What is Type 1 Diabetes Mellitus?
Type 1 diabetes or insulin-dependent diabetes mellitus, is also known as juvenile diabetes among the common folks. Because type 1 diabetes mellitus is usually seen in children or young people.
Type 1 diabetes mellitus, is a condition that mainly arises in the body because beta cells of the pancreas that it is responsible to produce insulin are destroyed. The pancreas is the only organ where insulin is produced, so it leads to insulin deficiency.In the body of a healthy person after meals, there is a rapid surge in the blood glucose level, due to the digestion and absorption of food.
This increase in blood glucose is much higher than the body normally needs, so our body stores the extra glucose in the form of glycogen with the help of insulin.In people with type 1, diabetes mellitus the body can’t process this increased glucose normally, due to lack of insulin.This leads to a high level of glucose circulating in their bloodstream.
Type 1 diabetes mellitus must not be confused with secondary diabetes, because secondary diabetes occurs when the pancreas gets damaged either due to some disease, infection, injury, or trauma.
Role of Insulin
INSULIN hormone is the main hormone responsible for blood glucose metabolism in our body.It helps the body cells to absorb glucose from the bloodstream to generate energy and thus helps to reduce the blood glucose level.
So, insulin deficiency leads to high blood glucose levels which can have many short and long term complications.
Cause of Type 1 Diabetes Mellitus
Type 1 diabetes is an autoimmune disease, occurs when your body’s immune system which is responsible for fighting infection, attacks its own pancreatic cells, leading to the destruction of insulin-producing beta cells of the pancreas.
The exact cause behind type 1 diabetes mellitus is unknown but it’s speculated that this condition might arise due to genes, which are triggered by certain environmental factors or pathogens.
Type 1 Diabetes symptoms
Type 1 Diabetes is more common in the early stages of life and shows appearances that are more rapid and instantaneous. Various symptoms associated with this disease are
• Increase in thirst( polydipsia):-
• Increased frequency of urination(polyuria)
•New bedwetting tendency among children who were usually dry at night.
• Extremely hungry feeling(polyphagia)
• Unexpected weight loss
• Generalized feel of weakness
• Impairment of vision
Treatment of type 1 diabetes mellitus
Since type 1 diabetes mellitus is a condition in which the body is unable to produce insulin.So a supplementary source of insulin is required to maintain the normal blood glucose level.
Primary treatment that is given in Type 1 diabetes mellitus is “insulin”. Along with insulin various supportive medication can also be prescribed by your doctor.
In 1922 the first human trial of insulin was done. But this was animal insulin which was extracted from the pancreas of animals (pig, cow, or dog). The main side effect associated with animal insulin was, that it triggered an allergic response in the body.
So, in 1978 first synthetically derived human insulin was made by the use of recombinant DNA technology, this was possible due to rapid advancement in the field of biotechnology. It was much safer insulin and does not trigger any kind of allergic response.
Today, there are various kinds of insulin available in the market right now depending on various kinds of necessity and parameters of use. But all types of insulin basically have the same effect, to reduce the blood sugar.
On the basis of duration of action, insulin is categorized into four categories
•Rapid acting insulin– starts acting within 15 minutes after being injected and its effect lasts up to 3-4 hours. It is usually taken before meals.
•Short acting insulin– it starts working within 30 to 60 minutes after being injected in the body. Its effect lasts up to 5 to 8 hours. It is usually prescribed before meals.
•Intermediate acting insulin– it starts to work after 1 to 2 hours after being injected in the body. Its effect lasts up to 12 to 18 hours.
•long acting insulin– it is starting to work after 2 hours of injection in the body. Its effect can last up to 24 hours or even further.
Insulin is usually administered subcutaneously, in two ways either by insulin pen or subcutaneous injection.
The required dose of insulin to be injected is usually determined by the doctor after blood sugar analysis. Regular blood sugar tests and follow-ups are required to check the effectiveness of the medication. Because the required dose of insulin tends to vary over time.
Along with insulin, metformin is also often prescribed by doctors. Glycogen stored in hepatic cells is broken down to produce glucose. Metformin being a hypoglycemic drug prevents the rise in blood sugar by suppressing hepatic cells and glycogen breakdown.
Along with insulin “Pramlintide”, an injectable hormone is also often prescribed. It helps to prevent post-meal hyperglycemia.
it is very helpful for those people who are suffering from type 1 diabetes mellitus and needs to take multiple injections of insulin in a day. The insulin pump is a computerized device, that mimics the insulin delivery mechanism of the human pancreas. It is about the size of a smartphone that can be easily worn around the neck. These insulin pumps deliver insulin in the subcutaneous layer of fat through a catheter or cannula.
It is very helpful because it provides continuous and regular delivery of any short-acting insulin throughout the day. These pumps are programmed on the basis of the metabolism of a patient.
It is a highly advanced and sophisticated form of insulin pump that is under a closed-loop control of a computerized glucose monitoring device. It uses a real-time data feedback mechanism from a wireless glucose meter that is placed subcutaneously. The real-time data of blood glucose is used by the device to continuously and automatically control the blood glucose level by infusion of required doses of short-acting insulin. Artificial pancreas is highly effective in patients of type 1 diabetes mellitus who are suffering from chronic diabetic conditions.
Complications of type 1 diabetes mellitus
- Cardiovascular disease:- people with type 1 diabetes mellitus are at higher risk of developing blood clots, increase cholesterol levels, and high blood pressure. This can further increase the risk of stroke heart attack angina or heart failure.
- Poor blood flow:- patients of type 1 diabetes mellitus, who usually had a history of high blood sugar in past, tend to develop atherosclerosis or (hardened arteries). This leads to the poor blood supply in the peripheral organs like hands and feet. So it makes it harder for any wound or opens sore, to heal normally. When that happens infection might get spread to larger areas leading to gangrene. In serious cases, amputation of a limb is required.
- Peripheral neuropathy:- increase blood sugar and poor blood supply in the peripheral organs cause damage to nervous tissue. This leads to decreased pain and touch sensation in distal organs like hands and feet. So there are chances that any accidental injury might get unnoticed by the patient of type 1 diabetes mellitus.Increase blood sugar and poor pain sensation leads the infection to spread further resulting in tissue necrosis and gangrene. In serious cases often amputation of infected limb or digit(finger or toe) is the only option left, to prevent the further spread of infection.
- Retinopathy:- diabetic retinopathy is very common in adults who you are suffering from type 1 diabetes mellitus for more than 15 years. Around 80% of adults with type 1 diabetes mellitus are affected by diabetic retinopathy, but it is rare in patients before puberty. To prevent it, maintenance of blood sugar, blood pressure, cholesterol in a healthy range is needed.
- Kidney damage:- around 20% to 30% patients of type 1 diabetes mellitus, get a condition called nephropathy. Nephrons are the basic units of kidneys. Around 1 million nephrons present in each kidney. These nephrons filter the blood to excrete urea, drugs, and many toxic chemicals and thus helps to maintain normal osmotic and ph balance of the blood.In patients with type 1 diabetes mellitus increase, blood pressure and blood sugar levels cause damage to nephrons. Gradually with time, due to damage, the number of nephrons in each kidney is reduced. So ultimately a condition arises when there are not enough nephrons left in either of kidneys to effectively filter the blood. This condition is called kidney damage or kidney failure.
- Skin problems:- people with type 1 diabetes mellitus tend to have a higher risk of bacterial and fungal infections. They also often develop blisters or rashes in moist areas of skin like armpits and groins.
Type 1 diabetes mellitus management
- People with type 1 diabetes mellitus are needed to pay more attention to their meals. They should also eat a balanced healthy diet and should pay more attention to what they eat and when to eat.
- Food mainly comprises of main nutrients that are carbohydrates proteins and fats All of these have different calorific values and provide energy to our bodies carbohydrate-containing food tends to have high calorific value in nature and leads to a surge in blood sugar. Proteins and fats are less calorific when compared to carbohydrates. Proteins are needed for growth and repair whereas fats are required for building energy reserves in the body and for the production of many steroid hormones.
- They should also try to maintain a fine level of balance between their daily calorie intake, insulin dose, and their physical activity. This will help them to maintain their blood sugar level in a healthy range.
- They should also take a well balanced and healthy diet with a proper diet plan. For people suffering from type 1diabetes Mellitus dietitians usually plan light breakfast lunch and dinner with scheduled in between the meal snacks.
- They should also closely monitor the blood sugar level by regular fasting and postprandial blood sugar check-ups.
- Checking blood sugar regularly helps the patient to maintain his blood sugar in a healthy range. Which will be very helpful in preventing further complications.
- Exercising regularly is also very important in the treatment of type 1 diabetes mellitus. Regular exercise helps to lower down the blood sugar level. It also helps to reduce the risk of other conditions like hypertension and heart diseases.