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TYPE 1 DIABETES

What Is Type 1 Diabetes?

Type 1 diabetes mellitus (type 1 diabetes, insulin-dependent diabetes mellitus), one of the most common chronic diseases in childhood, is caused by insulin deficiency following auto-immune destruction of the pancreatic beta cells. Until the one and only therapeutic option – the life-long supplementation of insulin or its analogues – was established, affected children died within a short time. Although extensive investigations on the pathogenesis of type 1 diabetes have been performed, the underlying causes and mechanisms are still far from being completely understood. The consequence is a lack of prevention strategies or causal therapies.

What Causes Type 1 Diabetes?

Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake) that destroys the cells in the pancreas that make insulin, called beta cells. This process can go on for months or years before any symptoms appear.

Some people have certain genes (traits passed on from parent to child) that make them more likely to develop type 1 diabetes, though many won’t go on to have type 1 diabetes even if they have the genes. Being exposed to a trigger in the environment, such as a virus, is also thought to play a part in developing type 1 diabetes. Diet and lifestyle habits don’t cause type 1 diabetes.

Risk factors

Some known risk factors for type 1 diabetes include:

Symptoms

HIGH BLOOD SUGAR

The following symptoms may be the first signs of type 1 diabetes. Or, they may occur when blood sugar is high.

For other people, these serious warning symptoms may be the first signs of type 1 diabetes. Or, they may happen when blood sugar is very high (diabetic ketoacidosis):

LOW BLOOD SUGAR

Low blood sugar (hypoglycemia) can develop quickly in people with diabetes who are taking insulin. Symptoms usually appear when a person’s blood sugar level falls below 70 milligrams per deciliter (mg/dL), or 3.9 mmol/L. Watch for:

After many years, diabetes can lead to serious health problems, and as a result, many other symptoms.

DIAGONSIS AND TREATMENT

Diagnostic tests include:

If the A1C test isn’t available, or if you have certain conditions that can make the A1C test inaccurate — such as pregnancy or an uncommon form of hemoglobin (hemoglobin variant) — your doctor may use these tests:

If you’re diagnosed with diabetes, your doctor may also run blood tests to check for autoantibodies that are common in type 1 diabetes. These tests help your doctor distinguish between type 1 and type 2 diabetes when the diagnosis is uncertain. The presence of ketones — byproducts from the breakdown of fat — in your urine also suggests type 1 diabetes, rather than type 2.

After the diagnosis

You’ll regularly visit your doctor to discuss diabetes management. During these visits, the doctor will check your A1C levels. Your target A1C goal may vary depending on your age and various other factors, but the American Diabetes Association generally recommends that A1C levels be below 7 percent, which translates to an estimated average glucose of 154 mg/dL (8.5 mmol/L).

Compared with repeated daily blood sugar tests, A1C testing better indicates how well your diabetes treatment plan is working. An elevated A1C level may signal the need for a change in your insulin regimen, meal plan or both.

In addition to the A1C test, the doctor will also take blood and urine samples periodically to check your cholesterol levels, thyroid function, liver function and kidney function. The doctor will also examine you to assess your blood pressure and will check the sites where you test your blood sugar and deliver insulin.

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