What is type 1 diabetes?
Type 1 diabetes mellitus also called insulin-dependent, or juvenile-onset diabetes is when the pancreas either does not produce insulin or produces insufficient insulin. This is an autoimmune condition in which the immune system attacks and destroys the β-cells of the pancreas. The pancreatic β-cells are responsible for producing insulin and their destruction will result to a deficiency in the amount of insulin produced. Anyone can get type 1 diabetes (T1D) except children under 6 months of age. Patients with insulin-dependent diabetes require a daily intake of insulin to stay alive. In addition to daily insulin injections, they must also follow strict diet and exercise regimens. Patients with T1Ds have their life span reduced by about one-third (1/3) because of the complications that arise with type 1 diabetes.
Causes of type 1 diabetes
Type 1 diabetes (T1D) is caused by an autoimmune reaction in which the immune system attacks the insulin producing cells of the pancreas called the β-cells of the islets of Langerhans. The exact cause of this is not known. But many factors have been shown to contribute to T1D. Factors which contribute to T1D include genetic composition, environmental influence, early diet, viral infection, or autoimmune diseases. Lifestyle, weight or eating too much sugar does not cause type 1 diabetes.
Type 1 diabetes develops slowly over time and symptoms will emerge only when more than 80 % of β-cells have been destroyed. Therefore, there is usually a rapid onset of symptoms. This rapid onset of symptoms helps to differentiate type 1 and type 2 diabetes. Unlike type 1 diabetes, the symptoms for type 2 diabetes develop very slowly over time.
Signs and symptoms of type 1 diabetes
Signs and symptoms may appear suddenly in children, adolescents and adults and include:
- Frequent urination: This happens because the kidney is attempting to expel excess blood sugar.
- Increase thirst due to frequent urination and dehydration.
- Dry mouth: Frequent urination and dehydration may cause a person to experience dry mouth.
- Fatigue and body weakness: This happens because your body is putting countless effort to expel excess sugar out and because of dehydration. Also, it is low in energy since it cannot make use of glucose.
- Blurred visions: High levels of glucose will cause glucose to accumulate in the lens of the eye. This results to swelling and precipitation of lens proteins. Consequently, the eye becomes opaque resulting to blur visions. This can result to complete loss of sight with time.
- Unexplained weight loss: The body burns calories to actively expel excess glucose. In addition, it is unable to use glucose for generating energy, and starts burning fat and protein. Inability to use glucose in addition to dehydration and the strain placed on your body causes loss in body weight.
- Bed wetting especially in children who normally do not bed wet.
- Increase hunger: With type 1 diabetes, your body is actively trying to always expel excess glucose. This results to an increase feeling of hunger
- Slow healing cuts or wounds: Elevated blood sugar levels damage blood vessels resulting to a weaken circulation. The result is that blood is not adequately circulated through every area of your body. Consequently, cuts or wounds will take weeks or months to heal.
- Tingling or numbness in the hands or feet: Uncontrolled high blood sugar damages and weakens blood vessels. Consequently, oxygen and nutrients cannot reach the brain adequately resulting to nerves damage overtime. Damage to nerves comes with a feeling of tingling or numbness.
Diabetic ketoacidosis (DKA)
In T1D, the body is actively expelling glucose such that, there is not enough left for fuel. To compensate, the body then begins to break down fat as well. Breaking down of fat results to the accumulation of substances called ketones in the blood. Ketones are acidic substances and hence will cause your blood to become acidic. This is known as diabetic ketoacidosis (DKA). Accumulation of ketone in the blood will trigger the respiration system to breath faster and heavily at a consistent pace to expel carbon dioxide in the blood. Carbon dioxide is acidic and as acidic ketones build up, more carbon dioxide is expelled in an attempt to create a balance. This abnormal breathing pattern is referred to as Kussmaul respiration or Kussmaul breathing. Kussmaul respiration is a sign of medical emergency associated with diabetes.
In addition to triggering rapid or heavy breathing, high levels of ketones in the blood will also cause fruity-smelling breath. Therefore, fruity smelling breath is a sign of diabetic ketoacidosis.
Complications of type 1 diabetes
High level of blood glucose or sugar (hyperglycemia) slowly damages organs with time. In addition, daily injection of insulin results to inaccurate metabolic control. Eventually, these two factors lead to complications most of which are life threatening or disabling. Complications due to diabetes type 1 diabetes (T1D) include:
Nerve impairment or damage (neuropathy)
Blood vessels are responsible for transporting oxygen and nutrients to your brain or nerves. High levels of blood sugar weakens and damages blood vessels and over time results to nerve damage. Nerve damage comes with a feeling of tingling, numbness, or pain especially at the tips of the fingers or toes and may spread upward to other parts of your body. If a balance in blood sugar is not maintained, it will eventually lead to a complete loss of sensation in the affected limb.
Nerve damage together with poor blood flow also causes erectile dysfunction in men and loss of sexual sensation in women. If the damage affects nerves of the gastrointestinal tract, then complications such as nausea, vomiting, diarrhea, or constipation will occur.
Kidney damage (nephropathy)
Each kidney is made up of millions of tiny filtration units composed of tiny blood vessels (capillaries). High blood sugar overtime weakens and damages these tiny and delicate blood vessels and can also lead to high blood pressure. Eventually, this leads to kidney failure or an end-stage kidney disease requiring dialysis or kidney transplant.
High blood sugar damages blood vessels and nerves which help for the smooth functioning of your heart. The longer you have T1D, the higher your chances of developing cardiovascular diseases including stroke, heart attack, coronary artery disease (chest pain and discomfort), heart attack, narrowing of the arteries and high blood pressure.
The high level of glucose observed in T1D causes accumulation of glucose in the lens of the eye. This causes blur visions and eventually leads to loss of sight or blindness. Damage to the blood vessels of the retina due to poorly controlled blood sugar also leads to diabetic retinopathy.
High levels of sugar in the blood and urine creates a suitable environment for microorganism to flourish. This makes patients with T1D susceptible to fungal or bacterial infections of the skin, mouth, urinary tract, or vagina. Maintaining a sugar balance can help reduce the possibility of getting an infection.
Complications during pregnancy
High blood sugar is life threatening to both a mother and her baby. For the baby, there’s risk of miscarriage, still birth or birth defects. On the other hand, the mother runs the risk high blood pressure, preeclampsia, or diabetic ketoacidosis.
High blood sugar weakens and damage blood vessels. This affects circulation to every part of the body especially the feet which are furthest from the heart. Diabetics with infections or wound on the feet might not heal easily and such can lead to gangrene. Ultimately, the need for toe, foot or leg amputation may arise.
Risk factors for type 1 diabetes
Type 1 diabetes (T1D) affects only 5 to 10 % of people with diabetes. Although both men and women are at equal risk of having T1D, some factors can make some individuals more susceptible than others. This includes:
- Family history of type 1 diabetes. If you have parents, brothers, or sisters with T1D, then you have an inherited susceptibility to developing the disease.
- Type 1 diabetes affect individuals of any age, but it mostly affects people below the age of twenty notably children between ages 4 and 7 and those between ages 10 and 14.
- Genetic makeup. Individuals with certain genetic composition are susceptible to developing T1D.
- Geographical location or environment. As you move away from the equator, you are at higher risk of developing T1D. In order words, people living in northern climates will be more susceptible to T1D.
- Race/ethnicity. Caucasians (whites) are more susceptible to T1D than Blacks or Latinos. Chinese have a lower risk of developing T1D.
- Diseases or infection. Certain viruses such as mumps, coxsackie and German measles may cause T1D by instigating the immune system to turn against the body. On the other hand, having certain autoimmune conditions such as Grave’s disease, pernicious anemia or multiple sclerosis can cause the immune system to also turn against the body.
- Early diet. According to research, children given cow’s milk at a very young age (before 2 months) have a higher risk of developing autoimmune diseases including T1D. Also, the study showed that introducing children to cereal-based meals before 3 months increases the risk of T1D.
Prevention of type 1 diabetes
Presently, there exist no natural or medical intervention that can be used to prevent type 1 diabetes (T1D) completely. However, you can reduce the risk of acquiring T1D in your lifetime by managing the following risk factors:
- Regular checkups. Autoimmune diseases and viral infections are known to increase the risk for T1D. Therefore, always go for regular checkups especially if you do not feel well. The earlier a disease or infection is diagnosed, the easier it can be treated.
- Monitor blood sugar and cholesterol level regularly. Do this before and after eating or exercising. This will help you to pinpoint early signs and from this you can modify your lifestyle accordingly.
- Genetic screening. Genetic makeup is one of the major causes of type 1 diabetes. Therefore, genetic screening can help identify risk factors for T1D. Although tests may be positive, there is no guarantee that T1D will be prevented. But your doctor can suggest some lifestyle changes, self-management education and support which will assist to reduce the risk.
- Early diet. Do not introduce your children to dairy products or cereal based meals before 2 months old. It increase the risk of type 1 diabetes according to this research.
Can exercising prevent type 1 diabetes?
No. Regular exercise cannot prevent you from having type 1 diabetes. However, it can be used to control your blood sugar levels and avoid long-term complications.
Diagnoses of Type 1 diabetes
Type 1 diabetes (T1D) can be tested or diagnosed using simple blood tests which measure the amount of glucose in the blood. To rule out type 2 diabetes (T2D) and confirm diagnosis of T1D, your healthcare provider will also take into consideration the onset of symptoms. Compared to T2D, symptoms for T1D are very sudden. Your blood may also be tested for autoantibodies which is an indication that the immune system is attacking the body as in the case with T1D and not T2D. Ketones are substances produced when your body burns fat for energy instead of glucose. The presence of ketones in urine will also be tested and indicates T1D instead of T2D if present.
Treatment of type 1 diabetes
There is currently no permanent cure for the treatment of type 1 diabetes. However, the development of effective immunosuppressive drugs and advances in medical research has led to β-cell transplant as a possible cure for type 1 diabetes. But this is still considered an experimental therapy and not yet widely available.
Managing type 1 diabetes
Although type 1 diabetes cannot be permanently treated, you can still live a normal life and avoid or minimize complications by careful management of your blood sugar levels. You can manage type 1 diabetes as follows:
- Get a healthy lifestyle including healthy balance diet and physical exercise.
- Keep your blood sugar under control when eating or exercising.
- Regularly monitor your blood sugar and cholesterol level before and after eating, exercising or a taking an insulin dose to understand how your body is affected. This will help you determine how much insulin you need to take and to change your lifestyle accordingly.
- Take good care of your feet, mouth, or genitals to prevent infection, wound or complications.
- Regularly go for medical, dental or eye checkup.
- Stop smoking!