Type 1 diabetes: pathophysiology and diagnosis
Type 1 diabetes is caused by the autoimmune destruction of the insulin-producing b-cells of the islets of Langerhans. Genetic and environmental factors are thought to play a part in the onset of the disease, which usually occurs in childhood and young adulthood.
A capillary blood glucose level of greater than 11mmol/L alongside a history of classic osmotic symptoms (polyuria and polydipsia) supports a diagnosis of type 1 diabetes; many patients will be admitted to hospital with diabetic ketoacidosis in the first instance. Insulin administration is needed to control blood glucose levels, and optimising overall glycaemic control can help prevent long-term micro- and macrovascular complications.
Elizabeth Hackett is principal pharmacist for diabetes and Alison Gallagher is a consultant physician and diabetologist, both at University Hospitals of Leicester NHS Trust. Natasha Jacques is principal pharmacist for specialist services at Heart of England NHS Foundation Trust.
Citation: Clinical Pharmacist DOI: 10.1211/CP.2013.11119460
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