Type 1 diabetes, also called diabetes mellitus type 1, is an autoimmune disease that results in high blood sugar. This is because the body cannot create enough of the hormone insulin. People with type 1 diabetes need to take insulin injections to stay healthy. If they do not get enough insulin, they can become very sick or even die. People with type 1 diabetes are at increased risk of of diseases involing blood vessels such as stroke, heart disease or gangrene. About 15% of people with diabetes have type 1.
Cause
Type 1 diabetes is a condition caused by a lack of insulin in the body. Insulin is a hormone produced by cells in the pancreas. Insulin is responsible for moving sugars out of the blood and into cells to be used by the body for energy. If insulin is not made, the body will search for other ways to get the sugars needed to feed the body's cells, including breaking down muscle and fat, leading to a loss of weight.
Insulin is not being produced in the pancreas due to an autoimmune condition attacking its cells. The body's immune system mistakenly attacks the cells responsible for producing insulin in the pancreas, the beta cell. The beta cells are damaged in a way that prevents them from producing more insulin. As more and more of these cells are damaged, less insulin is produced in the body. This means that more sugar remains in the bloodstream rather than being moved into cells. This high blood sugar causes the symptoms seen in type 1 diabetes.
The disease is thought to be strongly linked to genetic factors, but the trigger that starts the autoimmune disease is not currently known.
Epidemiology
In the past, type 1 diabetes was generally thought to be a disorder in children and teenagers. However, it's now been found that adults can be diagnosed with the disease.
Although type 1 diabetes can now be diagnosed at any age, it is one of the most common chronic conditions in children and young adults. Being diagnosed at ages 5–7 or at the start of puberty is particularly common. Type 1 diabetes is also slightly more common in boys.
Cases of type 1 diabetes have been increasing across the world for several decades. Approximately 1 in 300 people are diagnosed with type 1 diabetes by the age of 18 in the United States.
Symptoms
In type 1 diabetes, symptoms generally develop over a few days or weeks, though may take longer in adults. The main symptoms are: Feeling very thirsty Urinating more often than normal Exhaustion Loss of weight Bedwetting (especially in children) Blurring of sight Slow healing of wounds and grazes
Nausea, vomiting and heavy breathing are more serious symptoms that occur at a later stage in the disease.
Complications
People with type 1 diabetes may have to deal with both short-term and long-term complications, particularly if the disease is not well managed.
Short-term complications
Hypoglycaemia
Hypoglycaemia is when blood sugar levels decrease to below normal. This is most commonly due to overuse of medications for diabetes type 1 like insulin, poor diet control, and rigorous exercise. The risk of suffering from low blood sugar is increased by drinking alcohol. This may lead to various other symptoms, including confusion, loss of consciousness, clumsiness, seizures or death.
Diabetic ketoacidosis
Diabetic ketoacidosis (DKA) is a very serious complication of type 1 diabetes. It is a medical emergency and requires rapid medical attention to prevent further damage to a patient, if left untreated it can potentially lead to death. DKA occurs when there is not enough insulin in the body to supply sugars to the body's cells. In order to give its cells enough energy to survive, the body begins to produce acidic ketone bodies which are then used to feed energy to the cells.
If too many ketone bodies build up the blood becomes acidic, damaging the body and leading to the symptoms: Vomiting Dehydration Difficult breathing Fast heartbeat Confusion Coma
Long-term complications
If diabetes is not treated, even mildly raised blood sugar levels can damage nerves, organs and blood vessels in the body.