J Korean Diabetes.  2015 Jun;16(2):101-107. 10.4093/jkd.2015.16.2.101.

Diagnosis and Glycemic Control of Type 1 Diabetes

Affiliations
  • 1Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea. pedendo@paik.ac.kr

Abstract

Type 1 diabetes mellitus (T1DM) is characterized by an immune-mediated beta-cell destruction that causes lifelong insulin dependency. Diagnosis of diabetes is based on fasting glucose, 2-h plasma glucose value after a 75-g oral glucose tolerance test, or hemoglobin A1c (HbA1c) levels. Differentiation between type 1 and 2 diabetes is important for both education and treatment. Diabetes-associated autoantibodies, c-peptide and clinical characteristics should be considered to confirm the diagnosis of T1DM. A single HbA1c target of < 7.5% across all pediatric age groups is recommended. In nonpregnant adults, a reasonable HbA1c goal is < 7.0% to reduce the incidence of microvascular complications of T1DM. Glycemic targets should be individualized according to lifestyle, psychosocial and medical circumstances.

Keyword

Diagnosis; Glycemic target; Type 1 diabetes

MeSH Terms

Adult
Autoantibodies
Blood Glucose
C-Peptide
Diabetes Mellitus, Type 1
Diagnosis*
Education
Fasting
Glucose
Glucose Tolerance Test
Humans
Incidence
Insulin
Life Style
Autoantibodies
C-Peptide
Glucose
Insulin

Cited by  1 articles

Management of Type 1 Diabetes in Adolescents
Yeong Sun Kim
J Korean Diabetes. 2018;19(3):175-179.    doi: 10.4093/jkd.2018.19.3.175.


Reference

References

1. DIAMOND Project Group. Incidence and trends of childhood Type 1 diabetes worldwide 1990–1999. Diabet Med. 2006; 23:857–66.
2. Patterson CC, Dahlquist GG, Gyürüs E, Green A, Soltész G. EURODIAB Study Group. Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. Lancet. 2009; 373:2027–33.
Article
3. Shin CH. Epidemiologic characteristics of type 1 diabetes in children aged 14 years or under in Korea, 1985–2000. Korean J Pediatr. 2008; 51:569–75.
Article
4. Chiang JL, Kirkman M, Laffel LM, Peters AL. Type 1 Diabetes Sourcebook Authors. Type 1 diabetes through the life span: a position statement of the American Diabetes Association. Diabetes Care. 2014; 37:2034–54.
Article
5. The International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009; 32:1327–34.
6. Nowicka P, Santoro N, Liu H, Lartaud D, Shaw MM, Goldberg R, Guandalini C, Savoye M, Rose P, Caprio S. Utility of hemoglobin A(1c) for diagnosing prediabetes and diabetes in obese children and adolescents. Diabetes Care. 2011; 34:1306–11.
Article
7. Korean Diabetes Association: Treatment guideline for diabetes. 5th ed.Seoul: Gold's Planning and Development;2013. p. 5–9.
8. Craig ME, Jefferies C, Dabelea D, Balde N, Seth A, Donaghue KC. Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2014; 15(Suppl 20):). 4–17.
Article
9. Kapellen TM, Gausche R, Dost A, Wiegand S, Flechtner-Mors M, Keller E, Kiess W, Holl RW. DPV-Science-Initiative of the German Competence Network Diabetes and the German Competence Network Obesity (Consortium LARGE). Children and adolescents with type 1 diabetes in Germany are more overweight than healthy controls: results comparing DPV database and CrescNet database. J Pediatr Endocrinol Metab. 2014; 27:209–14.
Article
10. Dabelea D, Rewers A, Stafford JM, Standiford DA, Lawrence JM, Saydah S, Imperatore G, D'Agostino RB Jr, Mayer-Davis EJ, Pihoker C. SEARCH for Diabetes in Youth Study Group. Trends in the prevalence of ketoacidosis at diabetes diagnosis: the SEARCH for diabetes in youth study. Pediatrics. 2014; 133:e938–45.
Article
11. Wenzlau JM, Juhl K, Yu L, Moua O, Sarkar SA, Gottlieb P, Rewers M, Eisenbarth GS, Jensen J, Davidson HW, Hutton JC. The cation efflux transporter ZnT8 (Slc30A8) is a major autoantigen in human type 1 diabetes. Proc Natl Acad Sci U S A. 2007; 104:17040–5.
Article
12. Watkins RA, Evans-Molina C, Blum JS, DiMeglio LA. Established and emerging biomarkers for the prediction of type 1 diabetes: a systematic review. Transl Res. 2014; 164:110–21.
Article
13. Tuomi T, Zimmet P, Rowley MJ, Min HK, Vichayanrat A, Lee HK, Rhee BD, Vannasaeng S, Humphrey AR, Mackay IR. Differing frequency of autoantibodies to glutamic acid decarboxylase among Koreans, Thais, and Australians with diabetes mellitus. Clin Immunol Immunopathol. 1995; 74:202–6.
Article
14. Thai AC, Ng WY, Loke KY, Lee WR, Lui KF, Cheah JS. Anti-GAD antibodies in Chinese patients with youth and adult-onset IDDM and NIDDM. Diabetologia. 1997; 40:1425–30.
Article
15. Klingensmith GJ, Pyle L, Arslanian S, Copeland KC, Cuttler L, Kaufman F, Laffel L, Marcovina S, Tollefsen SE, Weinstock RS, Linder B. TODAY Study Group. The presence of GAD and IA-2 antibodies in youth with a type 2 diabetes phenotype: results from the TODAY study. Diabetes Care. 2010; 33:1970–5.
16. Dabelea D, Pihoker C, Talton JW, D'Agostino RB Jr, Fujimoto W, Klingensmith GJ, Lawrence JM, Linder B, Marcovina SM, Mayer-Davis EJ, Imperatore G, Dolan LM. SEARCH for Diabetes in Youth Study. Etiological approach to characterization of diabetes type: the SEARCH for Diabetes in Youth Study. Diabetes Care. 2011; 34:1628–33.
17. Davis AK, DuBose SN, Haller MJ, Miller KM, DiMeglio LA, Bethin KE, Goland RS, Greenberg EM, Liljenquist DR, Ahmann AJ, Marcovina SM, Peters AL, Beck RW, Greenbaum CJ. T1D Exchange Clinic Network. Prevalence of detectable C-Peptide according to age at diagnosis and duration of type 1 diabetes. Diabetes Care. 2015; 38:476–81.
Article
18. The effect of intensive treatment of diabetes on the development and progression of longterm complications in insulindependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993; 329:977–86.
19. Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes treatment on the development and progression of longterm complications in adolescents with insulindependent diabetes mellitus: Diabetes Control and Complications Trial. J Pediatr. 1994; 125:177–88.
20. Rovet JF, Ehrlich RM. The effect of hypoglycemic seizures on cognitive function in children with diabetes: a 7-year prospective study. J Pediatr. 1999; 134:503–6.
Article
21. Cato MA, Mauras N, Ambrosino J, Bondurant A, Conrad AL, Kollman C, Cheng P, Beck RW, Ruedy KJ, Aye T, Reiss AL, White NH, Hershey T. Diabetes Research in Children Network (DirecNet). Cognitive functioning in young children with type 1 diabetes. J Int Neuropsychol Soc. 2014; 20:238–47.
Article
22. Marzelli MJ, Mazaika PK, Barnea-Goraly N, Hershey T, Tsalikian E, Tamborlane W, Mauras N, White NH, Buckingham B, Beck RW, Ruedy KJ, Kollman C, Cheng P, Reiss AL. Diabetes Research in Children Network (DirecNet). Neuroanatomical correlates of dysglycemia in young children with type 1 diabetes. Diabetes. 2014; 63:343–53.
Article
23. Kirchhoff BA, Lugar HM, Smith SE, Meyer EJ, Perantie DC, Kolody BC, Koller JM, Arbelaez AM, Shimony JS, Hershey T. Hypoglycaemia-induced changes in regional brain volume and memory function. Diabet Med. 2013; 30:e151–6.
Article
24. Barnea-Goraly N, Raman M, Mazaika P, Marzelli M, Hershey T, Weinzimer SA, Aye T, Buckingham B, Mauras N, White NH, Fox LA, Tansey M, Beck RW, Ruedy KJ, Kollman C, Cheng P, Reiss AL. Diabetes Research in Children Network (DirecNet). Alterations in white matter structure in young children with type 1 diabetes. Diabetes Care. 2014; 37:332–40.
Article
25. Ly TT, Nicholas JA, Retterath A, Lim EM, Davis EA, Jones TW. Effect of sensor-augmented insulin pump therapy and automated insulin suspension vs standard insulin pump therapy on hypoglycemia in patients with type 1 diabetes: a randomized clinical trial. JAMA. 2013; 310:1240–7.
26. Cooper MN, O'Connell SM, Davis EA, Jones TW. A population-based study of risk factors for severe hypoglycaemia in a contemporary cohort of childhood-onset type 1 diabetes. Diabetologia. 2013; 56:2164–70.
Article
27. Rewers M, Pihoker C, Donaghue K, Hanas R, Swift P, Klingensmith GJ. Assessment and monitoring of glycemic control in children and adolescents with diabetes. Pediatr Diabetes 2009 10 (Suppl 12):. 71–81.
28. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. N Engl J Med. 2000; 342:381–9.
29. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, Peters AL, Tsapas A, Wender R, Matthews DR. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia. 2015; 58:429–42.
Article
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