Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Juvenile diabetesDiabetes type 1Diabetes type 1.5Diabetes type 2Gestational diabetes ++ 250 Diabetes mellitus249.91 Secondary diabetes mellitus with unspecified complication, uncontrolled ++ E08.8 Diabetes mellitus due to underlying condition with unspecified complicationsE09.8 Drug or chemical induced diabetes mellitus with unspecified complicationsE08.65 Diabetes mellitus due to underlying condition with hyperglycemia ++ As of January 2013, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology. Therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated. +++ Description ++ Diabetes mellitusPrimary diabetes mellitusType 1: Inability of the body to produce insulin, formerly referred to as juvenile diabetesType 1.5: Latent autoimmune diabetes in adults (LADA), signs of both type 1 and type 2 diabetes where the body can initially produce some insulin but ultimately cannotType 2: Insulin resistance; inability of the body to produce adequate insulin or inability for adequate insulin uptake by the body to sufficiently regulate insulin/glucose, some insulin is produced by the pancreasImpaired glucose tolerance (IGT)Gestational diabetes mellitusSecondary diabetes mellitusDestructive pancreatic diseaseEndocrine diseasesDrug induced diabetesStress diabetes +++ Essentials of Diagnosis ++ Frequent urinationUnexplained weight loss; especially with Type 1Excessive thirstIncreased hungerInappropriate sweatingDizzinessNauseaDecreased activity toleranceHyperosmolar Hyperglycemic Nonketotic SyndromeRare condition in which blood sugar is 600 mg/dl or above and can result in death; in those who may have diagnosed or undiagnosed diabetes can result in coma and death +++ General Considerations ++ May cause pathology in multiple organ systemsKidney and urinary tractGI: liver, pancreasCardiovascular: heart, peripheral circulationNeuromuscular: neuropathyIntegumentaryVisionReproductive systemMay result in secondary problems; such as aerobic capacity and muscle endurance impairment, sarcopenia, weakness/impaired muscle performance, musculoskeletal problems, neuromuscular problems, weight loss or weight gain—indicating the need for physical therapy intervention depending on severityIncreased incidence of tendonitisIncreased incidence of frozen shoulderExercise may cause hypoglycemiaExercise may interfere with timed insulin uptake if performed in area of injection site soon after injectingMetabolic syndrome: presence ofHigh blood pressureHigh cholesterolBelly fatElevated blood sugarHyperlipidemia +++ Demographics ++ Occurs in males and femalesHigher incidence in African Americans and HispanicsType 2 is more common in individuals who are obese, and is on the rise in children secondary to sedentary lifestyle and obesityDuring 2002 to 2005, 15,600 children were newly diagnosed with type 1 diabetes annually, and 3,600 youth were newly diagnosed with type 2 diabetes annually1Among children younger than 10 years, the rate of new cases was 19.7 per 100,000 each year for type 1 diabetes and 0.4 per 100,000 for type 2 diabetes. Among children ages 10 years or older, the rate of new ... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free a profile for additional features.