Diabetes Chronic Illness Outline

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Type 1 diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood.

See also:

Gestational diabetes
Type 2 diabetes


Type 1 diabetes can occur at any age. However, it is most often diagnosed in children, adolescents, or young adults.

Insulin is a hormone produced by special cells, called beta cells, in the pancreas. The pancreas is found behind your stomach. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy. In type 1 diabetes, beta cells produce little or no insulin.

Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy. This leads to the symptoms of type 1 diabetes.

The exact cause of type 1 diabetes is unknown. Most likely it is an autoimmune disorder. An infection or some other trigger causes the body to mistakenly attack the cells in the pancreas that make insulin. This kind of disorder can be passed down through families.


These symptoms may be the first signs of type 1 diabetes, or may occur when the blood sugar is high:

Being very thirsty
Feeling hungry
Feeling tired or fatigued
Having blurry eyesight
Losing the feeling or feeling tingling in your feet
Losing weight without trying
Urinating more often

For other people, these warning symptoms may be the first signs of type 1 diabetes, or they may happen when the blood sugar is very high (see: diabetic ketoacidosis):

Deep, rapid breathing
Dry skin and mouth
Flushed face
Fruity breath odor
Nausea or vomiting, inability to keep down fluids
Stomach pain

Low blood sugar (hypoglycemia) can develop quickly in people with diabetes who are taking insulin. Symptoms usually appear when the blood sugar level falls below 70 mg/dL. Watch for:

Rapid heartbeat (palpitations)

Exams and Tests

Diabetes is diagnosed with the following blood tests:

Fasting blood glucose level -- diabetes is diagnosed if it is higher than 126 mg/dL two times Random (nonfasting) blood glucose level -- you may have diabetes if it is higher than 200 mg/dL, and you have symptoms such as increased thirst, urination, and fatigue (this must be confirmed with a fasting test) Oral glucose tolerance test -- diabetes is diagnosed if the glucose level is higher than 200 mg/dL after 2 hours Hemoglobin A1c test

Normal: Less than 5.7%
Pre-diabetes: Between 5.7% and 6.4%
Diabetes: 6.5% or higher

Ketone testing is also sometimes used. The ketone test is done using a urine sample or blood sample. Ketone testing may be done:

When the blood sugar is higher than 240 mg/dL
During an illness such as pneumonia, heart attack, or stroke When nausea or vomiting occur
During pregnancy

The following tests or exams will help you and your doctor monitor your diabetes and prevent problems caused by diabetes:

Check the skin and bones on your feet and legs.
Check to see if your feet are getting numb.
Have your blood pressure checked at least every year (blood pressure goal should be 130/80 mm/Hg or lower). Have your hemoglobin A1c test (HbA1c) done every 6 months if your diabetes is well controlled; otherwise, every 3 months. Have your cholesterol and triglyceride levels checked yearly (aim for LDL cholesterol levels below 70-100 mg/dL). Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine). Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease. See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.


Because type 1 diabetes can start quickly and the symptoms can be severe, people who have just been diagnosed may need to stay in the hospital.

If you have just been diagnosed with type 1 diabetes, you...
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