April 9, 2024

All About Type 1 Diabetes: Top Pathologist Answers Your Questions

Written by our expert

Drneha

Dr. Neha Singh

Master's in Pathology (DNB) & MBBS

All About Type 1 Diabetes: Top Pathologist Answers Your Questions
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Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves. 

About 422 million people worldwide have diabetes, the majority living in low-and middle-income countries, and 1.5 million deaths are directly attributed to diabetes each year.

Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades. 

Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself.

 The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin.

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Why Does Type 1 Diabetes Happen?

Type 1 diabetes is an autoimmune condition where the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas called beta cells. Insulin is a hormone that helps regulate blood sugar (glucose) levels by allowing glucose to enter cells and be used for energy production.

When beta cells are destroyed, the body can no longer produce enough insulin, leading to high glucose levels in the blood.

The exact cause of type 1 diabetes is not fully understood, but it is believed to involve a combination of genetic predisposition and environmental factors. Certain genes make some individuals more susceptible to developing type 1 diabetes.

Still, environmental triggers such as viral infections or exposure to certain toxins may also play a role in triggering the autoimmune response that leads to the destruction of beta cells.

Type 1 diabetes typically develops early in life, often during childhood or adolescence, although it can occur at any age. Unlike type 2 diabetes, which is often associated with lifestyle factors such as obesity and physical inactivity, type 1 diabetes is not preventable and cannot be cured.

People with type 1 diabetes require lifelong insulin therapy to manage their blood sugar levels and prevent complications.

What Happens in Type 1 Diabetes?

In type 1 diabetes, the body's immune system attacks and destroys the insulin-producing beta cells in the pancreas. This autoimmune response leads to a deficiency in insulin production, resulting in high levels of glucose (sugar) in the bloodstream, a condition known as hyperglycemia.

Different Types Of Diabetes And Their Symptoms
Symptoms of type 1 diabetes Source

Without sufficient insulin, glucose cannot enter cells to be used for energy, so it builds up in the bloodstream instead. This can lead to various symptoms and complications, including:

  • Frequent urination: Excess glucose in the bloodstream is filtered by the kidneys and excreted in the urine, leading to increased urination
  • Excessive thirst: The body tries to compensate for fluid loss due to increased urination by increasing thirst.
  • Extreme hunger: Despite high levels of glucose in the bloodstream, cells are unable to access it for energy, leading to persistent hunger.
  • Unexplained weight loss: Without enough insulin to facilitate the uptake of glucose into cells, the body starts to break down fat and muscle tissue for energy, resulting in unintended weight loss
  • Fatigue: Cells are deprived of glucose for energy, leading to fatigue and weakness.
  • Blurry vision: High levels of glucose in the bloodstream can cause fluid to be pulled from the lenses of the eyes, affecting their ability to focus properly.

If left untreated, type 1 diabetes can lead to severe complications, including diabetic ketoacidosis (DKA), a life-threatening condition characterized by dangerously high levels of ketones in the blood, as well as long-term complications affecting the eyes, kidneys, nerves, and cardiovascular system.

Managing type 1 diabetes requires regular monitoring of blood glucose levels, insulin therapy (usually through injections or an insulin pump), a healthy diet, regular exercise, and close medical supervision to prevent complications and maintain optimal health.

How is Type 1 Diabetes Diagnosed?

Type 1 diabetes is diagnosed through a combination of symptoms, blood tests, and medical history. Here's how it typically unfolds:

  1. Symptoms Recognition: The process often begins with the recognition of common symptoms of diabetes, such as excessive thirst, frequent urination, unexplained weight loss, fatigue, and blurred vision.
  1. Medical History and Physical Examination: A healthcare provider will take a detailed medical history, asking about symptoms, family history of diabetes, and any other relevant medical conditions. They will also perform a physical examination to check for signs of diabetes and its complications.
  2. Blood Tests: The definitive diagnosis of type 1 diabetes is made through blood tests that measure blood glucose levels and other markers:
    • Fasting Plasma Glucose Test: This test measures blood glucose levels after a period of fasting (usually overnight). A fasting blood glucose level of 126 milligrams per deciliter (mg/dL) or higher on two separate occasions indicates diabetes.
    • Oral Glucose Tolerance Test (OGTT): This test involves drinking a sugary solution and then measuring blood glucose levels before and two hours after consumption. A blood glucose level of 200 mg/dL or higher two hours after drinking the solution indicates diabetes.
  3. Hemoglobin A1c Test: This blood test measures the average blood glucose level over the past two to three months. An A1c level of 6.5% or higher is indicative of diabetes.
  4. Additional Tests: In some cases, additional tests may be performed to confirm the diagnosis or evaluate for complications of diabetes, such as urine tests to check for the presence of glucose and ketones, and tests to assess pancreatic function and autoantibodies associated with type 1 diabetes, such as antibodies to insulin, glutamic acid decarboxylase (GAD), and islet cell cytoplasm.

Once diagnosed, individuals with type 1 diabetes require ongoing medical care and management to control blood glucose levels and prevent complications. This typically involves regular monitoring of blood glucose levels, insulin therapy, dietary management, regular exercise, and routine medical check-ups.

Can Type 1 Diabetes Be Cured ?

While there is no cure for type 1 diabetes yet, ongoing research offers hope for better treatments and eventual cures. In the meantime, managing type 1 diabetes through careful monitoring, insulin therapy, and lifestyle adjustments remains essential for maintaining health and preventing complications.

Current treatments for type 1 diabetes focus on managing blood sugar levels through insulin therapy, diet, exercise, and other medications as needed. Insulin therapy is essential because people with type 1 diabetes do not produce insulin and need to replace it through injections or an insulin pump to survive.

Several research avenues are exploring potential cures or long-term management strategies for type 1 diabetes, including:

  1. Pancreas or Islet Cell Transplantation: Transplanting a pancreas or isolated islet cells from a donor into a person with type 1 diabetes may restore insulin production. However, this approach is limited by the availability of donor organs and the need for lifelong immunosuppressive medications to prevent rejection.
  2. Beta Cell Replacement Therapy: Researchers are exploring ways to replace the destroyed beta cells in the pancreas with new beta cells generated from stem cells or other sources. This approach aims to restore insulin production while avoiding the need for immunosuppressive drugs.
  3. Immunomodulation Therapy: Strategies to modulate the immune system and prevent the autoimmune attack on beta cells are being investigated. This includes immunotherapy approaches aimed at inducing immune tolerance to beta cells or suppressing the autoimmune response.
  4. Artificial Pancreas: Advances in technology have led to the development of artificial pancreas systems that automate insulin delivery based on real-time glucose monitoring. While not a cure, these systems can significantly improve

Which is Worse, Type 1 Diabetes or 2 ?

Comparing the severity of type 1 and type 2 diabetes is not straightforward because they are different conditions with unique characteristics, risk factors, and complications. Here are some key differences:

  • Cause:
    • Type 1 diabetes: It is an autoimmune condition where the body's immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas.
    • Type 2 diabetes: It is characterized by insulin resistance, where the body's cells do not respond effectively to insulin, combined with relative insulin deficiency. Risk factors for type 2 diabetes include obesity, sedentary lifestyle, family history, and age.
  • Onset:
    • Type 1 diabetes: It often develops during childhood or adolescence, but it can occur at any age.
    • Type 2 diabetes: It typically develops in adults, although it is becoming more common in younger individuals, including adolescents and children, due to rising rates of obesity and sedentary lifestyle.
  • Treatment:
    • Type 1 diabetes: It requires lifelong insulin therapy to manage blood sugar levels.
    • Type 2 diabetes: Initially, treatment may involve lifestyle modifications such as diet and exercise, oral medications, and sometimes insulin therapy if other measures are insufficient.
  • Complications:
    • Both type 1 and type 2 diabetes can lead to similar long-term complications if not properly managed, including heart disease, stroke, kidney disease, nerve damage (neuropathy), eye damage (retinopathy), and foot problems.
    • Type 1 diabetes is associated with a higher risk of diabetic ketoacidosis (DKA), a potentially life-threatening condition characterized by high levels of ketones in the blood.
    • Type 2 diabetes is often associated with a higher risk of other health conditions such as high blood pressure, high cholesterol, and fatty liver disease.

In terms of severity, both types of diabetes can have serious consequences if left untreated or poorly managed. However, the specific challenges and risks associated with each type may vary, and individual experiences can differ widely.

It's important for individuals with diabetes to work closely with healthcare providers to develop personalized treatment plans and manage their condition effectively.

Do you have specific questions or concerns about type 1 diabets? Shoot an email to [email protected].

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