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Type 1 Diabetes Mellitus

What is Type 1 diabetes mellitus?

Type 1 diabetes mellitus is characterized by a complete deficiency of insulin. There are approximately 30,000 new cases per year.

  • Autoimmune (genetic predisposition to autoimmune dysfunction) – characterized by the production of autoantibodies against the beta-cells of the pancreas resulting in destruction of these cells.
  • Idiopathic- small subset without an autoimmune basis for beta cell destruction.

  • Increased thirst
  • Blurry vision
  • Weight loss – this is usually loss of weight within a short period of time.
  • Generalized fatigue.
  • Tingling and/or numbness in any part of the body especially in the extremities- hands and feet
  • Increased urine output especially at night

Dr Thomas will do a comprehensive medical evaluation, including eliciting a detailed personal and family history and do the appropriate blood tests and any other relevant investigations to diagnose diabetes mellitus and screen you for any complications of diabetes mellitus.  Typically, a diagnosis of diabetes is made if your fasting blood glucose levels is more than 126 mg/dl or a random blood glucose is greater than or equal to 200 mg/dl or Hemoglobin A1c is 6.5% or higher.

The management of Type 1 diabetes mellitus is multi-disciplinary.  Dr Reena Thomas will confirm the diagnosis of diabetes, discuss the pathophysiology of diabetes, monitoring of blood glucose levels and the rationale for optimal treatment of diabetes mellitus with either oral medications and or injectable GLP-1/GIP agonist therapy and or insulin therapy.

She will refer you to appropriate providers like a registered dietician, psychologist, podiatrist, and other specialists that may need to be involved depending on the complications of diabetes mellitus.

Blood glucose monitoring is important for optimal management of diabetes mellitus. Dr Thomas will advise you on the option of monitoring that is appropriate for you.

Self-monitoring of blood glucose levels

Using glucometer (SBGM). Ideally, blood glucose levels should be checked at least 4 times a day – before meals and before bed.

Continuous glucose monitoring

This uses a device to automatically estimate your blood glucose levels at any time of the day. This method helps to review your 24-hour glucose levels and helps you understand the impact of food, exercise, and other activities of daily living on your blood glucose levels. There are different types of sensors in the marketplace.

Dr Thomas will give you an individualized treatment plan focusing on healthy eating, physical activity, and a tailored medication plan.

  • Medical Nutrition Therapy – this includes Healthy eating and lifestyle habits.
  • Insulin therapy – Dr Thomas will initiate you on an Individualized integration of insulin regimens which includes both rapid-acting and long term or basal insulin regimens.

Dr Thomas will prescribe the most appropriate insulin delivery system after discussing the pros and cons of the different delivery systems. Currently the different insulin delivery systems include:

  1. Pre-filled Insulin pens
  2. Insulin vials and syringes
  3. Continuous subcutaneous insulin infusion (Insulin pumps).

Dr Thomas will see you at regular intervals, which is typically 3-to-4-month intervals. She will monitor how well you are managing your diabetes, review blood glucose monitoring profiles, insulin therapy and address any barriers to optimal management to diabetes mellitus. She will ensure timely prescriptions of insulin and any other accessories needed for diabetes mellitus.

At a Glance

Dr. Reena Thomas, MD

  • Dual American board-certified endocrinologist
  • Author of numerous academic and clinic research
  • Learn more