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type 1 diabetes mellitus
one of the two major types of diabetes mellitus, characterized by abrupt onset of symptoms, inadequate production of insulin,
and dependence on exogenous insulin to sustain life. The peak age of onset is 12 years, although onset can be at any age. The lack of insulin production by the
beta cells of the pancreas may result from viral infection, an autoimmune response, and possibly genetic factors; islet cell antibodies are usually detectable at diagnosis. When it is not well controlled, lack of insulin causes hyperglycemia, protein wasting, and production of ketone bodies owing to increased fat metabolism. The hyperglycemia leads to sugar (glucose) in the urine, osmotic diuresis, hyperosmolarity, dehydration, and diabetic ketoacidosis. It is accompanied by disease of blood vessels, especially the small ones, which affects the retinas, kidneys, and basement
membrane of arterioles throughout the body. Other symptoms include excessive urination, thirst, and hunger; weight loss; paresthesias; and blurred vision. If untreated, the ketoacidosis can progress to nausea and vomiting, stupor, and potentially fatal coma (diabetic coma). This type is called also insulin-dependent or juvenile-onset diabetes mellitus.
Copyright 2007. An Elsevier publication. All rights reserved.
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