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Kontroll ved diabetes type 1

Diabetes type 1 krever regelmessige kontroller og oppfølging hos spesialist. Tidlig hjelp ved høyt blodsukker kan spare deg for alvorlige komplikasjoner. Vanligvis skjer slike kontroller hver tredje til fjerde måned.

Konsultasjon
Personer med type 1-diabetes henvises til spesialist ved diagnosetidspunktet, og for de fleste vil videre oppfølging og behandling skje der.

Sist oppdatert:

27. apr. 2022

Innhold i artikkelen

Hvorfor bør diabetes kontrolleres?

Diabetes mellitus er en livslang tilstand med økt risiko for både akutte komplikasjoner og senkomplikasjoner. Kvaliteten på behandlingen er helt avgjørende for om komplikasjoner oppstår. Gjentatte episoder med svært høye eller svært lave glukose-verdier i blod gir økt risiko for komplikasjoner. Målsetningen med behandlingen er å sikre mest mulig stabile glukoseverdier, så nær opp mot de verdiene man ser hos personer uten diabetes. Dette kan være svært krevende, spesielt i perioder med sykdom eller store variasjoner i aktivitetsnivået. Noen ganger opplever man unormale glukoseverdier selv om alt er gjort på riktig måte.

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Det er en målsetning at alle barn med diabetes type 1 skal få tilbud om å bruke insulinpumpe, og kontinuerlig vevsglukosemåler. 

Oppfølging med regelmessige kontroller er viktig for personer med diabetes type 1. Vi skiller mellom egenkontroll og kontroller utført ved legekontoret eller sykehuset.

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Diabetes type 1 . Referanselisten for dette dokumentet vises nedenfor

  1. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes. Lancet. 2014 Jan 4; 383(9911): 69–82. www.ncbi.nlm.nih.gov
  2. Norsk diabetesregister for voksne. Diabetes type 1. Årsrapport for 2023. www.kvalitetsregistre.no
  3. Nasjonalt medisinsk kvalitetsregister for barne- og ungdomsdiabetes. Barnediabetesregisteret. Årsrapport 2023. www.kvalitetsregistre.no
  4. Atkinson MA, Roep BO, Posgai A, Wheeler DCS, Peakman M. The challenge of modulating β-cell autoimmunity in type 1 diabetes. Lancet Diabetes Endocrinol. 2019;7(1):52-64. PMID: 30528099. PubMed
  5. Kakleas K, Karayianni C, Critselis E, et al. The prevalence and risk factors for coeliac disease among children and adolescents with type 1 diabetes mellitus. Diabetes Res Clin Pract 2010;90:202-208. PubMed
  6. Davis AK, DuBose SN, Haller MJ, et al. Prevalence of detectable C-peptide according to age at diagnosis and duration of type 1 diabetes. Diabetes Care December 17, 2014. Published online before print December 17, 2014, . doi:10.2337/dc14-1952 DOI
  7. Wang L, Lovejoy NF, Faustman DL. Persistence of prolonged C-peptide production in type 1 diabetes as measured with an ultrasensitive C-peptide assay. Diabetes Care 2012; 35: 465-70. pmid:22355018 PubMed
  8. Norris JM, Beaty B, Klingensmith G, Yu L, Hoffman M, Chase HP, et al. Lack of association between early exposure to cow's milk protein and -cell autoimmunity: diabetes autoimmunity study in the young (DAISY). JAMA 1996;276: 609-14. Journal of the American Medical Association
  9. Hober D, Sauter P. Pathogenesis of type 1 diabetes mellitus: interplay between enterovirus and host. Nat Rev Endocrinol 2010;6:279-289 PubMed
  10. Norris JM, Barriga K, Klingensmith G, Hoffman M, Eisenbarth GS, Erlich HA, et al. Timing of initial cereal exposure in infancy and risk of islet autoimmunity. JAMA 2003;290: 1713-20. Journal of the American Medical Association
  11. Ziegler AG, Schmid S, Huber D, Hummel M, Bonifacio E. Early infant feeding and risk of developing type 1A diabetes-associated autoantibodies. JAMA 2003;290: 1721-8. Journal of the American Medical Association
  12. Lombardi A, Tsomos E, Hammerstad SS, Tomer Y. Interferon alpha: The key trigger of type 1 diabetes. J Autoimmun. 2018;94:7-15. PMID: 30115527. PubMed
  13. Fousteri G, Dave Jhatakia A. Viral Infections and Autoimmune Disease: Roles of LCMV in Delineating Mechanisms of Immune Tolerance. Viruses. 2019;11(10):885. Published 2019 Sep 21. PMID: 31546586. PubMed
  14. Helsedirektoratet. Nasjonal faglig retningslinje for diabetes. Sist oppdatert 15.04.2020. helsedirektoratet.no
  15. Crawford F, Cezard G, Chappell FM, et al. A systematic review and individual patient data meta-analysis of prognostic factors for foot ulceration in people with diabetes: the international research collaboration for the prediction of diabetic foot ulcerations (PODUS). Health Technol Assess. 2015 Jul;19(57):1-210. PubMed
  16. Hals IK, Fiskvik Fleiner H, Reimers N, et al. Investigating optimal β-cell-preserving treatment in latent autoimmune diabetes in adults: Results from a 21-month randomized trial.. Diabetes Obes Metab 2019; 21: 2219-27. pmid:31148332 PubMed
  17. Aldring og helse. Fagprosedyre for diabetes i kommunale helse- og omsorgstjenester. Forlaget aldring og helse 2023.
  18. Lind M et al. HbA1c level as a risk factor for retinopathy and nephropathy in children and adults with type 1 diabetes: Swedish population based cohort study. BMJ 2019 Aug 28; 366:l4894. pmid: 31462492 PubMed
  19. Birkeland KI. Insulinbehandling ved type 1-diabetes hos voksne. Tidsskr Nor Legeforen 2006; 126: 776-8. PubMed
  20. Sustained effect of intensive treatment of type 1 diabetes mellitus on development and progression of diabetic nephropathy: the Epidemiology of Diabetes Interventions and Complications (EDIC) study. JAMA 2003; 290: 2159-67. Journal of the American Medical Association
  21. Boyko EJ, Zelnick LR, Braffet B, et al. Risk of Foot Ulcer and Lower-Extremity Amputation Among Participants in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study. Diabetes Care 2022; 45: 357-364. pmid:35007329 PubMed
  22. Nathan DM, Cleary PA, Backlund JY, et al, for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with Type 1 diabetes. N Engl J Med 2005; 353: 2643-53. New England Journal of Medicine
  23. Avgerinos I, Manolopoulos A, Michailidis T, et al. Comparative efficacy and safety of glucose-lowering drugs as adjunctive therapy for adults with type 1 diabetes: A systematic review and network meta-analysis. Diabetes Obes Metab. 2020. PMID: 33300282 PubMed
  24. Russell SJ, El-Khatib FH, Sinha M, et al. Outpatient Glycemic Control with a Bionic Pancreas in Type 1 Diabetes. N Engl J Med 2014. doi:DOI: 10.1056/NEJMoa1314474 DOI
  25. Thalange N, Bereket A, Larsen J, et al. Insulin analogues in children with Type 1 diabetes: a 52-week randomized clinical trial. Diabet Med 2013 Feb; 30(2): 216-25. PubMed
  26. Davies MJ, Gross JL, Ono Y, et al. Efficacy and safety of insulin degludec given as part of basal-bolus treatment with mealtime insulin aspart in type 1 diabetes: a 26-week randomized, open-label, treat-to-target non-inferiority trial. Diabetes Obes Metab. 2014 Apr 7.
  27. Bergenstal RM, Tamborlane WV, Ahmann A, et al. Effectiveness of Sensor-augmented insulin-pump therapy in type 1 diabetes. N Engl J Med, June 29, 2010.
  28. Brown SA, Kovatchev BP, Raghinaru D, et al. Six-Month Randomized, Multicenter Trial of Closed-Loop Control in Type 1 Diabetes. N Engl J Med 2019; 381: 1707-17. pmid:31618560 PubMed
  29. Burnside MJ, Lewis DM, Crocket HR, et al. Open-Source Automated Insulin Delivery in Type 1 Diabetes. N Engl J Med 2022; 387: 869-881. pmid:36069869 PubMed
  30. Writing Committee for the Type 1 Diabetes TrialNet Oral Insulin Study Group . Effect of Oral Insulin on Prevention of Diabetes in Relatives of Patients With Type 1 Diabetes A Randomized Clinical Trial. JAMA 2017; 318: 1891-902. pmid:29164254 PubMed
  31. The Diabetes Virus Detection and Intervention Trial. Nettside besøkt 06.12.20. forskningsprosjekter.ihelse.net
  32. Lind M, Svensson A-M, Kosiborod M, et al. Glycemic Control and Excess Mortality in Type 1 Diabetes. N Engl J Med 2014; 371: 1972-82. doi:10.1056/NEJMoa1408214 DOI
  33. Usher-Smith JA, Thompson MJ, Sharp SJ, Walter FM. Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults; a systematic review. BMJ 2011; 343: d4092. BMJ (DOI)
  34. Toni G, Berioli MG, Cerquiglini L, et al. Eating Disorders and Disordered Eating Symptoms in Adolescents with Type 1 Diabetes. Nutrients. 2017;9(8):906. Published 2017 Aug 19. PMID: 28825608. PubMed
  35. Finne P, Reunanen A, Stenman S, Groop P-H, Grönhagen-Riska C. Incidence of end-stage renal disease in patients with type 1 diabetes. JAMA 2005; 294: 1782-7. PubMed
  36. Gagnum V, Saeed M, Stene LC, et al. Low Incidence of End-Stage Renal Disease in Childhood-Onset Type 1 Diabetes Followed for Up to 42 Years.. Diabetes Care 2018; 41: 420-5. pmid:29025877 PubMed
  37. Holte KB, Svanteson M, Hanssen KF, Haig Y, Solheim S, Berg TJ. Undiagnosed coronary artery disease in long-term type 1 diabetes. The Dialong study. J Diabetes Complications. 2019;33(5):383-389. PMID: 30846232 PubMed
  38. Lind M, Bounias I, Olsson M, et al. Glycaemic control and incidence of heart failure in 20985 patients with type 1 diabetes: an observational study. Lancet 2011; 378: 140-6. PubMed
  39. Avdic T, Eliasson B, Rawshani A, et al. Non-coronary arterial outcomes in people with type 1 diabetes mellitus: a Swedish retrospective cohort study. Lancet Reg Health 2024. doi:10.1016/j.lanepe.2024.100852 DOI
  40. Matuleviciene-Anängen V, Rosengren A, Svensson AM, et al. Glycaemic control and excess risk of major coronary events in persons with type 1 diabetes. Heart 2017. pmid:28710186 PubMed
  41. Huxley RR, Peters SA, Mishra GD, Woodward M. Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2015;3:198-206. doi:10.1016/S2213-8587(14)70248-7 DOI
  42. Wagner S, Nørgaard K, Willaing I, et al. Upper-extremity impairments in type 1 diabetes: Results from a controlled nationwide study. Diabetes Care 2023; 46: 1204-1208. pmid:37000698 PubMed
  43. Larkin ME, Barnie A, Braffett BH, et al. Musculoskeletal Complications in Type 1 Diabetes. Diabetes Care. 2014 Apr 10.
  44. Juel NG, Brox JI, Brunborg C, et al. Very High Prevalence of Frozen Shoulder in Patients With Type 1 Diabetes of ≥45 Years' Duration: The Dialong Shoulder Study. Arch Phys Med Rehabil 2017; 98: 1551-9. pmid:28219686 PubMed
  45. Perkins BA, Ficociello LH, Silva KH. Regression of microalbuminuria in type 1 diabetes. N Engl J Med 2003; 348: 2285-93. pmid:12788992 PubMed
  46. Cooper MN, de Klerk NH, Jones TW, Davis EA.. Clinical and demographic risk factors associated with mortality during early adulthood in a population-based cohort of childhood-onset type 1 diabetes. Diabet Med 2014; 31(12): 1550-8. doi:10.1111/dme.12522 DOI
  47. Katz M, Laffel L. Mortality in type 1 diabetes in the current era. Two steps forward, one step backward. JAMA. 2015;313(1):35-36 . doi:10.1001/jama.2014.16327 DOI
  48. Orchard TJ, Secrest AM, Miller RG, Costacou T. In the absence of renal disease, 20 year mortality risk in type 1 diabetes is comparable to that of the general population. Diabetologia. 2010;53(11):2312-2319. PubMed
  49. Groop PH, Thomas MC, Moran JL, et al; FinnDiane Study Group. The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes. Diabetes. 2009;58(7):1651-1658. PubMed
  50. Hallström S, Wijkman MO, Ludvigsson J, et al. Risk factors, mortality trends and cardiovasuclar diseases in people with Type 1 diabetes and controls: A Swedish observational cohort study. Lancet Reg Health Eur. 2022;21:100469. Published 2022 Jul 22. doi:10.1016/j.lanepe.2022.100469. PMID: 35898332 PubMed
  51. DCCT/EDIC Research Group. Association between 7 years of intensive treatment of type 1 diabetes and long-term mortality. JAMA. doi:10.1001/jama.2014.16107. DOI
  52. Havas S, Donner T. Tight control of type 1 diabetes: Recommendations for patients. Am Fam Physician 2006; 74: 971-8. PubMed
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