English
Characteristic | Immune-mediated type 1 diabetes | Idiopathic type 1 diabetes | Monogenic diabetes | Type 2 diabetes |
---|---|---|---|---|
Prevalence | ||||
In children with diabetes (overall) | Most cases of type 1 diabetes in children, but 5% to 10% of all diabetes | 10% or higher in African-American children | 1% to 6% | Approximately 12% |
Ethnicity | All, white populations at highest risk (30%-60% lower in African-American populations) | African-American and Asian | All | All, minority groups at highest risk in North America |
Onset | ||||
Typical age at onset in children | Throughout childhood and adolescence, but may occur into 8th or 9th decade of life | Pubertal | Typically younger than 35 years | Puberty (mean age, 13.5 years) |
Onset | Acute severe | Acute severe | Gradual | Insidious to severe |
DKA at onset | Approximately 32% in United States (up to 80% globally) | Episodic | Not typical | 5% to 20% |
Heredity | ||||
Affected relative | 3% to 10% | More than 75% | 50% to 90% | Up to 90% |
Inheritance | Polygenic | Autosomal dominant | Autosomal dominant | Polygenic |
HLA-DR3/4 association | Present | Absent | Absent | Absent |
Insulin status | ||||
Insulin (C-peptide) secretion | Reduced or absent | Variably reduced | Variably reduced | Varies (up 85% impairment at time of diagnosis) |
Insulin sensitivity | Normal when controlled | Normal | Normal | Reduced |
Insulin dependence | Lifelong | Intermittent | Variable | Variable |
Associated features | ||||
Islet autoantibodies | + (80%-90%) | − | − (less than 1%) | − (less than 10%) |
Acanthosis nigricans | − | − | − (matches general population) | + (86%) |
Obesity | − (matches general population) | +/− (varies by population) | − (uncommon) | + (very common, more than 90%) |
Cystic fibrosis–related diabetes r43c78
New diagnosis
Established diagnosis
Initial management of children with newly diagnosed type 1 diabetes
Long-term management of chronic disease in children with type 1 diabetes consists of several components, which together constitute a comprehensive treatment plan r29
Insulin therapy
Glucose monitoring r51
Medical nutrition therapy
Type of insulin | Onset | Peak | Duration |
---|---|---|---|
Ultra-rapid-acting | |||
Aspart (Fiasp) | 15 to 20 minutes | 1 to 3 hours | 3 to 5 hours |
Rapid-acting | |||
Aspart (Novolog) | 15 to 30 minutes | 1 to 3 hours | 3 to 5 hours |
Lispro (Humalog) | 15 to 30 minutes | 1 to 3 hours | 3 to 5 hours |
Glulisine (Apidra) | 15 to 30 minutes | 1 to 3 hours | 3 to 5 hours |
Short-acting | |||
Regular Insulin | 30 to 60 minutes | 2 to 4 hours | 5 to 8 hours |
Intermediate-acting | |||
NPH | 2 to 4 hours | 4 to 8 hours | 12 to 18 hours |
Long-acting | |||
Detemir (Levemir) | 2 to 4 hours | None | 12 to 24 hours |
Glargine (Lantus) | 2 to 4 hours | None | Up to 24 hours |
Degludec (Tresiba) | 2 to 4 hours | None | More than 24 hours |
Fluid administration to correct dehydration c90
Blood glucose monitoring r64c91
Diabetes education and self-management training r29c92c93
Medical nutrition therapy r52c94
Immunizations r63
Other lifestyle issues c98
Physical activity c99
Behavioral and psychosocial aspects of care r29
Various diabetes advocacy position statements are available from the American Diabetes Association, including the following: r78
During the COVID-19 pandemic, telehealth should be used for sick day management and routine diabetes care
Complications r92