Type 1 Diabetes
Definition
Type 1 diabetes is a chronic autoimmune condition characterized by the body's inability to produce insulin, a hormone required for glucose regulation. This results in high blood sugar levels, which can lead to various complications if not managed properly. It is typically diagnosed in childhood or adolescence and requires lifelong insulin therapy for management.
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Diabetes Center
Our goal at the Diabetes Center is to give patients the tools necessary to successfully manage the day-to-day challenges of living with diabetes and prevent long-term diabetes complications. We provide comprehensive management and education for adults with type 1 and type 2 diabetes. We focus on lifestyle interventions and use the latest medications and technologies to improve our patients’ health. We also treat patients with: Pre-diabetes and metabolic syndrome Obesity Polycystic ovarian syndrome Lipid or cholesterol abnormalities Our nationally recognized doctors and nurse practitioners work as a team to address our patients’ needs in managing diabetes and other conditions. We understand that living with diabetes presents challenges. We focus on education and making patients their own advocates. Through the most current and state-of-the-art treatments, we will help them better manage their care. Oral Medications There are several classes of oral diabetes medications that we may prescribe if patients have type 2 diabetes. These medications differ in the way they work to reduce blood glucose levels. Frequently, oral medications from different classes are used in combination. Sulfonylureas: These drugs increase the amount of insulin produced by the pancreas. Meglitinides: These drugs rapidly increase the amount of insulin produced by the pancreas. Biguanides: Metformin is the only biguanide on the market. It is thought to work by reducing the production of glucose in the liver. Alpha-Glucosidase Inhibitors: These medications reduce the amount of glucose absorbed in the intestines. Thiazolidinediones: This agent makes the body more sensitive to insulin. Dipeptidyl Peptidase 4 inhibitors (DPP-4 inhibitors): These drugs increase the amount of insulin produced by the pancreas after a meal and reduce the amount of glucose produced by the liver. Injection Therapies There are several classes of injection therapies for diabetes. These treatments are given by an injection under the skin. The most common injection therapy is insulin, which comes in many different formulations that differ in how fast they work and how long they last. Below is a list of the different types of insulins. Technologies and Experimental Treatments Insulin Pumps: Insulin pumps were first pioneered at Yale in the 1970s. An insulin pump is an electronic, pager-sized, battery-powered device that delivers insulin continuously through a small plastic catheter under the skin. Insulin is delivered in different amounts (“basal” or “bolus” levels) during the day and controlled by the patient. While fasting, patients will administer a low level of continuous “basal” insulin to keep their blood glucose in the normal range. Prior to meals, they will determine a “bolus” of insulin based on the amount of carbohydrates in the meal. Continuous Glucose Monitoring systems (CGM): A CGM is a device that measures glucose under the skin (also known as “interstitial” glucose) every five minutes thrPediatric Endocrinology & Diabetes
Considered one of the nation’s most respected sections in endocrinology and diabetes, our team includes nationally recognized physicians, certified nurse practitioners, nurse educators, dietitians, social workers, and other caregivers. We help children and their families with the many problems that may accompany defects in the endocrine system, including diabetes, growth problems, and obesity. Yale Pediatric Endocrinology faculty are expert in the clinical management of endocrine and metabolic disorders, including: Type 1 diabetes Type 2 diabetes Obesity & weight management in children Interdisciplinary bariatric surgery clinic Lipid disorders, including hyperlipidemia and lipodystrophy General endocrine disorders Thyroid disease Parathyroid Adrenal, including congenital adrenal hyperplasia Pituitary Neuroendocrine Growth & puberty Polycystic ovarian syndrome Metabolic bone disease, including nutritional rickets & osteomalacia Interdisciplinary differences in sexual differentiation Interdisciplinary transgender program Hormonal complications of cancer and cancer treatmentPediatric Weight Solutions Program
We help children who are overweight or obese improve their health through a variety of strategies, including behavior and lifestyle modification. We understand that many factors can contribute to obesity, including genetics, diet, physical activity level, psychological issues, and adverse family events. Our team includes board-certified pediatric endocrinologists, advanced practice registered nurses, physician assistants, a registered dietitian, a bariatric surgeon, and an endocrinologist who specializes in diabetes and obesity management for adults and children. We work together to tailor treatment to each child and his or her family. Seventeen percent of children ages 2 to 19 in the United States are obese, according to the Centers for Disease Control and Prevention. While there is no cure for obesity, our caregivers work with children to prevent serious health complications that can accompany it, including: Prediabetes and type 2 diabetes Polycystic Ovary Syndrome (PCOS) High cholesterol Fatty liver disease When a child is referred to us—typically from a pediatrician—our first step is to do a full medical examination and check for obesity-related diseases and complications. We offer a traditional approach to weight loss through lifestyle changes, and incorporate the whole family into the process. We refer many children to Yale School of Medicine’s Bright Bodies Program in New Haven, which teaches children and their families about nutrition and encourages them to exercise. If lifestyle and behavioral modifications are not successful, medications are a potential option for children 16 and older. Our last step, if necessary, would be bariatric surgery, also for children 16 and up. There are rigid protocols for the surgery, as well as pre- and post-surgical care. Once patients turn 21, we can seamlessly transition them into an adult program for weight management.