Type 1 Diabetes Mellitus Questions & Answers

Updated: Oct 08, 2021
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
  • Print
Questions & Answers

Overview

When is screening indicated for type 1 diabetes mellitus (DM)?

What is type 1 diabetes mellitus (DM)?

What are the classic symptoms of type 1 diabetes mellitus (DM)?

What are non-classic symptoms of type 1 diabetes mellitus (DM)?

How might type 1 diabetes mellitus (DM) initially present?

What are the ADA diagnostic criteria for type 1 diabetes mellitus (DM)?

Which lab tests are performed in the diagnosis of type 1 diabetes mellitus (DM)?

How are glycemic goals established for type 1 diabetes mellitus (DM)?

How are blood glucose levels monitored in type 1 diabetes mellitus (DM)?

When is insulin therapy indicated for type 1 diabetes mellitus (DM)?

What are common insulin regimens used for the treatment of type 1 diabetes mellitus (DM)?

What is the role of diet in the treatment of type 1 diabetes mellitus (DM)?

What is the role of exercise in the treatment of type 1 diabetes mellitus (DM)?

What is type 1 diabetes mellitus (DM)?

Which age groups are at highest risk for type 1 diabetes mellitus (DM)?

How are type 1 and type 2 diabetes mellitus (DM) differentiated?

What is the approach to treatment of type 1 diabetes mellitus (DM)?

What is the medical cost of type 1 diabetes mellitus (DM) in the US?

What is the pathophysiology of type 1 diabetes mellitus (DM)?

What is the role of autoimmunity in the pathogenesis of type 1 diabetes mellitus (DM)?

Which autoimmune diseases are associated with type 1 diabetes mellitus (DM)?

What is the role of pancreatic volume in the pathogenesis of type 1 diabetes mellitus (DM)?

What are the genetic determinants of type 1 diabetes mellitus (DM)?

What is the cause of sensory and autonomic neuropathy in type 1 diabetes mellitus (DM)?

What is the association between microvascular disease and type 1 diabetes mellitus (DM)?

What is the source of renal lesions in type 1 diabetes mellitus (DM)?

What is the significance of vitamin D deficiency in type 1 diabetes mellitus (DM)?

What is the pathogenesis of nephropathy in type 1 diabetes mellitus (DM)?

What is double diabetes?

What is the significance of low estimated glucose disposal rate (eGDR) in type 1 diabetes mellitus (DM)?

What causes type 1 diabetes mellitus (DM)?

What is the sibling risk for type 1 diabetes mellitus (DM)?

What is the parent-to-child risk for type 1 diabetes mellitus (DM)?

How does the frequency of type 1 diabetes mellitus (DM) vary geographically?

Which DR-DQ haplotypes increase the risk for type 1 diabetes mellitus (DM)?

Which DR-DQ haplotypes decrease the risk for type 1 diabetes mellitus (DM)?

Which DR-DQ haplotypes confers the highest risk for type 1 diabetes mellitus (DM)?

Which ethnic groups carry high risk DR-DQ haplotypes for type 1 diabetes mellitus (DM)?

Which genes are associated with susceptibility to type 1 diabetes mellitus (DM)?

What are the nongenetic risk factors for type 1 diabetes mellitus (DM)?

What is the relationship between maternal age and the susceptibility to type 1 diabetes mellitus (DM)?

What is the association between vitamin D and type 1 diabetes mellitus (DM)?

What is the association between upper respiratory infection and type 1 diabetes mellitus (DM), and is coronavirus disease 2019 (COVID-19) related to new-onset type 1 and type 2 diabetes mellitus?

What is the prevalence and incidence of type 1 diabetes mellitus (DM) in the US?

What is the global prevalence of type 1 diabetes mellitus (DM)?

How does the incidence of type 1 diabetes mellitus (DM) vary by age?

How does the prevalence of type 1 diabetes mellitus (DM) vary by sex?

How does the prevalence of type 1 diabetes mellitus (DM) vary by race?

What are the morbidities of type 1 diabetes mellitus (DM)?

What factors affect the long-term prognosis of type 1 diabetes mellitus (DM)?

What are complications of type 1 diabetes mellitus (DM)?

How does coronary vasodilator dysfunction affect the prognosis of type 1 diabetes mellitus (DM), and how does diabetes affect mortality in coronavirus disease 2019 (COVID-19)?

What is the association between type 1 diabetes mellitus (DM) and small-fiber neuropathy?

What are the mortality differences between early-onset and late-onset type 1 diabetes mellitus (DM)?

Which factors are indicators of poorer prognosis in type 1 diabetes mellitus (DM)?

What is the role of patient education in the management of type 1 diabetes mellitus (DM)?

What education about type 1 diabetes mellitus (DM) should patients be given at every clinical visit?

What are the ADA recommendations for patient education of older adolescents with type 1 diabetes mellitus (DM)?

What is key information to include in patient education about type 1 diabetes mellitus (DM)?

What education should dietitians give patients with type 1 diabetes mellitus (DM)?

Presentation

What are the most common symptoms of type 1 diabetes mellitus (DM)?

What causes polyuria in type 1 diabetes mellitus (DM)?

What causes symptoms of type 1 diabetes mellitus (DM)?

How soon after beta-cell destruction do patients with type 1 diabetes mellitus (DM) become symptomatic?

How is the onset of symptomatic type 1 diabetes mellitus (DM) characterized?

What are the signs and symptoms of type 1 diabetes mellitus (DM)?

What are the GI symptoms of type 1 diabetes mellitus (DM)?

What is frequency of neuropathy in type 1 diabetes mellitus (DM)?

What is the focus of medical history of a patient with type 1 diabetes mellitus (DM)?

What history is needed in patients with type 1 diabetes mellitus (DM) who use a pump or a multiple-injection regimen?

What information should be included in a type 1 diabetes mellitus (DM) history?

How is glycemic exposure in established type 1 diabetes mellitus (DM) assessed?

Which questions regarding hypoglycemia and hyperglycemia symptoms should be asked of patients with type 1 diabetes mellitus (DM)?

Which questions regarding microvascular complications should be asked of patients with type 1 diabetes mellitus (DM)?

Which questions regarding macrovascular complications should be asked of patients with type 1 diabetes mellitus (DM)?

Which questions regarding neuropathy should be asked of patients with type 1 diabetes mellitus (DM)?

Which questions regarding foot disease should be asked of patients with type 1 diabetes mellitus (DM)?

What are the physical findings characteristic of new-onset type 1 diabetes mellitus (DM)?

How often should patients with type 1 diabetes mellitus (DM) be examined?

What is included in a diabetes-focused physical exam?

How are the vital signs assessed in type 1 diabetes mellitus (DM)?

What is included in the funduscopic exam for type 1 diabetes mellitus (DM)?

What is included in the foot exam for type 1 diabetes mellitus (DM)?

Which factors increase the risk of infection in type 1 diabetes mellitus (DM)?

What are the most common sites of infection in type 1 diabetes mellitus (DM)?

Which infections occur almost exclusively in type 1 diabetes mellitus (DM), and what is the relationship of coronavirus disease 2019 (COVID-19) to diabetes?

What are ophthalmologic complications of type 1 diabetes mellitus (DM)?

What is diabetic retinopathy?

What are the stages in the progression of diabetic retinopathy?

How does diabetic retinopathy progress in stage 1 and 2?

How does diabetic retinopathy progress in stages 3, 4 and 5?

What are renal complications of type 1 diabetes mellitus (DM)?

What are the types of diabetic neuropathy?

What is the most common type of diabetic neuropathy?

What are acute-onset mononeuropathies of type 1 diabetes mellitus (DM)?

What are cranial nerve complications of type 1 diabetes mellitus (DM)?

What are macrovascular complications of type 1 diabetes mellitus (DM)?

What are the risk factors for macrovascular disease in type 1 diabetes mellitus (DM)?

DDX

Which conditions and factors should be considered in the differential diagnosis of type 1 diabetes mellitus (DM)?

How are type 1 and type 2 diabetes mellitus (DM) differentiated?

How is monogenic diabetes differentiated from type 1 diabetes mellitus (DM)?

What are the differential diagnoses for Type 1 Diabetes Mellitus?

Workup

What is the role of HbA1c measurement in the diagnosis of type 1 diabetes mellitus (DM)?

What is the role of plasma glucose concentration in the diagnosis of type 1 diabetes mellitus (DM)?

What is the role of fingerstick glucose test in the diagnosis of type 1 diabetes mellitus (DM)?

How are glucose levels determined in the diagnosis of type 1 diabetes mellitus (DM)?

What are the ADA recommendations for the measurement of HbA1c in type 1 diabetes mellitus (DM)?

What are limitations of HbA1c levels in the diagnosis of type 1 diabetes mellitus (DM)?

What is an HbA1c assay indicated in the diagnosis of type 1 diabetes mellitus (DM)?

What are the advantages of HbA1c testing over glucose measurement for the diagnosis of type 1 diabetes mellitus (DM)?

What is the HbA1c criterion for diagnosis of type 1 diabetes mellitus (DM)?

What effect does seasonal variability have on HbA1c levels used for diagnosis of type 1 diabetes mellitus (DM)?

What is the role of HbF in the diagnosis of type 1 diabetes mellitus (DM), and what are the concerns regarding the accuracy of HbA1c testing?

What are the ADS guidelines for use of HbA1c in the management of type 1 diabetes mellitus (DM)?

What is the role of fructosamine assay in the diagnosis of type 1 diabetes mellitus (DM)?

What is the role of WBC count and blood and urine cultures in the diagnosis of type 1 diabetes mellitus (DM)?

How is diabetic ketoacidosis (DKA) diagnosed?

Who should be screened for type 1 diabetes mellitus (DM)?

What are the AACE recommendations for distinguishing between type 1 and type 2 diabetes mellitus (DM)?

What are some classical symptoms of type 1 diabetes mellitus (DM)?

What is the role of islet-cell (IA2) levels in the diagnosis of type 1 diabetes mellitus (DM), and what is the ADA/EASD algorithm for the diagnosis of type 1 DM?

Treatment

What is included in insulin therapy for type 1 diabetes mellitus (DM)?

When is little or no insulin therapy needed for type 1 diabetes mellitus (DM)?

What is the approach for treatment of new-onset type 1 diabetes mellitus (DM)?

What are the American Disease Association (ADA) treatment guidelines for type 1 diabetes mellitus (DM)?

What is the role of exogenous glucagonlike peptide 1 (GLP-1) in the treatment of type 1 diabetes mellitus (DM)?

When is pancreatic transplantation indicated for the treatment of type 1 diabetes mellitus (DM)?

What health risks are decreased with tight glycemic control in type 1 diabetes mellitus (DM)?

What are the benefits to tight glycemic control in type 1 diabetes mellitus (DM)?

How are HbA1c target levels determined in the treatment of type 1 diabetes mellitus (DM)?

Which health risks increase with tight glycemic control of type 1 diabetes mellitus (DM)?

What is the role of self-monitoring in the management of type 1 diabetes mellitus (DM)?

How frequently should plasma glucose be monitored in type 1 diabetes mellitus (DM)?

When is urine ketone testing indicated in type 1 diabetes mellitus (DM)?

What is the role of continuous glucose monitors (CGMs) in the treatment of type 1 diabetes mellitus (DM)?

What are the limitations of continuous glucose monitors (CGMs) for the treatment of type 1 diabetes mellitus (DM)?

What is the benefit of continuous glucose monitors (CGMs) for the treatment of type 1 diabetes mellitus (DM)?

When is the intermittent use of a continuous glucose monitor (CGM) indicated in the treatment of type 1 diabetes mellitus (DM)?

Which continuous glucose monitor (CGM) is the most accurate for type 1 diabetes mellitus (DM)?

What is the sensor-augmented insulin pump system for type 1 diabetes mellitus (DM)?

Which continuous glucose monitors (CGMs) have been FDA approved for the management of type 1 diabetes mellitus (DM), and what is a flash glucose monitoring system?

What is the role of artificial pancreases in the treatment of type 1 diabetes mellitus (DM)?

What types of insulin preparations are used in the treatment of type 1 diabetes mellitus (DM)?

What is the role of rapid-acting insulins in the treatment of type 1 diabetes mellitus (DM)?

What is the efficacy of rapid-acting inhaled insulin powder (Afrezza) in the treatment of type 1 diabetes mellitus (DM)?

What is the role of short-acting insulins in the treatment of type 1 diabetes mellitus (DM)?

Which type of insulin is the most effective for lowering postprandial hyperglycemia in type 1 diabetes mellitus (DM)?

What is the role of aspart (Fiasp) in the treatment of type 1 diabetes mellitus (DM)?

What is the role of Semilente insulin in the treatment of type 1 diabetes mellitus (DM)?

Which intermediate-acting insulins are used for the treatment of type 1 diabetes mellitus (DM)?

What is the role of lente insulin in the treatment of type 1 diabetes mellitus (DM)?

Which long-acting insulins are used for the treatment of type 1 diabetes mellitus (DM)?

What is the role of degludec (Tresiba) in the treatment of type 1 diabetes mellitus (DM)?

How are insulins mixed in the treatment of type 1 diabetes mellitus (DM)?

What is the role of ultrafast-acting insulin in the treatment of type 1 diabetes mellitus (DM)?

What is the evidence of increased cancer risk from insulin glargine (Lantus) treatment of type 1 diabetes mellitus (DM)?

How is insulin administered for the treatment of type 1 diabetes mellitus (DM)?

What are some common insulin regimens for the treatment of type 1 diabetes mellitus (DM)?

How quickly does insulin used for the treatment of type 1 diabetes mellitus (DM) expire?

How is the initial daily insulin dose calculated for type 1 diabetes mellitus (DM)?

How is the initial daily insulin dose calculated for children with type 1 diabetes mellitus (DM)?

What are the risks and benefits of administering multiple subcutaneous insulin injections for type 1 diabetes mellitus (DM)?

Which types of insulin are administered for the treatment of type 1 diabetes mellitus (DM)?

How should daily doses of insulin be adjusted in the treatment of type 1 diabetes mellitus (DM)?

How are small battery-operated infusion pumps used in the treatment of type 1 diabetes mellitus (DM)?

What is the role of continuous subcutaneous insulin infusion (CSII) in the treatment of type 1 diabetes mellitus (DM)?

What are the benefits of pump therapy for the treatment of type 1 diabetes mellitus (DM)?

How can early morning hyperglycemia be prevented in type 1 diabetes mellitus (DM)?

How do altitude changes affect insulin pump delivery in the treatment of type 1 diabetes mellitus (DM)?

What are the AACE/ACE guidelines for insulin pump management in type 1 diabetes mellitus (DM)?

Which are the signs and symptoms of insulin allergy?

What are the causes of hypoglycemia in type 1 diabetes mellitus (DM)?

What are symptoms of hypoglycemia in type 1 diabetes mellitus (DM)?

What are the health risks of repeated hypoglycemia in type 1 diabetes mellitus (DM)?

What is the evidence of cognitive impairment as a result of hypoglycemia in type 1 diabetes mellitus (DM)?

What are the risks of hyperglycemia in type 1 diabetes mellitus (DM)?

What is the treatment for hyperglycemia in type 1 diabetes mellitus (DM)?

What is the importance of follow-up following treatment of hyperglycemia in type 1 diabetes mellitus (DM)?

Which type 1 diabetes mellitus (DM) comorbidities may aggravate hyperglycemia?

What is diabetic ketoacidosis (DKA)?

What is the dawn phenomenon in type 1 diabetes mellitus (DM)?

What is the Somogyi phenomenon in type 1 diabetes mellitus (DM)?

How are the dawn and Somogyi phenomena in type 1 diabetes mellitus (DM) managed?

What is the role of insulin in the treatment of hyperglycemia in type 1 diabetes mellitus (DM)?

What is the ADA recommendation for dietary treatment of type 1 diabetes mellitus (DM)?

What is included in the diet management plan for type 1 diabetes mellitus (DM)?

What is the recommended caloric distribution for management of type 1 diabetes mellitus (DM)?

What are the recommended food group intakes for patients with type 1 diabetes mellitus (DM)?

What are the activity recommendations for management of type 1 diabetes mellitus (DM)?

Which infectious diseases are at higher risk in patients with type 1 diabetes mellitus (DM)?

What are the ophthalmologic complications of type 1 diabetes mellitus (DM)?

What are the dangers of nephrotoxic agents in patients with type 1 diabetes mellitus (DM)?

What the alternative to contrast-enhanced imaging for patients with type 1 diabetes mellitus (DM)?

What are the ADA recommendations for nephropathy screening in type 1 diabetes mellitus (DM)?

What are complications of micro- and macroalbuminuria in type 1 diabetes mellitus (DM)?

How is blood pressure controlled in type 1 diabetes mellitus (DM)?

What are complications of diabetic neuropathy?

What are complications of diabetic foot disease?

When is referral to a podiatrist indicated in the treatment of type 1 diabetes mellitus (DM)?

What is Charcot joint in type 1 diabetes mellitus (DM)?

What are macrovascular disease complications in type 1 diabetes mellitus (DM)?

What is the ADA recommended blood pressure goal for comorbid hypertension and type 1 diabetes mellitus (DM)?

How is atherosclerosis prevented in type 1 diabetes mellitus (DM)?

What is the risk of cardiovascular disease in patients with type 1 diabetes mellitus (DM)?

What is the association between silent ischemia and type 1 diabetes mellitus (DM)?

How are lipid abnormalities resolved in patients with type 1 diabetes mellitus (DM)?

What are the ADA guidelines on the use of statins in patients with type 1 diabetes mellitus (DM)?

How is type 1 diabetes mellitus (DM) managed during surgical procedures?

What are complication of serious medical illness or surgical procedures in patients with type 1 diabetes mellitus (DM)?

Why should near-normal blood glucose levels be maintained in medical and surgical patients with type 1 diabetes mellitus (DM)?

How is ketosis prevented in hospitalized patients with type 1 diabetes mellitus (DM)?

What insulin regimen should be used for patients with type 1 diabetes mellitus (DM) undergoing minor surgery?

When are the different types of insulin indicated for the treatment of type 1 diabetes mellitus (DM) in patients with restricted food intake prior to medical procedures?

Which types of insulin should be administered for prevention of hypoglycemia in hospitalized patients with type 1 diabetes mellitus (DM)?

What effect does cardiovascular disease or renal dysfunction have on the morbidity and mortality of patients with type 1 diabetes mellitus (DM)?

What are the insulin therapy requirements in critically ill patients with type 1 diabetes mellitus (DM)?

What are the ADA recommended blood glucose goals for non-critically ill patients with type 1 diabetes mellitus (DM)?

What are the ACP guidelines for glycemic control in hospitalized patients with type 1 diabetes mellitus (DM)?

How are plasma glucose and ketones monitored in patients with type 1 diabetes mellitus (DM) undergoing surgical procedures?

When is insulin administered for type 1 diabetes mellitus (DM) in patients undergoing surgical procedures?

What is the postoperative standard of care for type 1 diabetes mellitus (DM)?

What are the treatment options for type 1 diabetes mellitus (DM) during pregnancy?

Which trials have been conducted on the prevention of type 1 diabetes mellitus (DM)?

What were the results of the Diabetes Prevention Trial-Type 1 (DPT-1)?

What is the role of nicotinamide in the prevention of type 1 diabetes mellitus (DM)?

What is the role of antigen-based immunotherapy in the prevention of type 1 diabetes mellitus (DM)?

What is the role of teplizumab in the prevention of type 1 diabetes mellitus (DM)?

What is the role of abatacept in the prevention of type 1 diabetes mellitus (DM)?

What are the recommended referrals for patients with type 1 diabetes mellitus (DM)?

Guidelines

What are the A-grade recommendations from the American Diabetes Association’s Standards of Medical Care in Diabetes 2018?

What is contained in the American Diabetes Association (ADA) position statement on type 1 diabetes in children and adolescents?

What are the ADA guidelines on managing hypertension in type 1 diabetes mellitus (DM)?

What are the ISPAD guidelines on diabetic vascular complications in children and adolescents with type 1 diabetes mellitus (DM)?

What are the ISPAD clinical practice consensus guidelines on glycemic control targets and glucose monitoring in type 1 diabetes mellitus (DM)?

What are the Endocrine Society guidelines on the management of diabetes mellitus (DM) in older adults?

What expert panel recommendations have been put forward on the management of diabetes mellitus (DM) in patients with coronavirus disease 2019 (COVID-19)?

What are the AACE guidelines for the use of advanced technology in the management of diabetes mellitus (DM)?

Medications

What is the first-line treatment for type 1 diabetes mellitus (DM)?

Which medications in the drug class Hypoglycemia Antidotes are used in the treatment of Type 1 Diabetes Mellitus?

Which medications in the drug class Antidiabetics, Amylinomimetics are used in the treatment of Type 1 Diabetes Mellitus?

Which medications in the drug class Antidiabetics, Insulins are used in the treatment of Type 1 Diabetes Mellitus?