السكري النوع الأول

Definition

Type 1 diabetes is autoimmune destruction of the pancreatic beta cells, so insulin production stops completely.

Who gets it?

Mostly children and young adults, but it can appear at any age.

Symptoms

• Intense thirst and frequent urination
• Hunger with weight loss
• Fatigue and blurred vision
• May first present as DKA

DKA

• High glucose, ketones, acidosis
• Vomiting, abdominal pain, Kussmaul breathing, fruity breath
• Treatment: fluids first, then IV insulin, with potassium monitoring

Diagnosis

Fasting glucose 126 mg/dL or more, random 200 with symptoms, or HbA1c 6.5% or more, plus pancreatic autoantibodies.

Treatment

• Lifelong insulin: long-acting basal plus rapid-acting mealtime, or an insulin pump
• Glucose monitoring and carbohydrate counting

Nursing care

• Teach injection and site rotation
• Recognise hypoglycaemia and treat with the 15–15 rule
• Sick-day rules: never stop insulin

Exam point

In DKA, insulin is not started if potassium is below 3.3 until it is replaced.