In the early 1980s, a breakthrough occurred in the understanding of diabetes. Researchers discovered antibodies in the blood of some people with diabetes, targeting the beta cells making insulin. This discovery revealed that Type 1 diabetes, which was then called childhood diabetes, was actually an autoimmune disease where the body destroyed its own beta cells because they appeared to be foreign. The presence of these antibodies distinguished it from Type 2 or adult-onset diabetes. It is important to know the symptoms and causes of Type 1 Diabetes.
4.1 Suspected Causes of Type 1
- Vitamin D deficiency
- coxsackie B
- congenital rubella
- lunch meat
- farm well water
- Cow’s milk in infants
From Using Insulin © 2003
The immune system is designed to defend the body against attack from foreign substances. In Type 1 diabetes, however, a massive error occurs, and the immune system begins attacking the body’s own beta cells. Destructive antibodies targeted against the beta cells appear in the blood long before enough damage has occurred to create symptoms. Testing for these antibodies allows early diagnosis, but a definitive way to stop the attack has not been developed as yet.
Type 1 diabetes is an autoimmune disease similar to Lupus, pernicious anemia, or rheumatoid arthritis. Type 1 can start at any age, but many cases begin in childhood, adolescence, or early adulthood.
Medical experts have not yet discovered what triggers the attack by the immune system. Researchers believe certain viruses and environmental toxins trigger the immune system’s attack by changing the beta cells to appear foreign to the body.
Type 1 diabetes begins when the beta cells in the pancreas are so severely damaged that they can no longer make insulin. Destruction of beta cells is usually gradual, taking place over several years. When only 10 percent of the beta cells remain, the symptoms of Type 1 diabetes can begin abruptly, with the blood sugar rising to dangerous levels. A child or adolescent may feel fine up to this point but then rapidly develop the extreme symptoms typical of Type 1.
In adults, the same destruction occurs but often progresses more slowly, with insulin production typically continuing for many years. Some adults with early Type 1 diabetes, sometimes referred to as Type 1.5, can manage with relatively normal blood sugars for several years using only oral medications. Insulin eventually becomes necessary as the cell destruction continues.
Symptoms of Type 1 Diabetes
4.2 Type 1 Symptoms
- Excessive thirst
- Frequent urination
- Excessive tiredness
- Extreme hunger
- Weight loss
- Abdominal pain
From Using Insulin © 2003
Symptoms of Type 1 are easy to identify because they are specific and severe and because they usually start in otherwise healthy children, young adults, or even a few older adults. The child or adult becomes tired, very thirsty, and starts to urinate frequently during the day and night. Even though the person eats more, he or she loses weight.
Insulin is a hormone that helps cells produce glucose transporters and move them onto the cell wall so glucose enters the cell, where it can be turned into energy. Because insulin is low, the glucose can not enter the cells for use as fuel, so it backs up in the blood, causing the blood sugar to rise. More fat is released for use as fuel, making levels of fat and ketones, a by-product, rise in the blood.
As ketones build in the blood, the blood becomes more acidic, and the person develops the symptoms already mentioned and becomes quite ill. Abdominal pain, dehydration, nausea, and vomiting ensue. Once the very serious and life-threatening condition called ketoacidosis starts, immediate hospitalization is required to save the person’s life.
Type 1 occurs in one of every ten people with diabetes. It has both strong and weak genetic subgroups. Genetics is important but is not a dominant factor in most cases. When both parents have Type 1 diabetes, there is only a 20% chance that a child will get it. Most Type 1’s, about 75%, have a weak or nonexistent inheritance pattern. They are often the only ones in the family with Type 1 diabetes. But in about one out of four, there is a strong inheritance pattern with several members of the family having the disease. A person with Type 1 will have a parent, aunt, uncle, brother or sister or two, or several cousins who have Type 1 diabetes. There seems to be little or no link between Type 1 and Type 2 diabetes.
Once the attack has destroyed the beta cells, life depends on replacing natural insulin with injected insulin. Good health depends on how well this is done. Insulin is ideally given to act simultaneously and in the same amount as the pancreas’ normal insulin release. When insulin injections mimic the pancreas, Type 1 diabetes turns out to be a very manageable disease.
Blood sugars can be normalized if insulin is delivered flexibly to match needs. Add to this a healthy diet and regular exercise, and the person can look forward to a normal, healthy life.
Here is a summary of the key points from the page on Type 1 diabetes at diabetesnet.com:
- Type 1 diabetes is an autoimmune disease where the body attacks and destroys the insulin-producing cells in the pancreas. This leaves the body unable to produce enough insulin to regulate blood sugar levels.
- It often develops in children and young adults but can appear at any age. Risk factors include family history and certain genes/viruses that may trigger the autoimmune response.
- Without sufficient insulin, blood sugar builds up in the bloodstream and can cause short-term acute symptoms and long-term damage to organs and tissues in the body.
- Managing type 1 diabetes requires taking manufactured insulin (by injection or pump), monitoring blood glucose levels, counting carbohydrates, and being careful about diet and physical activity. Even so, blood sugar can fluctuate unpredictably.
- While there is no cure, treatment focuses on keeping blood sugar levels as close to normal as possible to minimize high/low blood sugar complications. New technologies like continuous glucose monitors and insulin pumps help with management.
- With proper, diligent treatment and management, people with type 1 diabetes can live long, healthy lives. Research is also underway for improved treatment options and possibly finding ways to prevent or cure the disease.