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Typ 1-diabetes

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Sakkunnig:
Definition:
Typ 1-diabetes kännetecknas av en autoimmun destruktion av betacellerna i pankreas (bukspottkörteln) med utveckling av absolut insulinbrist och kronisk hyperglykemi. Detta kan i sin tur leda till ökad risk för hjärt-kärlsjukdom.
Förekomst:
Vanligast är att individer <20 år insjuknar. Det finns ungefär 50 000 patienter med typ 1-diabetes i Sverige, varav 7 000 barn.
Symtom:
Kan variera från lindriga symtom med polyuri, ökad törst och viktnedgång till mer allvarliga symtom, som till exempel kräkningar, buksmärta och nedsatt medvetandenivå (särskilt vid diabetisk ketoacidos ).
Kliniska fynd:
Vid långsamt insjuknande kan kliniska fynd saknas helt. Vid diabetisk ketoacidos kan allvarlig dehydrering, frekventa kräkningar, polyuri trots dehydrering, viktnedgång, kräkningar, acetonlukt, hyperventilation, nedsatt medvetandegrad, försämrad perifer cirkulation med snabb hjärtfrekvens och hypotension med perifer cyanos förekomma.
Diagnostik:
Bygger på att plasmaglukos ligger över vissa gränsvärden. Typiska symtom/fynd kan bidra till diagnosen. I regel förekommer autoantikroppar mot betaceller. 
Behandling:
Består av regelbunden insulinbehandling och behandling av andra riskfaktorer för hjärt-kärlsjukdom, såsom dyslipidemi eller hypertoni. Egenbehandling med regelbunden fysisk aktivitet, varierad kost och rökfrihet.
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  • Johan Jendle, specialist i endokrinologi och professor i medicin, Örebro universitet
  • Remy Waardenburg, specialist i allmänmedicin, medicinsk redaktör Medibas