GuidelinesPrimary Care STG

Type 1 Diabetes Mellitus

Endocrine Conditions

Clinical Presentation

General Measures

DESCRIPTION

Type 1 diabetes mellitus, previously known as juvenile onset diabetes mellitus and as insulin-dependent diabetes mellitus (IDDM), occurs because of a lack of insulin. The result is an increase in blood glucose concentration

CLINICAL PRESENTATION

Hunger
Polyuria
Ketoacidosis
Thirst
Unexplained weight loss
Tiredness

DIAGNOSIS

Type 1 diabetes mellitus is diagnosed when the classic symptoms of polyuria and polydipsia are associated with hyperglycaemia:

Random plasma glucose ≥11.1 mmol/L
Random is defined as any time of day without regard to time since last meal

OR

Fasting plasma glucose ≥7.0 mmol/L
Fasting is defined as no caloric intake for ≥8 hours

OR

2-hour plasma glucose in a 75 g oral glucose tolerance test ≥11.1 mmol/l

GENERAL MEASURES

Education regarding diabetes and its complications
Even and regular meal consumption
Dietary emphasis should be on regulating carbohydrate, fibre and fat intake (See: Diabetes mellitus, in adults for recommended diet plan)
Increased physical activity, aim for 30 minutes 5 times a week
Appropriate weight loss if body mass index >25 kg/m2
Education about foot care
Monitor for development of depression
All patients should wear a notification bracelet

REFERRAL

All patients

Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare Level, 2024 Edition