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Dia­betes mel­li­tus type 1 (also known as type 1 dia­betes, or T1DM; for­mer­ly insulin-depen­dent dia­betes or juve­nile dia­betes) is a form of dia­betes mel­li­tus that results from the autoim­mune destruc­tion of the insulin-pro­duc­ing beta cells in the pan­creas. The sub­se­quent lack of insulin leads to increased blood and urine glu­cose. The clas­si­cal symp­toms are polyuria (fre­quent uri­na­tion), poly­dip­sia (increased thirst), polypha­gia (increased hunger) and weight loss. The cause of dia­betes mel­li­tus type 1 is unknown. Type 1 dia­betes can be dis­tin­guished from type 2 by autoan­ti­body test­ing. The C‑peptide assay, which mea­sures endoge­nous insulin pro­duc­tion, can also be used. Admin­is­tra­tion of insulin is essen­tial for sur­vival. Insulin ther­a­py must be con­tin­ued indef­i­nite­ly and does not usu­al­ly impair nor­mal dai­ly activ­i­ties. Peo­ple are usu­al­ly trained to man­age their dia­betes inde­pen­dent­ly; how­ev­er, for some this can be chal­leng­ing. Untreat­ed, dia­betes can cause many com­pli­ca­tions. Acute com­pli­ca­tions include dia­bet­ic ketoaci­do­sis and non­ke­tot­ic hyper­os­mo­lar coma. Seri­ous long-term com­pli­ca­tions include heart dis­ease, stroke, kid­ney fail­ure, foot ulcers and dam­age to the eyes. Fur­ther­more, com­pli­ca­tions may arise from low blood sug­ar caused by exces­sive treat­ment. Dia­betes mel­li­tus type 1 accounts for 5% of cas­es of dia­betes. Glob­al­ly, the num­ber of peo­ple with DM type 1 is unknown, although it is esti­mat­ed that about 80,000 chil­dren devel­op the dis­ease each year. With­in the Unit­ed States the num­ber of affect­ed per­sons is esti­mat­ed at one to three mil­lion. The devel­op­ment of new cas­es vary by coun­try and region; the low­est rates appears to be in Japan and Chi­na with approx­i­mate­ly 1 per­son per 100,000 per year; the high­est rates are found in Scan­di­navia where it is clos­er to 35 new cas­es per 100,000 per year. The Unit­ed States and north­ern Europe fall some­where in between with 8–17 new cas­es per 100,000 per year.