Type I diabetes What we need to know

Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas cannot produce enough insulin, or there is resistance to the insulin produced.

Symptoms

Symptoms of type 1 diabetes may develop suddenly over a short period of time. these are:

• Increased thirst
• Sweating at night
• Urinating frequency
• increased hunger
• Weight loss without effort
• Irritability and other mood changes
• Constant weakness and fatigue
• blurred vision

reasons

Type 1 diabetes is an autoimmune disease in which pancreatic islet beta cells are damaged as a result of autoaggressive processes. It is these cells that synthesize insulin.

Other possible causes of the disease are:

• genetic factor
• Effects of viral and other environmental factors

The role of insulin

After a large number of islet beta-cells are damaged, insulin production is drastically reduced or completely stopped.

Insulin is produced by the pancreas.

• The pancreas secretes insulin into the bloodstream
• Insulin acts on the received sugar and ensures its absorption by the cells
• In this way, insulin lowers blood sugar levels
• As soon as the blood sugar level decreases, the release of insulin into the blood by the pancreas decreases

The role of glucose

Glucose is a simple sugar - which is the main source of energy.

• The main sources of glucose are: the food we eat and the breakdown of glycogen stored in the liver.
• The absorption of glucose in the blood by the cells is carried out with the participation of insulin
• The liver stores glucose by converting it to glycogen
• When blood sugar levels are low, the liver breaks down stored glycogen into glucose and releases it into the bloodstream.

In type 1 diabetes, there is little or no insulin, which is necessary for the cells to take up glucose. Accumulation of high concentration of glucose in the blood causes various complications.

Risk factors

• family history – The presence of type 1 diabetes in first-degree relatives - siblings and parents - increases the risk of developing it.
• genetics – Specific gene mutations predispose to the development of the disease
• age – Type 1 diabetes occurs at all ages, but it is noteworthy that the peak of detection occurs in two age groups, namely: 4-7 years age group and 10-14 years age group in children.

Complications

The progression of type 1 diabetes affects many organs and organ systems.

Cardiovascular Diseases - coronary artery injuries, angina pectoris, heart attack, heart attack, arterial hypertension, atherosclerosis.

nervous system Damage - central and peripheral neuropathies, sensitivity disorders, damage to the vegetative (internal) nervous system, erectile dysfunction and others.

eyes

Kidney damage (nephropathy) – Damage to the smallest blood vessels of the kidney disrupts its filtration properties. In advanced cases, kidney failure occurs and mechanical filtration (dialysis) is required.

visual impairments – Diabetes damages the retina (the light-sensing cells at the back of the eye) causing retinopathy and sometimes complete blindness. Diabetes increases the risk of developing other eye pathologies - cataracts and glaucoma.

ankle injury – Obstruction of blood flow in the blood vessels of the limbs, and especially in the foot, increases the risk of tissue damage and the development of a number of diseases, which may even end in amputation of the limb.

Pathologies of the skin and oral cavity - During diabetes, any infectious disease on the skin and mucous membranes develops easily. It can be bacterial and fungal diseases. Dry skin and mucous membranes and gum disease also accompany diabetes.

Pregnancy complications – A high concentration of glucose in the blood threatens the health of both the mother and the fetus. Pregnancy termination, premature birth, and developmental defects may occur in pregnant women with untreated diabetes.

Prevention

There is virtually no way to prevent type 1 diabetes, although scientific research is underway to prevent further damage to pancreatic islet cells and the development of complications.

Diagnosis

Diagnostic tests for type 1 diabetes include:

• Determination of glycated hemoglobin. This test shows the average blood glucose level over the past 2-3 months. A glycated hemoglobin level of 6.5% or more indicates the diagnostics of diabetes.

Glycated hemoglobin test is complicated by some conditions, such as pregnancy and the presence of an atypical variant of hemoglobin.

• Random determination of glucose in the blood. – A blood sample is taken randomly and additional tests are also performed to confirm the diagnostics. In this study, regardless of how long after the meal the study was conducted, a blood glucose level of 200 mg/dL or more indicates a probable diagnostics of diabetes.
• Determination of fasting glycemia. Fasting glycemic index is determined in the blood sample. 126mg/dL (7mmol/L) and more on 2 occasions indicates the diagnostics of diabetes.

when Type 1 diabetes When the diagnostics is made, a study on the presence of autoantibodies, which is characteristic of this type of diabetes as an autoimmune disease, is necessarily conducted. This is important for determining the type of diabetes.

autoantibodies

The presence of one or more types of pancreatic autoantibodies is found in 93-96% of patients with type I diabetes, both in adults and children. These antibodies have also been found in relatives of type XNUMX diabetics who are at risk of developing diabetes. These patients are initially misdiagnosed with type II diabetes before insulin dependence develops.

Latent type I diabetes can be distinguished from type II diabetes by detecting one or another type of pancreatic autoantibodies.

The risk of developing diabetes in the future can be assessed by detecting any anti-pancreas antibodies in patients with gestational diabetes.

There are several types of type I diabetes are antibodies Found:

1. Zinc transporter 8 AAK autoantibodies
2. Insulin autoantibodies
3. Antibodies to the tyrosine phosphatase-like islet antigen IA2
4. Antibodies against glutamate decarboxylase (GAD)
5. Pancreatic islet cell autoantibodies

The process of beta cell destruction in the history of diabetes development includes 5 phases:

1. genetic predisposition;
2. positive autoantibodies;
3. Abnormal insulin response to glucose tolerance test;
4. pathological oral glucose tolerance test;
5. Manifestation of clinical diabetes.

After the onset of type 1 diabetes, insulin antibody levels decrease or are virtually undetected. However, after starting insulin therapy, antibody levels may increase (especially when using insulin of animal origin). Therefore, higher doses of insulin may be required for treatment because of the antibody-induced insulin resistance.

Most cases of type 1 diabetes develop sporadically, in the absence of a family history of diabetes. Environmental factors are thought to play an important role in the development of diabetes because they act as triggers of the autoimmune process.

Treatment

Treatment for type 1 diabetes includes:

• Injectable insulin therapy
• Control of carbohydrate, fat and protein intake
• Frequent monitoring of blood glucose levels
• healthy eating
• Moderate physical activity

The goal of treatment is to maintain the level of glycemia in the blood close to normal values: fasting - within 80-130 mg/dl (4.44 - 7.2 mmol/l) and no more than 2 mg/dl (180 mmol/l) 10 hours after eating.

In type 1 diabetes, insulin administration continues throughout life.

Along with the blood sugar concentration, it is important to control other parameters as well:

Regulation of blood pressure

blood thinners

Statins – to control lipid levels

Complications

In case of type 1 diabetes, despite the efforts, complications still occur.

Hypoglycemia – decrease in blood sugar concentration

It can be caused by skipping meals, completely removing carbohydrates from the diet, physically overloading and injecting an excessive dose of insulin.

Early symptoms of hypoglycemia are:

• Pale skin
• Shivering
• Dizziness or lightheadedness
• Profuse sweating
• Feeling nauseous or very hungry
• Increased pulse rate or rhythm disturbance
• attention deficit
• Feeling weak
• Irritability
• headache
• Numbness in the face or limbs

Without intervention, the condition worsens and the symptoms worsen:

• Confusion of consciousness - with or without a change in behavior
• Violation of coordination
• slurred speech
• Blurred or "tunnel" vision
• Inability to receive food and water
• muscle weakness
• Drowsiness

As hypoglycemia worsens, the following may occur:

• heartbreak
• Suppression of consciousness - even to coma
• death (rare)

At the first symptoms of hypoglycemia, it is recommended to determine the glucose level. The condition can be alleviated by eating foods or drinks containing simple carbohydrates. If the condition worsens, it is often necessary to administer glucagon by injection or nasal spray. Glucagon is a hormone that helps raise blood sugar (breaks down liver glycogen into glucose).

Hyperglycemia – increased blood sugar concentration

Despite insulin therapy, it is possible for blood glucose levels to rise sharply. The reason for this is: excessive or improper nutrition, injection of less than necessary volume of insulin, and others.

Symptoms include:

• frequency of urination
• increase thirst
• blurred vision
• Weakness
• headache
• Irritability

When these symptoms develop, it is recommended to determine the glucose level and, if necessary, inject an additional dose of insulin. After an insulin injection, the sugar level will not decrease as quickly as it has increased, so it is better to consult your doctor.

Diabetic ketoacidosis

This is a condition where ketones in the urine increase as glucose levels rise. The provoking cause of ketoacidosis is cellular starvation, due to which the breakdown of fat begins and the formation of toxic products of breakdown - ketones. Diabetic ketoacidosis is a life-threatening condition that requires immediate attention.

Symptoms:

• Nausea-vomiting
• stomach-ache
• The sweet smell of exhaled air
• increased breathing
• dry mouth
• Weakness
• Changing consciousness
• Coma

During the development of the mentioned symptoms, when ketoacidosis is suspected, it is necessary to determine the ketones in the urine and, if necessary, seek emergency medical help for the patient.

"Synevo" offers diabetes monitoring and diagnostic tests:

 "Synevo" also offers auto-antibody tests and panels for diagnosing type I diabetes:

Source:

https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/diagnostics-treatment/drc-20353017

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