Type 1 diabetes usually presents with classic, often sudden symptoms of:
passing large amounts of urine (polyuria)
excessive thirst (polydipsia)
Fatigue
Unexplained weight loss
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In the older adult, the presentation may be slower and less dramatic often leading to a misdiagnosis of type 2 diabetes.
Diabetes is diagnosed quite simply by measuring the levels of glucose in the blood. A formal diagnosis should always be done by a pathology laboratory.
The World Health Organization (WHO) and the American Diabetes Association (ADA) recognise the following conditions for the diagnosis of diabetes:
1. Symptoms of diabetes plus casual plasma glucose concentration _¡Ý11.1 mmol/l (Casual is defined by the ADA as any time of day without regard to time since last meal)
OR
2. Fasting Plasma Glucose (FPG) ¡Ý7.0 mmol/l. (Fasting is defined by the ADA as no caloric intake for at least 8 hours). The normal fasting levels are between 3,3 mmol/l and 5,9 mmol/l.
The following factors would favour the final diagnosis of Type 1 over type 2 diabetes:
The presence of ketones (acetone related substances) in the urine
Positive tests for antibodies against specific tissues or enzymes in the pancreas or against insulin itself
Generally younger age and slim build
Lack of family history of diabetes
Reviewed by Michael Brown & Vanessa Melville; B Nursing (Wits) and Accredited Diabetes Educators; Centre for Diabetes and Endocrinology (Pty) Ltd, Houghton, Johannesburg
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