Causes and Symptoms of Type 1 diabetes | Endocrinology

Type 1 Diabetes

What is type 1 diabetes?

Type 1 diabetes is a chronic disease. In people with type 1 diabetes, the cells of the pancreas that make insulin are destroyed and the body cannot make insulin.

Insulin is a hormone that helps the body’s cells use glucose for energy. Glucose reaches your body from the food you eat. Insulin allows glucose to pass from the blood into the cells of the body.

When cells are adequate, the liver and muscle tissues store excess glucose in the form of glycogen called blood sugar. It is broken down into blood sugar and released when you need energy between meals, exercise, or sleep.

In type 1 diabetes, the body cannot process glucose due to a lack of insulin. Glucose from your diet does not enter your cells. More glucose circulates in the blood. High blood sugar levels can cause short-term and long-term problems.

This occurs when your immune system destroys the insulin-producing cells in your pancreas. These are called beta cells. This condition is most often diagnosed in children and adolescents, which is why it is called childhood diabetes.

A condition called secondary diabetes is similar to type 1, but your beta cells are not killed by your immune system, but by something like disease or injury to your pancreas.

Both are different for type 2 diabetes, in which your body does not respond to insulin

Causes of type 1 diabetes

Eliminates the beta cell damage process of type 1 diabetes. Glucose does not enter the cells because there is no insulin to work with. Instead, it forms in your blood and your cells starve. It causes high blood sugar levels, which can cause:

Dehydration. When you have excess sugar in your blood, you see more. The way your body gets rid of it. With that urine, a lot of water comes out and your body dries up.

Weightloss. The glucose that comes out when you urinate incorporates calories. This is why most people with high blood sugar lose weight. Dehydration also plays a role.

Diabetic ketoacidosis (DKA). If your body doesn’t get enough glucose for fuel, it will break down fat cells instead. It produces chemicals called ketones. Your liver releases stored sugar to help. But your body won’t use it without insulin, so it will rise in your blood, along with acidic ketones. A mix of excess glucose, dehydration, and acid build-up is called ketoacidosis and can be fatal if not treated right away.

Damage to your body. Over time, high blood glucose levels can damage the nerves and small blood vessels in the eyes, kidneys, and heart. They can also lead to atherosclerosis or atherosclerosis, which can lead to heart attack and stroke.

Doctors do not know all the causes that cause it. But they know that their genes play a role.

They know you can get type 1 diabetes when something around you, like a virus, tells your immune system to go after your pancreas. They are present in all people with the condition when their blood sugar is high.

Type 1 diabetes can occur along with other autoimmune diseases such as Graves disease or vitiligo.

Symptoms of type 1 diabetes

The following are the symptoms of type 1 diabetes:

  • High appetite
  • Excessive thirst
  • Blurry vision
  • Fatigue
  • Frequent urination

A person can also develop ketoacidosis, a diabetes problem. Symptoms of this condition:

  • Breathe faster
  • Dry skin and mouth
  • Swollen face
  • The smell of fruity breath
  • Nausea
  • Vomiting or abdominal pain

If you have one or more symptoms of type 1 diabetes, you should see your doctor. If you have symptoms of ketoacidosis, you should seek medical help immediately. Ketoacidosis is a medical emergency. Learn more about the early signs of diabetes and advanced symptoms.

Risk factors

In-Type 1 diabetes, the body does not make insulin or does not have enough hormones. This condition affects approximately 5% of people with diabetes.

Doctors treat type 1 diabetes with insulin injections or insulin pumps along with diet control.

Main risk factors for type 1 diabetes:

  • Family history: Having parents or siblings with type 1 diabetes increases the risk of having the same type of person.
  • Age: Type 1 diabetes usually develops in babies and children. This is one of the most common conditions that develop in childhood. Children are usually under the age of 14 when they are diagnosed. Type 1 diabetes can occur at any age, although the development of type 1 diabetes is very rare.
  • Genetics: Having certain genes increases the risk of type 1 diabetes. A person’s doctor can check for these genes.

Other aspects of type 1 diabetes are being investigated, and this 2012 study suggests that geographic distance from the equator increases risk. However, more research is needed to confirm other risk factors.

Diagnosis of type 1 diabetes

Diagnostic tests include:

Glycated hemoglobin (A1C) test.  It measures the percentage of blood sugar in the red blood cells (hemoglobin) along with the oxygen-carrying protein. If your blood sugar levels are high, you have more hemoglobin with sugar. A1C levels of 6.5 percent or higher on two different tests indicate diabetes.

If the A1C test is not available, or if you have certain conditions that can make the A1C test inappropriate, such as pregnancy or abnormal hemoglobin (hemoglobin variant), your doctor may use these tests:

Random blood sugar test. The blood sample is taken at random and confirmed by repeated tests. Blood sugar values are expressed in milligrams per milliliter (mg / dL) or millimoles (mmol / L) per liter. Regardless of the last time you ate, a random blood sugar level of 200 mg / dL (11.1 mmol / L) or more indicates diabetes, especially in combination with any signs and symptoms of diabetes, such as frequent urination and extreme thirst.

Fasting blood sugar test. Fasting blood sugar levels below 100 mg / dL (5.6 mmol / L) are normal. Fasting blood sugar levels of 100 to 125 mg / dL (5.6 to 6.9 mmol / L) are considered prediabetes. If it is 126 mg / dL (7 mmol / L) or more on two different tests, you have diabetes.

If you are diagnosed with diabetes, your doctor may also run blood tests to look for common autoantibodies in type 1 diabetes. These tests can help your doctor distinguish between type 1 and type 2 diabetes when the diagnosis is uncertain. The presence of ketones, a byproduct of fat breakdown, in your urine indicates that you have type 1 diabetes rather than type 2 diabetes.

Treatment for type 1 diabetes

Treatment for type 1 diabetes includes:

  • Insulin intake
  • Carbohydrate, fat, and protein count
  • Frequent blood sugar monitoring
  • Eat a healthy diet
  • Exercise regularly and maintain a healthy weight

The goal is to keep your blood sugar level as close to normal as possible to delay or prevent problems. In general, your blood sugar levels during the day should be between 80 and 130 mg / dL (4.44 to 7.2 mmol / L) before meals and no more than 180 mg / dL (10 mmol / L) after your meal. food. After eating.

Insulin and other drugs

Anyone with type 1 diabetes needs insulin therapy for life.

There are many types of insulin and they include:

  • Short-acting insulin (regular)
  • Fast-acting insulin
  • Intermediate Acting Insulin (NPH)
  • Long-acting insulin

Examples of short-acting (regular) insulin are Humulin R and Novolin R. Examples of a fast-acting insulin are insulin glucose (Apidra), insulin lispro (Humalog), and Insulin Aspart (Novolog). Long-acting insulins include insulin glargine (Lantus, Tozio solo star), insulin detemir (Levemir), and insulin degludec (Tresiba). Intermediate-acting insulins include NPH insulin (Novolin N, humulin N).

Example showing an insulin pump

Open the pop-up Insulin Pump dialog

Insulin administration

Insulin cannot be taken by mouth to lower blood sugar because enzymes in the stomach break down insulin and inhibit its action. You must receive it by injection or by an insulin pump.

Injections You can use a fine needle and an insulin syringe or pen to inject insulin under the skin. Insulin pens look similar to ink pens and are available in non-reusable or reusable variants.

If you choose injections, you will need a mix of insulin types to use day and night. Multiple daily injections in combination with rapid-acting insulin mimic the body’s normal use of insulin more closely than the old insulin regimen, requiring only one or two injections per day. A regimen of three or more insulin injections a day has been shown to improve blood sugar levels.

Insulin bomb. You wear this cell phone-sized device outside of your body. A tube connects the insulin reservoir to a catheter that is inserted under the skin of your abdomen. This type of pump can be worn in a variety of ways around the waist, in a pocket, or with specially designed pump belts.

There is also a cordless pump option. You wear a pad that holds a reservoir of insulin over your body, which holds a small catheter inserted under your skin. The insulin pad can be used on the abdomen, back, leg, or arm. Programming is done with a wireless device that communicates with the pod.

The pumps are programmed to automatically deliver specific amounts of rapid-acting insulin. This fixed dose of insulin is called the basal rate, and it replaces the chronic insulin you are using.

When you eat, program the pump with the number of carbohydrates you eat and your current blood sugar level, and what is called the bolus dose of insulin to cover your meal and correct it if your blood sugar rises. Some research has found that insulin pumping is more effective in controlling blood sugar levels than injections. But most people achieve good blood sugar levels with injections. An insulin pump in conjunction with a continuous glucose monitoring device (CGM) provides more rigorous blood sugar control.

Other drugs

Additional medications may be prescribed for people with type 1 diabetes, including:

Medications for hypertension. Your doctor may prescribe angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) to help keep your kidneys healthy. These medications are recommended for people with diabetes who have blood pressure greater than 140/90 mm Hg (mm Hg).

Aspirin. Your doctor may recommend that you take aspirin.

Prevention

If you don’t smoke cigarettes, you will greatly reduce your risk of lung cancer and emphysema. By maintaining a healthy weight, eating a moderate diet, and exercising regularly, you greatly increase your chances of having a healthy heart.

If you have a family history of the disease or are at risk of developing type 1 diabetes, can you do anything to stop it? The answer is a definite “maybe”.

Diabetes experts have now identified type 1 diabetes as an autoimmune disease in which the body’s immune system, for some reason, begins to attack and destroy the beta islet cells of the pancreas that produce and release insulin. When enough beta islands are destroyed, the body does not produce enough insulin to properly control blood sugar, resulting in type 1 diabetes.

Since type 1 diabetes is caused by the general immune system, researchers believe that it can be prevented by intervening and preventing, interrupting, or at least slowing down the development process of the disease. So far, the result has been mixed at best.

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