Type 1 Diabetes Mellitus

A large proportion of patients with insulin-dependent diabetes are diagnosed as suffering from this disease after being hospitalized for diabetic ketoacidosis. This medical emergency occurs when glucose can not be used as a source of energy for the body as fat and protein catabolism are producing excess ketones and fatty acids. This occurs in all patients with type 1 diabetes (and in some cases of type 2 diabetes) when blood glucose levels are extremely high.


For the diagnosis of diabetes are taken into account family history, clinical examination and tests that emphasize high levels of blood glucose.

-The measurement of glucose, usually on an empty stomach, but blood can be harvested at any time if the individual has not eaten

-Oral glucose tolerance test (TTOG) – drink a glucose solution and blood glucose measured 2 hours after ingestion.

Measuring the level of hemoglobin A1c, glycated hemoglobin (glucohemoglobina) is a common practice in diabetes. This test is recommended for proper monitoring of treatment in patients who do not often measure blood sugar levels at home. Hemoglibina-A1c is determined at 2-3 months from starting treatment and is assessed as blood glucose after initiation of therapy. {loadposition in_articol}

Both ambulatory determination of glucose and urine glucose screening is not recommended for screening or diagnosis of diabetes.

Early Diagnosis

Screening is recommended for children or adults whose parents, brothers and sisters have been diagnosed with type 1 diabetes. Although determination of anti-insular beta cells is a marker for type 1 diabetes, it is not recommended as a screening method.

Risk factors for type 1 diabetes are:

– Family history of type 1 diabetes mellitus increases the risk of cell antibodies but not the risk that the person to develop that type 1 diabetes. Only 10-15% of patients with type 1 diabetes have a family history:

-Risk is 6% if the father has insulin-dependent diabetes

-Where siblings have type 1 diabetes risk of disease is 5%

Parent with type 1 diabetes, the risk of diabetes for the the descendants is 2%

-In case of twins the risk is 30-50%

-Where a parent and a brother / sister insulin-dependent diabetes risk is 30%.

Viral infections during childhood – an enterovirus infection, especially infection coxackie B 6-fold increase risk of type 1 diabetes.

Consumption of cow’s milk:

Infants weaned before the age of 3 months or fed cow’s milk before the age of 4 months have significantly greater risk of making type 1 diabetes when associated with this genetic predisposition or other risk factors . Experts do not know the role of cow’s milk in the pathogenesis of type 1 diabetes mellitus.

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