clinical features of type I diabetes (IDDM)

Last edited 11/2018

Type 1 diabetes (T1D) presentation may vary from non-emergency to severe dehydration, shock and diabetic ketoacidosis (1).

Symptoms are usually similar in both types of diabetes, however they may vary in their degree and develop more rapidly in T1D. Some of the symptoms include (2).

  • weight loss due to dehydration and catabolism
  • polyurea, polydipsia (due to osmotic diuresis), polyphagia,
  • constipation
  • fatigue
  • cramps
  • blurred vision
  • bacterial and fungal infections e.g. - candidiasis (2)

Some individuals may develop symptoms within days and present with diabetic ketoacidosis.

  • severe dehydration
  • frequent vomiting with nausea and abdominal pain
  • continuing polyuria despite the presence of dehydration
  • muscle and fat impairment,
  • flushed cheeks due to ketoacidosis
  • hyperventilation
  • ketotic breath
  • progressive loss of consciousness (disoriented, semi-comatose or rarely comatose)
  • shock (rapid pulse rate, poor peripheral circulation with peripheral cyanosis) (1).

Main T1D symptoms may be interpreted erroneously, especially in healthy children with no previous problems e.g. –

  • recent onset of enuresis in a previously toilet-trained child - excessive fluid ingestion or urinary tract infection may be suspected
  • polydypsia - may be thought to be psychogenic or due to hot weather conditions seen in summer
  • vomiting – misdiagnosed as gastroenteritis
  • chronic weight loss or failure to gain weight in a growing child - bowel and/or feeding problems may be suspected
  • abdominal pain associated with ketoacidosis – may be diagnosed as an acute abdomen leading to a surgical referral
  • hyperventilation of ketoacidosis - may be misdiagnosed as pneumonia or asthma (cough and breathlessness distinguish these conditions from diabetic ketoacidosis) (1)