TYPE 1 DIABETES
Type 1 diabetes mellitus is the most frequent endocrine-metabolic disease of childhood and adolescence. It is caused by the destruction by the immune system of the cells of the pancreas that produce insulin (beta cells) and forces patients to have an average of 5 insulin injections per day for their entire life.
The cause of type 1 diabetes is a reduced availability of insulin, due to the loss, through destruction, of the pancreatic cells responsible for producing this hormone.
What is type 1 diabetes?
Type 1 diabetes mellitus is an autoimmune disease. It manifests itself with the total (or almost) inability of the pancreas to synthesize and release insulin, a hormone with hypoglycemic function.
If on the one hand the basic mechanism is known, on the other the specific reasons behind it (probably genetic) are not known.
What happens is the destruction of pancreatic beta cells by the immune system.
The diagnosis is therefore based on the search for antibodies implicated in the reaction.
Type 1 diabetes mellitus almost always begins at a young age.
Mild onsets cause classic symptoms such as: increased urination, thirst and appetite, and weight loss. The very serious ones include loss of consciousness and coma.
The treatment of type 1 diabetics is therefore chronic without the possibility of recovery. Fundamentally consisting of the injection of insulin or infusion through an insulin pump, appropriately calibrated based on diet and physical activity, it does not involve other measures.
If left untreated, type 1 diabetes mellitus causes various serious complications, both acute and chronic. Other complications of type 1 diabetes mellitus are collateral in nature and are mainly based on hypoglycemia caused by the administration of an excessive dose of insulin.
To date, therapeutic possibilities have significantly improved compared to the past and the quality of life of the person with diabetes is almost comparable to that of the healthy subject.
Type 1 diabetes mellitus represents 5-10% of overall cases of diabetes in the world.
Causes of type 1 diabetes
Type 1 diabetes is caused by the destruction of β cells – the only ones that produce insulin – by specific antibodies, and the consequent progressive deficiency of insulin.
Studies show that specific antibodies begin to develop in the months or years before symptoms appear.
Without insulin the body is unable to contain the post-prandial glycemic increase, because this hormone is responsible for the entry of glucose from the plasma into dependent or insulin-sensitive tissues. We are talking above all about skeletal, cardiac and adipose muscle tissue, in which the GLUT-4 receptor is mainly present.
For this reason, untreated people with diabetes 1 suffer from persistent hyperglycemia.
The triggering factor remains unclear and the most popular theories concern genetic predisposition, associated or not with a diabetogenic factor and/or exposure to an antigen
Symptoms and clinical signs of type 1 diabetes
Type 1 diabetes begins suddenly, generally during childhood or adolescence.
The main sign of type 1 diabetes is a very high blood sugar level, which typically occurs in children with polyuria (increased urination), polydipsia (increased thirst), and weight loss for a few days or weeks.
Children may also experience increased appetite, blurred vision, nocturnal enuresis, recurrent skin infections, candidiasis of the perineum, irritability, and low school performance.
Adults with type 1 diabetes tend to have more varied symptoms that appear over months rather than days or weeks.
Prolonged lack of insulin can also cause diabetic ketoacidosis, characterized by persistent fatigue, dry or flushed skin, abdominal pain, nausea or vomiting, confusion, difficulty breathing, and fruity-smelling breath.
Blood and urine tests reveal unusually high levels of glucose and ketones in the blood and urine.
Untreated ketoacidosis can progress rapidly to loss of consciousness, coma and death. The percentage of children whose type 1 diabetes begins with an episode of diabetic ketoacidosis reaches 15% in some parts of Europe and North America, and 80% in developing countries.
Type 1 diabetes: why me?
Diabetes explained to a child. Click to see the video in English.
