease
Psychological disorders
Retinopathy
Neuropathy
Nephropathy
HbA1C