View source for Diabetes mellitus type 1

===Definition===
A chronic condition, caused by death of the [[insulin]] producing cells in the islets of langerhans. The commonest side effect of this is high [[blood]] sugar.

===Epidemiology===
Around 7% of all [[diabetes]] sufferers have type 1. In the general population, about 0.4% of people have it. It generally presents in the teenage years, often around the age of 13.

===Pathophysiology===
Like nearly all the well known diseases, we don't really know what is going on. The general consensus is that the beta cells in the Islet of Langerhans (in the [[pancreas]]) are attacked by autoimmune processes.

There have been some links made with cow's milk. It can also be caused by [[viral]] attack, pancreatic problems and chemotherapy.

===Risk Factors===
*Family History
*Not being breast fed
*Other [[endocrine]] disorders
*[[Coeliac disease]]

===Clinical Features===
*Excessive urination (polyuria)
*Excessive thirst (polydipsia)
*[[Weight loss]]
*[[Coma]]
*[[Diabetic ketoacidosis]] (worth reading about, especially in [[Paediatrics|paeds]])

===Investigations===
You do two fasting glucose tests. If, on two occasions, they have a blood sugar over 7mmol/l, they have diabetes.
If they present with [[diabetic ketoacidosis|ketoacidosis]], you do a fair few [[blood]] and urine tests.

===Management===
There are 4 main areas of treatment:
#'''Insulin''' - you will need to inject this in order to keep blood sugar in check.
#'''Diet''' - eating sensibly is important, or at least, being aware of when and what you've eaten is important.
#'''Exercise''' - exercise uses blood sugar, so this has to be taken into account with swimming and eating.
#'''Blood sugar monitoring''' - both short term, to prevent [[hyperglycaemia]] and [[hypoglycaemia]], and long them HbA1c, to ensure that long term control is good.

===Prognosis===