What is type 1 diabetes?
Type 1 diabetes is most commonly diagnosed in children and adolescents, but can occur in adults as well. It is an autoimmune disorder, in which the body's own immune system attacks the beta cells in the Islets of Langerhans of the pancreas, destroying them or damaging them sufficiently to reduce insulin production. The autoimmune attack may be triggered by reaction to an infection, for example by one of the viruses of the Coxsackie virus family. A subtype of Type 1
(identifiable by the presence of antibodies against beta cells) develops slowly and so is often confused with Type 2. In addition, a small proportion of Type 1 cases has the hereditary maturity onset diabetes of the young (MODY).
Some poisons (e.g., a type of rat poison) work by selectively destroying certain types of cells, including pancreatic beta cells, thus producing 'artificial' Type 1 diabetes. Other pancreatic problems including trauma or tumor (either malignant or benign) can also lead to loss of insulin production and Type 1. Currently, Type 1 is treated with insulin injections, lifestyle adjustments, and careful monitoring of blood glucose levels using blood test kits. The treatment must be continued indefinitely. Experimental replacement of beta cells (by transplant) is being investigated in several research programs and may become clinically available in future.
About 5-10% of all North American cases of diabetes are Type 1 diabetics. The fraction of Type 1 diabetics in other parts of the world differs; this is likely due to both differences in the rate of Type 1 and differences in the rate of other Types, most prominently Type 2. Most of this difference is not currently understood. Formerly, Type 1 diabetes was called "childhood" or "juvenile" diabetes or "insulin dependent" diabetes. Each term is a misnomer, most especially since the obesity epidemic in recent years has led to increased incidence of Type 2 diabetes in children and adolescents and insulin is used in some Type 2 cases.
It is believed that the tendency to develop these abnormal antibodies in type 1 diabetes is, in part, genetically inherited, though the details are not fully understood. (Exposure to certain viral infections (mumps and Coxsackie viruses) or other environmental toxins may serve to trigger abnormal antibody responses that cause damage to the pancreas cells where insulin is made. These antibodies can be measured, and may help determine which individuals are at risk for developing type 1 diabetes. At present, the American Diabetes Association does not recommend general screening, though screening of high risk individuals, such as those with a first degree relative (sibling or parent) with type 1 diabetes should be encouraged. Type 1 diabetes tends to occur in young, lean individuals, usually before 30 years of age, however, older patients do present with this form of diabetes on occasion. This subgroup is referred to as latent autoimmune diabetes in adults (LADA). LADA is a slow, progressive form of type 1 diabetes. Only approximately 10% of the patients with diabetes mellitus have type 1 diabetes and the remaining 90% have type 2 diabetes mellitus.
People with Type 1 diabetes are more prone that people with Type 2 diabetes to develop a condition called ketosis. Ketosis is an abnormal buildup of substances known as ketones, which is caused by the break down too many fats. Ketosis can lead to the development of ketoacidosis. Ketosis and ketoacidosis both involve a buildup of ketones. However, ketosis does not involve increased acid levels like ketoacidosis does. See the section on signs and symptoms of diabetes to read more about ketoacidosis. Type 1 diabetes is also known as juvenile diabetes, juvenile-onset diabetes, brittle diabetes, ketosis-prone diabetes, immune-mediated diabetes, and idiopathic diabetes. The famous actress, Mary Tyler Moore, has Type 1 diabetes.
If you have Type 1 diabetes then your body will not be producing any insulin. Insulin is necessary for survival, so the only option is to provide the body with insulin from an outside source. Because it is a protein hormone, if it is taken by mouth (e.g. as a tablet) it is destroyed by the digestive system before it has chance to be absorbed. Insulin is therefore injected into the layer of fat that lies just beneath the skin. Alternatively, insulin can be supplied continuously by a pump; it is fed into the body through a long thin tube with a needle or plastic cannula that is inserted under the skin.
The amount of insulin that is given must closely match the body's requirements in order to keep the blood glucose level in the right range. Too much insulin causes it to fall too low (hypoglycaemia) and too little causes it to rise too high (hyperglycaemia). Both of these conditions are unpleasant and can be dangerous if they are not corrected. So, insulin needs to be closely matched with food intake (amount and timing) and exercise levels. This continual juggling act forms the crux of diabetes management and is only made possible with regular testing of blood glucose levels during the day.
More information on diabetes mellitus
What is diabetes mellitus? - Diabetes mellitus is a a condition characterized by hyperglycemia resulting from the body's inability to use blood glucose for energy. Diabetes mellitus can result in coma. Over time, complications can include nerve injury, blindness, kidney failure, and premature atherosclerosis with all of its complications.
What causes diabetes mellitus? - Diabetes mellitus is a disorder caused by insufficient production of the hormone insulin by the pancreas, or insensitivity of cells to the effects of insulin. Insulin is responsible for the absorption of glucose into cells for their energy needs and into the liver and fat cells for storage.
What is insulin? - Insulin is a hormone that is produced by specialized cells (beta cells) of the pancreas. In addition to helping glucose enter the cells, insulin is also important in tightly regulating the level of glucose in the blood.
What types of diabetes mellitus are there? - There are four main types of diabetes mellitus. They are type 1 diabetes mellitus, type 2 diabetes mellitus, type 3, and Gestational diabetes mellitus (type 4).
What is type 1 diabetes? - Formerly known as juvenile diabetes or insulin-dependent diabetes, type 1 diabetes is a life-long condition in which the pancreas stops making insulin. Type 1 diabetes develops most often in young people but can appear in adults.
What is type 2 diabetes? - Type 2 diabetes is the most common form of diabetes mellitus. People with type 2 diabetes produce insulin, but either do not make enough insulin or their bodies do not use the insulin they make. Type 2, also known as non-insulin dependent diabetes, typically occurs after the age of 40 years.
What're signs and symptoms of diabetes mellitus? - Type 2 diabetes almost always has a slow onset (often years). Early symptoms of Type 1 diabetes are often polyuria (frequent urination) and polydipsia (increased thirst, and consequent increased fluid intake).
What is diabetes insipidus? - Diabetes insipidus (DI) is a disease characterized by excretion of large amounts of severely diluted urine, which cannot be reduced when fluid intake is reduced.
What is diabetic coma? - Diabetic coma is a medical emergency in which a person with diabetes is unconscious because the blood glucose level is too low or too high. Patients with diabetes mellitus type 1 are especially prone to this condition.
What are the complications of diabetes mellitus? - Many people with diabetes mellitus eventually develop complications. A very common short-term complication of diabetes mellitus is hypoglycemia (abnormally low blood sugar levels).
How to diagnose diabetes mellitus? - The diagnosis of type 1 diabetes is usually prompted by recent symptoms of excessive urination (polyuria) and excessive thirst (polydipsia), often accompanied by weight loss. The diagnosis of other types of diabetes is made in many other ways.
Diagnosis protocol for diabetes - People over age 45 should be tested for diabetes. If the first blood glucose test is normal, they should be re-tested every three years. A diagnosis of diabetes is made when any three of these tests is positive, followed by a second positive test on a different day.
What is the treatment for diabetes? - Diabetes is a chronic disease with no cure, but it can almost always be managed effectively. Nowadays, the goal for diabetics is to avoid or minimize chronic diabetic complications, as well as to avoid acute problems of hyperglycemia or hypoglycemia.
What type of diabetes diet is suggested? - For some people with diabetes mellitus, a healthy diet and weight loss is enough to keep glucose levels in the blood normal.
What medications are available for diabetes? - Oral diabetes medicines, or oral hypoglycemics, can lower blood glucose in people who have diabetes, but are able to make some insulin. Six FDA-approved oral diabetes medications are now on the market.
How to prevent diabetes? - Diabetes prevention is proven, possible, and powerful. Studies show that people at high risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their body weight.
What should a child diabetes do every day? - To control diabetes and prevent complications, blood glucose levels must be as close to a "normal" range as safely possible. Families should work with a health care provider to help set a child's or teen's targets for blood glucose levels.
Smoking and diabetes - There is a growing body of evidence to suggest that smoking is an independent risk factor for diabetes and that among people with diabetes, smoking aggravates the risk of serious disease and premature death.