Type 1 Diabetes mellitus

DESCRIPTION

Type 1 diabetes mellitus, previously known as juvenile onset diabetes mellitus and as insulin-dependent diabetes mellitus (IDDM), occurs because of a lack of insulin. The result is an increase in blood glucose concentration.

CLINICAL PRESENTATION

  • hunger
  • thirst
  • polyuria
  • unexplained weight loss
  • ketoacidosis
  • tiredness

DIAGNOSIS

Type 1 diabetes mellitus is diagnosed when the classic symptoms of polyuria and polydipsia are associated with hyperglycaemia:

  • Random blood glucose ≥ 11.1 mmol/L
  • Random is defined as any time of day without regard to time since last meal

OR

  • Fasting blood glucose ≥ 7.0 mmol/L
  • Fasting is defined as no caloric intake for ≥8 hours

OR

  • 2-hour plasma glucose in a 75 g oral glucose tolerance test ≥ 11.1 mmol/l.

LoE:III[1]

GENERAL MEASURES

  • Education regarding diabetes and its complications.
  • Even and regular meal consumption.
  • Dietary emphasis should be on regulating carbohydrate, fibre and fat intake (See: Type 2 Diabetes mellitus, in adults for recommended diet plan).
  • Increased physical activity: aim for 30 minutes 5 times a week.
  • Appropriate weight loss if body mass index > 25 kg/m2.
  • Education about foot care.
  • Monitor for development of depression.
  • All patients should wear a notification bracelet.

REFERRAL

All patients.