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Diabetes mellitus, insulin-dependent, 23(IDDM23)

MedGen UID:
382610
Concept ID:
C2675472
Disease or Syndrome
Synonyms: IDDM23
 
OMIM®: 612622

Definition

Type 1 diabetes is a disorder characterized by abnormally high blood sugar levels. In this form of diabetes, specialized cells in the pancreas called beta cells stop producing insulin. Insulin controls how much glucose (a type of sugar) is passed from the blood into cells for conversion to energy. Lack of insulin results in the inability to use glucose for energy or to control the amount of sugar in the blood.Type 1 diabetes can occur at any age; however, it usually develops by early adulthood, most often starting in adolescence. The first signs and symptoms of the disorder are caused by high blood sugar and may include frequent urination (polyuria), excessive thirst (polydipsia), fatigue, blurred vision, tingling or loss of feeling in the hands and feet, and weight loss. These symptoms may recur during the course of the disorder if blood sugar is not well controlled by insulin replacement therapy. Improper control can also cause blood sugar levels to become too low (hypoglycemia). This may occur when the body's needs change, such as during exercise or if eating is delayed. Hypoglycemia can cause headache, dizziness, hunger, shaking, sweating, weakness, and agitation.Uncontrolled type 1 diabetes can lead to a life-threatening complication called diabetic ketoacidosis. Without insulin, cells cannot take in glucose. A lack of glucose in cells prompts the liver to try to compensate by releasing more glucose into the blood, and blood sugar can become extremely high. The cells, unable to use the glucose in the blood for energy, respond by using fats instead. Breaking down fats to obtain energy produces waste products called ketones, which can build up to toxic levels in people with type 1 diabetes, resulting in diabetic ketoacidosis. Affected individuals may begin breathing rapidly; develop a fruity odor in the breath; and experience nausea, vomiting, facial flushing, stomach pain, and dryness of the mouth (xerostomia). In severe cases, diabetic ketoacidosis can lead to coma and death.Over many years, the chronic high blood sugar associated with diabetes may cause damage to blood vessels and nerves, leading to complications affecting many organs and tissues. The retina, which is the light-sensitive tissue at the back of the eye, can be damaged (diabetic retinopathy), leading to vision loss and eventual blindness. Kidney damage (diabetic nephropathy) may also occur and can lead to kidney failure and end-stage renal disease (ESRD). Pain, tingling, and loss of normal sensation (diabetic neuropathy) often occur, especially in the feet. Impaired circulation and absence of the normal sensations that prompt reaction to injury can result in permanent damage to the feet; in severe cases, the damage can lead to amputation. People with type 1 diabetes are also at increased risk of heart attacks, strokes, and problems with urinary and sexual function.
[from GHR]

Recent clinical studies

Etiology

Qin C, Vaca E, Lovecchio F, Ver Halen JP, Hansen NM, Kim JY
Breast Cancer Res Treat 2014 Jul;146(2):429-38. Epub 2014 Jun 25 doi: 10.1007/s10549-014-3024-5. PMID: 24961932
Zuern CS, Rizas K, Eick C, Sterz K, Gawaz M, Bauer A
J Electrocardiol 2012 Nov-Dec;45(6):774-9. Epub 2012 Aug 31 doi: 10.1016/j.jelectrocard.2012.07.010. PMID: 22944520
Snel M, Gastaldelli A, Ouwens DM, Hesselink MK, Schaart G, Buzzigoli E, Frölich M, Romijn JA, Pijl H, Meinders AE, Jazet IM
J Clin Endocrinol Metab 2012 Jul;97(7):2512-20. Epub 2012 May 8 doi: 10.1210/jc.2011-3178. PMID: 22569236
Pfützner J, Hellhammer J, Musholt P, Pfützner AH, Böhnke J, Torsten H, Amann-Zalan I, Ganz M, Forst T, Pfützner A
J Diabetes Sci Technol 2011 Jan 1;5(1):158-65. doi: 10.1177/193229681100500122. PMID: 21303639Free PMC Article
Danne T, Battelino T, Kordonouri O, Hanas R, Klinkert C, Ludvigsson J, Barrio R, Aebi C, Gschwend S, Mullis PE, Schumacher U, Zumsteg U, Morandi A, Rabbone I, Cherubini V, Toni S, de Beaufort C, Hindmarsh P, Sumner A, van Waarde WM, van den Berg N, Phillip M
Pediatr Diabetes 2005 Dec;6(4):193-8. doi: 10.1111/j.1399-543X.2005.00131.x. PMID: 16390387

Diagnosis

Snel M, Gastaldelli A, Ouwens DM, Hesselink MK, Schaart G, Buzzigoli E, Frölich M, Romijn JA, Pijl H, Meinders AE, Jazet IM
J Clin Endocrinol Metab 2012 Jul;97(7):2512-20. Epub 2012 May 8 doi: 10.1210/jc.2011-3178. PMID: 22569236
Cho W, Lenke LG, Bridwell KH, Dorward IG, Shoda N, Baldus CR, Cho SK, Kang MM, Zebala LP, Pahys JM, Koester LA
Spine (Phila Pa 1976) 2012 Jul 15;37(16):E978-84. doi: 10.1097/BRS.0b013e31824edf42. PMID: 22343274
Lee SS, Han HS, Kim H
Pediatr Diabetes 2010 Dec;11(8):521-8. Epub 2010 Aug 15 doi: 10.1111/j.1399-5448.2009.00636.x. PMID: 20723100
Muroi R, Yagyu H, Kobayashi H, Nagata M, Sato N, Ideno J, Fujita N, Ando A, Okada K, Takiyama Y, Nagasaka S, Miyajima H, Nakano I, Ishibashi S
Diabet Med 2006 Oct;23(10):1136-9. doi: 10.1111/j.1464-5491.2006.01883.x. PMID: 16978380
Kanungo A, Shtauvere-Brameus A, Samal KC, Sanjeevi CB
Ann N Y Acad Sci 2002 Apr;958:232-4. PMID: 12021113

Therapy

Christensen M, Calanna S, Sparre-Ulrich AH, Kristensen PL, Rosenkilde MM, Faber J, Purrello F, van Hall G, Holst JJ, Vilsbøll T, Knop FK
Diabetes 2015 Jan;64(1):72-8. Epub 2014 Jul 22 doi: 10.2337/db14-0440. PMID: 25053587
Snel M, Gastaldelli A, Ouwens DM, Hesselink MK, Schaart G, Buzzigoli E, Frölich M, Romijn JA, Pijl H, Meinders AE, Jazet IM
J Clin Endocrinol Metab 2012 Jul;97(7):2512-20. Epub 2012 May 8 doi: 10.1210/jc.2011-3178. PMID: 22569236
Pfützner J, Hellhammer J, Musholt P, Pfützner AH, Böhnke J, Torsten H, Amann-Zalan I, Ganz M, Forst T, Pfützner A
J Diabetes Sci Technol 2011 Jan 1;5(1):158-65. doi: 10.1177/193229681100500122. PMID: 21303639Free PMC Article
Muroi R, Yagyu H, Kobayashi H, Nagata M, Sato N, Ideno J, Fujita N, Ando A, Okada K, Takiyama Y, Nagasaka S, Miyajima H, Nakano I, Ishibashi S
Diabet Med 2006 Oct;23(10):1136-9. doi: 10.1111/j.1464-5491.2006.01883.x. PMID: 16978380
Danne T, Battelino T, Kordonouri O, Hanas R, Klinkert C, Ludvigsson J, Barrio R, Aebi C, Gschwend S, Mullis PE, Schumacher U, Zumsteg U, Morandi A, Rabbone I, Cherubini V, Toni S, de Beaufort C, Hindmarsh P, Sumner A, van Waarde WM, van den Berg N, Phillip M
Pediatr Diabetes 2005 Dec;6(4):193-8. doi: 10.1111/j.1399-543X.2005.00131.x. PMID: 16390387

Prognosis

Zuern CS, Rizas K, Eick C, Sterz K, Gawaz M, Bauer A
J Electrocardiol 2012 Nov-Dec;45(6):774-9. Epub 2012 Aug 31 doi: 10.1016/j.jelectrocard.2012.07.010. PMID: 22944520
Lee SS, Han HS, Kim H
Pediatr Diabetes 2010 Dec;11(8):521-8. Epub 2010 Aug 15 doi: 10.1111/j.1399-5448.2009.00636.x. PMID: 20723100
Socci C, Orsenigo E, Santagostino I, Caumo A, Caldara R, Parolini D, Aldrighetti L, Castoldi R, Frasson M, Carvello M, Ghirardelli L, Secchi A, Di Carlo V, Staudacher C
Transplant Proc 2010 Jul-Aug;42(6):2068-70. doi: 10.1016/j.transproceed.2010.05.120. PMID: 20692410
Halimi JM, Bonnet F, Lange C, Balkau B, Tichet J, Marre M; DESIR Study Group.
J Hypertens 2008 Nov;26(11):2198-206. doi: 10.1097/HJH.0b013e328310ddff. PMID: 18854761
Kumbhani DJ, Healey NA, Thatte HS, Nawas S, Crittenden MD, Birjiniuk V, Treanor PR, Khuri SF
J Thorac Cardiovasc Surg 2007 Jun;133(6):1566-72. doi: 10.1016/j.jtcvs.2006.11.047. PMID: 17532958

Clinical prediction guides

Zuern CS, Rizas K, Eick C, Sterz K, Gawaz M, Bauer A
J Electrocardiol 2012 Nov-Dec;45(6):774-9. Epub 2012 Aug 31 doi: 10.1016/j.jelectrocard.2012.07.010. PMID: 22944520
Cho W, Lenke LG, Bridwell KH, Dorward IG, Shoda N, Baldus CR, Cho SK, Kang MM, Zebala LP, Pahys JM, Koester LA
Spine (Phila Pa 1976) 2012 Jul 15;37(16):E978-84. doi: 10.1097/BRS.0b013e31824edf42. PMID: 22343274
Halimi JM, Bonnet F, Lange C, Balkau B, Tichet J, Marre M; DESIR Study Group.
J Hypertens 2008 Nov;26(11):2198-206. doi: 10.1097/HJH.0b013e328310ddff. PMID: 18854761
Ashwell SG, Bradley C, Stephens JW, Witthaus E, Home PD
Diabetes Care 2008 Jun;31(6):1112-7. Epub 2008 Mar 13 doi: 10.2337/dc07-1183. PMID: 18339977
Wiesinger GF, Pleiner J, Quittan M, Fuchsjäger-Mayrl G, Crevenna R, Nuhr MJ, Francesconi C, Seit HP, Francesconi M, Fialka-Moser V, Wolzt M
Wien Klin Wochenschr 2001 Sep 17;113(17-18):670-5. PMID: 11603101

Recent systematic reviews

Morgan E, Halliday SR, Campbell GR, Cardwell CR, Patterson CC
Diabetologia 2016 Feb;59(2):237-43. Epub 2015 Nov 12 doi: 10.1007/s00125-015-3800-8. PMID: 26564178Free PMC Article
Quirk H, Blake H, Tennyson R, Randell TL, Glazebrook C
Diabet Med 2014 Oct;31(10):1163-73. doi: 10.1111/dme.12531. PMID: 24965376Free PMC Article
Fullerton B, Jeitler K, Seitz M, Horvath K, Berghold A, Siebenhofer A
Cochrane Database Syst Rev 2014 Feb 14;(2):CD009122. doi: 10.1002/14651858.CD009122.pub2. PMID: 24526393
Dehwah MA, Wang M, Huang QY
Genet Mol Res 2010 Jun 15;9(2):1109-20. doi: 10.4238/vol9-2gmr802. PMID: 20568056
Cardwell CR, Stene LC, Joner G, Cinek O, Svensson J, Goldacre MJ, Parslow RC, Pozzilli P, Brigis G, Stoyanov D, Urbonaite B, Sipetić S, Schober E, Ionescu-Tirgoviste C, Devoti G, de Beaufort CE, Buschard K, Patterson CC
Diabetologia 2008 May;51(5):726-35. Epub 2008 Feb 22 doi: 10.1007/s00125-008-0941-z. PMID: 18292986

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