Q&A: Raquel E. Burgos, MD, Highlights Early Type 1 Diabetes Care

Raquel E. Burgos, MD

Type 1 diabetes is a life-changing condition that can be far more manageable if caught at its earliest stages. Raquel E. Burgos, MD, of the Beyond Type 1 Science Advisory Council at BeyondType1.org, shared with MD Magazine how the disease has affected her own family, as well as her advice for an early diagnosis and treatment approach.

What are some of the warning signs of type 1 diabetes?

As a general pediatrician, the warning signs I most often see are excessive thirst and excessive urination. Oftentimes, weight loss is also noted, and parents share their child has had a recent viral illness. Some families report their child has complained of abdominal pain or has had a poor appetite. Sometimes parents have even noted a fruity odor to their child’s breath.

What’s your personal stake to the disease?

I have many personal ties to type 1 diabetes. My youngest sister and niece were both diagnosed at age 5. While already a practicing general pediatrician, my middle son was diagnosed at age 3. He was extremely thirsty and had a bedwetting episode, and was diagnosed with a quick urine and blood test. hankfully, he was diagnosed early with a blood sugar just over 200. I also have a cousin who was diagnosed at age 40.

Over the course of my career, I have diagnosed, cared for and supported many patients and families with type 1 diabetes. I feel strongly about all general practitioners and parents being educated and reminded of type 1 warning signs so patients can be diagnosed early and prior to the onset of diabetic ketoacidosis. With that, spread the word. Share the warning signs of type 1 diabetes with everyone you know. Remind your colleagues about these signs and how it’s easy in office labs to diagnose or rule out type 1 diabetes. This is especially important during busy illness seasons. Early diagnoses save lives!

How can an early diagnosis save lives?

Early diagnosis is key. If a new type 1 diabetic can be diagnosed early, before blood glucose levels have risen to life threatening ranges, long, inpatient intensive care unit hospitalizations and serious complications can be prevented.

When first warning signs are noticed by parents (excessive thirst/excessive urination), they should be reported to a doctor. A diagnosis can be reached with a few, simple, in office labs such as a urine dip and a finger stick blood glucose.

We need primary care doctors everywhere to remember type 1 diabetes in their differential diagnosis. When seeing a sick patient of any age with fatigue, poor appetite, abdominal complaints and weight loss, ask about excessive thirst and/or excessive urination. A few key questions and responses on history can raise one’s index of suspicion.

If the diagnosis is made, care and treatment by an endocrinologist inclusive of education, blood glucose testing, carb counting and insulin injections can begin. If diagnosis happens early, a patient may even be managed outpatient or with a short educational and therapeutic hospital stay to get care underway.

What is diabetic ketoacidosis?

Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. The condition develops when the body can't produce enough insulin (or isn’t receiving enough via injections) and blood glucoses are typically very high (300-plus) for a sustained period of time. DKA occurs for some at initial diagnosis or for others with concurrent illness or poor glucose control.

If a type 1 diabetic is experiencing high blood sugars, a quick urine dipstick test can be done at home to look for ketones. If a patient is with high blood sugars and ketones they must seek care right away.