13. Type 1 Diabetes Mellitus

  1. Charles G. D. Brook MA, MD, FRCP, FRCPCH1 and
  2. Mehul T. Dattani MD, FRCP, FRCPCH, DCH2,3

Published Online: 23 FEB 2012

DOI: 10.1002/9781119968153.ch13

Handbook of Clinical Pediatric Endocrinology, Second Edition

Handbook of Clinical Pediatric Endocrinology, Second Edition

How to Cite

Brook, C. G. D. and Dattani, M. T. (2012) Type 1 Diabetes Mellitus, in Handbook of Clinical Pediatric Endocrinology, Second Edition, Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119968153.ch13

Author Information

  1. 1

    University College London, London, UK

  2. 2

    Developmental Endocrinology Research Group, Clinical and Molecular Genetics Unit, UCL Institute of Child Health, UK

  3. 3

    Great Ormond Street Hospital for Children, London and University College London Hospitals, UK

Publication History

  1. Published Online: 23 FEB 2012
  2. Published Print: 13 APR 2012

ISBN Information

Print ISBN: 9780470657881

Online ISBN: 9781119968153

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Keywords:

  • classification of diabetes;
  • complications of diabetes;
  • definition of diabetes;
  • diabetes mellitus;
  • diabetic ketoacidosis;
  • diet;
  • distinguishing type 1 from type 2 diabetes;
  • exercise;
  • insulin pumps;
  • insulin therapy;
  • monitoring diabetic control;
  • side-effects of insulin;
  • transition to adult care;
  • type 1 diabetes;
  • type 2 diabetes

Summary

Type 1 diabetes is common. Understanding its pathology is easy but controlling it and preventing complications of diabetes starting in children is formidably difficult. This chapter aims to help. Distinguishing type 1 diabetes mellitus from type 2 diabetes mellitus can be challenging; the presence of autoantibodies and measurable concentrations of C-peptide can aid in the diagnosis. Children with type 1 diabetes mellitus should be treated by a team which includes an endocrinologist, a specialist nurse educator, and a mental health professional. Therapy must be individualized. Type 1 diabetes mellitus should be intensively treated to reduce the incidence and progression of long-term complications. Hypoglycemia is a serious barrier to “tight” control. Diabetic ketoacidosis is a preventable, potentially fatal complication of established diabetes which is most commonly due to omission of insulin or the administration of inadequate insulin during infection. Long-term micro- and macrovascular complications are inevitable but rare before puberty. Screening for them should start within 5 years of the onset of disease and countermeasures be introduced as early as possible.