Diabetes mellitus type 1 history and symptoms

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

History

T1DM has different ways of presentation. Obtaining the history is the most important aspect of making a diagnosis of type 1 DM. Specific areas of focus when obtaining history include:

• Increase frequency of urination
• Unusually wet diapers
• Persistent thirst
• Weight loss

Symptoms

Infants

Symptoms of type 1 DM include:

• Persistent thirst
• Frequent urination
• Dehydration

Young children

Type 1 Diabetes mellitus can have one of the following presentations
Classic new onset	Diabetic ketoacidosis
Most common presentation of type 1 DM Frequent urination Excessive thirst Unexplained weight loss Extreme hunger Sudden vision changes Tingling or numbness in hands or feet Fatigue Very dry skin Sores that are slow to heal More infections than usual. Nausea, vomiting, or stomach pains Difficulty in vision Oral Thrush may be present, or/ yeast infections that fail to go away, this is because the normal fungal/flora present in oral cavity/cervix in women, the balance is upset and bacterial began to feast on the high sugar from urine output/ dry mouth from extreme thirst.	Early Symptoms Sluggish, extreme tiredness Fruity smell to breath/compare to nail polish remover, similar to peardrops Extreme thirst, despite large fluid intake Constant urination Extreme weight-loss Oral Thrush may be present, or/ yeast infections that fail to go away, this is because the normal fungal/flora present in oral cavity/cervix in women, the balance is upset and bacterial began to feast on the high sugar from urine output/ dry mouth from extreme thirst. Muscle wasting Agitation / Irritation / Aggression / Confusion Late Symptoms At this point, DKA is life-threatening and medical attention should be sought immediately. Emesis (vomiting), although this is not always a sign of late-stage ketoacidosis, and can occur both in early-stage ketoacidosis and in non-ketoacidic hyperglycaemia. Confusion Abdominal pain Loss of appetite Flu-like symptoms Lethargy and apathy Extreme weakness Kussmaul breathing ("air hunger"). Patients breathe more deeply and/or rapidly. Unconsciousness (diabetic coma) after prolonged DKA. At this stage, speedy medical attention is imperative.