Type 1 diabetes Health Article

Support Groups

For additional information and resources, see diabetes support group.

Expectations (prognosis)

The outcome for people with diabetes varies. Studies show that tight control of blood glucose can prevent or delay complications to the eyes, kidneys, and nervous system. However, complications may occur even in those with good diabetes control.

Complications

Emergency complications include:

• Ketoacidosis
• Hypoglycemia

Long-term complications include:

• Vascular disease, including blocked arteries and heart attacks -- risk can be reduced by treating high cholesterol and blood pressure, exercising regularly, and avoiding or quitting tobacco products
• Eye problems, including diabetic retinopathy , retinal detachment, glaucoma, and cataracts
• Kidney disease (diabetic nephropathy)
• Nerve damage (diabetic neuropathy)
• Foot problems, including skin changes, arterial insufficiency, neuropathy, and specific foot deformities (hallux valgus, bunion, hammertoe, and calluses)
• Infections of the skin, female genital tract, and urinary tract

Calling your health care provider

If you are newly diagnosed with type 1 diabetes, you should probably have medical follow-up weekly until you have good control of blood glucose. Your health care provider will review results of home glucose monitoring and urine testing, and a diary of meals, snacks, and insulin injections.

As the disease becomes more stable, follow-up visits will be less frequent. Periodic visits to your health care provider is very important for monitoring potential long-term complications associated with diabetes.

Call your health care provider or go to the emergency room if you have symptoms ketoacidosis:

• Increased thirst and urination
• Nausea
• Deep and rapid breathing
• Abdominal pain
• Sweet-smelling breath
• Loss of consciousness (This may occur in insulin dependent diabetics who miss a dose of insulin, or if they are sick or have an infection.)

Go to the emergency room or call 911 if you have symptoms of severe hypoglycemia or insulin reaction:

• Trembling
• Weakness
• Drowsiness
• Headache
• Confusion
• Dizziness
• Double vision
• Lack of coordination
• Convulsions or unconsciousness

You can treat early signs of hypoglycemia at home by eating sugar or candy or taking glucose tablets. If your signs of hypoglycemia are still not relieved or if your blood glucose levels remain below 60 mg/dL, go to the emergency room.

References

Standards of medical care in diabetes--2007. Diabetes Care. Jan 2007;30 Suppl 1:S4-S41.

Larsen PR, Kronberg HM, Schlomo M, et al. Williams Textbook of Endocrinology. 10th ed. St. Louis, Mo: WB Saunders; 2003:1427-1468, 1485-1504.

Armstrong C. ADA Releases Standards of Medical Care for Patients with Diabetes. Am Fam Physician. Sept 2006; 74(5); 871-874.