Onset of type 1 DM is bi-modal, with the largest peak in the number of new cases occurring during childhood and a smaller peak occurring in early adulthood. Type 1 DM can occur as late as the eighth or ninth decade. Persons with type 1 DM tend to present with symptoms, and the disease is usually diagnosed soon after its clinical onset. As such, onset of their disease is insidious. They can be relatively symptom-free for years before diagnosis.
Diabetic complications are varied and serious.
Other complications include neuropathy, cardiovascular disease, and peripheral vascular disease. The most accurate method of screening is measurement of a fasting plasma glucose. Measurement of urine glucose has been used in the past but is much less accurate and is no longer recommended. Evidence indicates that early treatment of patients with established type 1 DM decreases the number of long-term, microvascular complications. Primary prevention trials for both type 1 and 2 DM are presently underway.