Type 1 diabetes mellitus

摘要

Type 1 diabetes mellitus (T1DM) is a chronic, lifelong disorder of glucose homeostasis characterized by autoimmune destruction of the insulin-producing pancreatic b-cell, leading progressively to insulin deficiency and resultant hyperglycemia. New-onset T1DM can present with the classic findings of polyuria, polydipsia, polyphagia, and weight loss; as diabetic ketoacidosis (DKA), with vomiting, abdominal pain, and lethargy in addition to the classic symptoms; or as an incidental finding discovered on urine or blood testing performed for other reasons. DKA is a life-threatening acute complication of T1DM that requires close monitoring for comorbidities, especially cerebral edema. Treatment focuses on rehydration and insulin replacement. Because T1DM is a chronic illness, the best possible management is achieved when patients and their families attain ownership of their condition as part of a continuing, empowering relationship with their diabetes care team. Optimal health and wellness is achieved when blood glucose is controlled tightly. Intensive control significantly decreases the likelihood of developing the microvascular and macrovascular complications of T1DM.