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How Does Type 1 Diabetes Develop?

What Is Type 1 Diabetes?

What Is Type 1 Diabetes?

The more severe form of diabetes is type 1, or insulin-dependent diabetes. It’s sometimes called “juvenile” diabetes, because type 1 diabetes usually develops in children and teenagers, though it can develop at any age. Immune System Attacks With type 1 diabetes, the body’s immune system attacks part of its own pancreas. Scientists are not sure why. But the immune system mistakenly sees the insulin-producing cells in the pancreas as foreign, and destroys them. This attack is known as "autoimmune" disease. These cells – called “islets” (pronounced EYE-lets) – are the ones that sense glucose in the blood and, in response, produce the necessary amount of insulin to normalize blood sugars. Insulin serves as a “key” to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy. Without insulin, there is no “key.” So, the sugar stays -- and builds up-- in the blood. The result: the body’s cells starve from the lack of glucose. And, if left untreated, the high level of “blood sugar” can damage eyes, kidneys, nerves, and the heart, and can also lead to coma and death. Insulin Therapy So, a person with type 1 treats the disease by taking insulin injections. This outside source of insulin now serves as the “key” -- bringing glucose to the body’s cells. The challenge with this treatment is that it’s often not possible to know precisely how much insulin to take. The amount is based on many factors, including: Food Exercise Stress Emotions and general health Balancing Act These factors fluctuate greatly throughout every day. So, deciding on what dose of insulin to take is a complicated balancing act. If you take too much, then your body burns too much glucose -- and your blood sugar can drop to a dangerously lo Continue reading >>

About Type 1 Diabetes

About Type 1 Diabetes

Type 1 diabetes is less common than type 2 diabetes. In the past, type 1 diabetes was called juvenile diabetes, juvenile-onset diabetes, or insulin-dependent diabetes. Today we realize those terms aren't accurate. People can develop type 1 as adults, children can develop type 2, and people with type 2 might need to take insulin shots. Causes Type 1 diabetes is known as an autoimmune disease. It happens because a person's immune system destroys the body's beta cells, which make insulin and release it into the blood stream. These cells are located in an organ called the pancreas. When the immune system destroys the beta cells, the body stops being able to make insulin. Signs of type 1 diabetes start to show up when half or more of the beta cells have been destroyed. People who have type 1 diabetes will begin to take insulin shots right away, to replace the insulin their bodies no longer make. Type 1 diabetes is inherited, which means a group of genes that can lead to type 1 diabetes is passed down from mothers and fathers to their children. A person with a parent, brother, or sister with type 1 diabetes has a greater chance of also developing type 1 diabetes. Genes play an important role in determining who gets type 1 diabetes and who doesn't. But they might not be the only influence. Environmental factors, including viruses and allergies, appear to trigger type 1 diabetes in some people who have inherited the genes. These factors can trigger type 1 diabetes at any point in a person's life. That's why some people don't develop type 1 diabetes until they're adults, while others develop it when they're children. Symptoms The symptoms for type 1 diabetes usually show up over a few days or even a few weeks and are caused by high levels of sugar in the blood. Symptoms include: Continue reading >>

Type 1 Diabetes Causes

Type 1 Diabetes Causes

It isn’t entirely clear what triggers the development of type 1 diabetes. Researchers do know that genes play a role; there is an inherited susceptibility. However, something must set off the immune system, causing it to turn against itself and leading to the development of type 1 diabetes. Genes Play a Role in Type 1 Diabetes Some people cannot develop type 1 diabetes; that’s because they don’t have the genetic coding that researchers have linked to type 1 diabetes. Scientists have figured out that type 1 diabetes can develop in people who have a particular HLA complex. HLA stands for human leukocyte antigen, and antigens function is to trigger an immune response in the body. There are several HLA complexes that are associated with type 1 diabetes, and all of them are on chromosome 6. Different HLA complexes can lead to the development of other autoimmune disorders, such as rheumatoid arthritis, ankylosing spondylitis, or juvenile rheumatoid arthritis. Like those conditions, type 1 diabetes has to be triggered by something—usually a viral infection. What Can Trigger Type 1 Diabetes Here’s the whole process of what happens with a viral infection: When a virus invades the body, the immune system starts to produce antibodies that fight the infection. T cells are in charge of making the antibodies, and then they also help in fighting the virus. However, if the virus has some of the same antigens as the beta cells—the cells that make insulin in the pancreas—then the T cells can actually turn against the beta cells. The T cell products (antibodies) can destroy the beta cells, and once all the beta cells in your body have been destroyed, you can’t produce enough insulin. It takes a long time (usually several years) for the T cells to destroy the majority of th Continue reading >>

Type 1 Diabetes: Causes, Symptoms, And Diagnosis

Type 1 Diabetes: Causes, Symptoms, And Diagnosis

In type 1 diabetes, your body does not produce insulin, which is the hormone necessary for processing glucose. Glucose is used by cells in your body as an energy source, and without insulin, glucose can’t get into those cells. It stays in the blood, and when you have too much glucose in your blood, it can damage your organs and other parts of your body. Therefore, people with type 1 diabetes must take insulin in order to manage their blood glucose levels and make sure their bodies get the energy they need. Type 1 diabetes used to be called juvenile diabetes or insulin-dependent diabetes, and you may still hear those names used. Type 1 Diabetes Causes Type 1 diabetes is an autoimmune disorder, which means that the immune system turns against your body. Instead of protecting the body, the immune system in people with type 1 diabetes starts to destroy beta cells—and those are the cells that are in charge of making insulin. The medical community isn’t sure what causes the immune system to start destroying the beta cells. Some thoughts are: a genetic susceptibility to developing type 1 diabetes certain viruses (for example, German measles or mumps) environmental factors Regardless of what triggers the immune system to turn against the beta cells, the end result is the same in type 1 diabetes: gradually, all beta cells are destroyed and the body is no longer able to produce insulin. Type 1 Diabetes Symptoms Type 1 diabetes develops gradually, but the symptoms come on suddenly. As soon as the body is no longer making insulin, blood glucose levels rise quickly, so the following type 1 diabetes warning signs can develop: extreme weakness extreme tiredness rapid weight loss increased appetite extreme thirst increased urination nausea and/or vomiting fruity breath wounds tha Continue reading >>

Diabetes Symptoms, (type 1 And Type 2)

Diabetes Symptoms, (type 1 And Type 2)

Diabetes type 1 and type 2 definition and facts Diabetes is a chronic condition associated with abnormally high levels of sugar (glucose) in the blood. Insulin produced by the pancreas lowers blood glucose. Absence or insufficient production of insulin, or an inability of the body to properly use insulin causes diabetes. The two types of diabetes are referred to as type 1 and type 2. Former names for these conditions were insulin-dependent and non-insulin-dependent diabetes, or juvenile onset and adult onset diabetes. Symptoms of type 1 and type 2 diabetes include increased urine output, excessive thirst, weight loss, hunger, fatigue, skin problems slow healing wounds, yeast infections, and tingling or numbness in the feet or toes. Some of the risk factors for getting diabetes include being overweight or obese, leading a sedentary lifestyle, a family history of diabetes, hypertension (high blood pressure), and low levels of the "good" cholesterol (HDL) and elevated levels of triglycerides in the blood. If you think you may have prediabetes or diabetes contact a health-care professional. Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar (glucose) levels that result from defects in insulin secretion, or its action, or both. Diabetes mellitus, commonly referred to as diabetes (as it will be in this article) was first identified as a disease associated with "sweet urine," and excessive muscle loss in the ancient world. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine, hence the term sweet urine. Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Whether you have type 1 diabetes, are a caregiver or loved one of a person with type 1 diabetes, or just want to learn more, the following page provides an overview of type 1 diabetes. New to type 1 diabetes? Check out "Starting Point: Type 1 Diabetes Basics," which answers some of the basic questions about type 1 diabetes: what is type 1 diabetes, what are its symptoms, how is it treated, and many more! Want to learn a bit more? See our “Helpful Links” page below, which provides links to diaTribe articles focused on type 1 diabetes. These pages provide helpful tips for living with type 1 diabetes, our patient-perspective column by Adam Brown, drug and device overviews, information about diabetes complications, and some extra pages we hope you’ll find useful! Starting Point: Type 1 Diabetes Basics What is the risk of developing type 1 diabetes if it runs in my family? What is Type 1 Diabetes? Type 1 diabetes is disease in which the body can no longer produce insulin. Insulin is normally needed to convert sugar (also called glucose) and other food sources into energy for the body’s cells. It is believed that in people with type 1 diabetes, the body’s own immune system attacks and kills the beta cells in the pancreas that produce insulin. Without insulin, the body cannot control blood sugar, and people can suffer from dangerously high blood sugar levels (called hyperglycemia). To control their blood glucose levels, people with type 1 diabetes take insulin injections. Before the discovery of insulin, type 1 diabetes was a death sentence (and it still is for patients with poor access to insulin). Can Type 1 Diabetes Be Prevented? Unfortunately, the genetic and environmental triggers for the immune attack that causes type 1 diabetes are not well understood, althoug Continue reading >>

What Is Type 1 Diabetes?

What Is Type 1 Diabetes?

In this section, we will share an easy-to-understand overview of type 1 diabetes, including what it is, diagnosis, treatment and links for learning more. Type 1 diabetes is an autoimmune disease. For unknown reasons, the immune system attacks the insulin producing cells in the pancreas called beta cells and destroys them. You can think of insulin as the key that unlocks your cells and enables them to access sugar. Without access to sugar, it builds up in your blood. You feel tired, your body turns to fat for energy and you lose weight, and you urinate frequently as your body tries to flush out all that excess sugar. Every human (well, all mammals, actually) need insulin to live. Everyone with diabetes needs to take some form in insulin in order to survive. Unfortunately, at this time, type 1 diabetes can’t be prevented or cured. You may have heard type 1 diabetes called juvenile diabetes. About half of people with type 1 diabetes are diagnosed in childhood, though the truth is that type 1 diabetes can develop at any age. This terminology has long since been abandoned. (See: How Many People Have Diabetes?) If left untreated, type 1 diabetes will eventually be fatal. How Do You Treat Type 1 Diabetes? Everyone with type 1 diabetes needs to take insulin to live. Insulin can come from insulin injections, insulin pump or inhaling insulin. Experimental treatments are using implanted insulin-producing cells. The primary challenge of type 1 diabetes is to take enough insulin to lower the high blood sugars but not so much that you have severe low blood sugars. This typically requires frequent checking of blood sugars or, if you have access, using a continuous glucose meter (CGM). Type 1 diabetes requires monitoring and managing all day long. (LADA, latent autoimmune diabetes in Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Introduction Diabetes is a lifelong condition that causes a person's blood sugar (glucose) level to become too high. The hormone insulin – produced by the pancreas – is responsible for controlling the amount of glucose in the blood. There are two main types of diabetes: Type 1 – where the pancreas doesn't produce any insulin Type 2 – where the pancreas doesn't produce enough insulin or the body’s cells don't react to insulin This topic is about type 1 diabetes. Read more about type 2 diabetes Another type of diabetes, known as gestational diabetes, occurs in some pregnant women and tends to disappear following birth. It's very important for diabetes to be diagnosed as soon as possible, because it will get progressively worse if left untreated. You should therefore visit your GP if you have symptoms, which include feeling thirsty, passing urine more often than usual and feeling tired all the time (see the list below for more diabetes symptoms). Type 1 and type 2 diabetes Type 1 diabetes can develop at any age, but usually appears before the age of 40, particularly in childhood. Around 10% of all diabetes is type 1, but it's the most common type of childhood diabetes. This is why it's sometimes called juvenile diabetes or early-onset diabetes. In type 1 diabetes, the pancreas (a small gland behind the stomach) doesn't produce any insulin – the hormone that regulates blood glucose levels. This is why it's also sometimes called insulin-dependent diabetes. If the amount of glucose in the blood is too high, it can, over time, seriously damage the body's organs. In type 2 diabetes, the body either doesn't produce enough insulin to function properly, or the body's cells don't react to insulin. Around 90% of adults with diabetes have type 2, and it tends to develop l Continue reading >>

The Stages Of Type 1 Diabetes (it Starts Earlier Than We Thought)

The Stages Of Type 1 Diabetes (it Starts Earlier Than We Thought)

My daughter Bisi was diagnosed with type 1 diabetes three years ago at the age of six. The first night after she was diagnosed, once she finally fell asleep in her hospital bed, tossing and turning despite the IV in her arm, I remember standing outside in the hall with my husband and a couple of medical residents, talking with them about her diagnosis. “Could this have been coming on for a while?” we asked them. I described how for a couple of years, Bisi had been almost unbearably cranky when she was hungry—to the point where I’d asked her pediatrician more than once if something might be wrong. No, the residents told us. Type 1 diabetes comes on very suddenly, in a matter of weeks, as the body’s beta cells suddenly die out under attack from the immune system. Every doctor or nurse we spoke with during the three days in the hospital (except for one, who said that our instincts were probably right), echoed what the two residents, fresh from medical school, told us. But it turns out they were wrong. JDRF and the American Diabetes Association, supported by other organizations in the field, recently put forth a new staging system for type 1 diabetes, where full-blown disease, like what landed Bisi in the hospital, is characterized as stage 3, part of an extended auto-immune process that often starts in infancy. This fall, Dr. Richard Insel, JDRF’s Chief Scientific Officer, explained the classification system to a group of reporters, talking through the importance of early diagnosis, and the hope that diagnosing the disease at an earlier stage could lead to breakthroughs in stopping the beta-cell destruction process—essentially, stopping the disease before it starts. Insel explained that stage 1 is when people test positive for multiple pancreatic islet auto-a Continue reading >>

Type 1 Diabetes In Adults

Type 1 Diabetes In Adults

For years, distinguishing between the various types of diabetes was pretty straightforward: “Juvenile diabetes,” an autoimmune disease, was diagnosed primarily in children and teenagers when their own body’s immune system destroyed the insulin-producing (beta) cells in their pancreas. “Adult-onset diabetes” occurred in adults and was generally associated with insulin resistance and often with overweight. And “gestational diabetes” occurred in pregnant women and disappeared once the pregnancy was over. In the past 25 years, however, determining what type of diabetes a person has has become more of a challenge. In large part, that’s because more and more children and teenagers are now being diagnosed with Type 2 diabetes — the type that occurred predominantly in adults in generations past. Most of these children and teens are overweight. At the same time, it’s becoming clearer that Type 1 diabetes can occur at any age and sometimes occurs in people who are overweight. In addition, another type of diabetes, called latent autoimmune diabetes in adults, or LADA, that shares some characteristics with both Type 1 and Type 2 diabetes, has been recognized. Muddying the water further is the realization that diabetic ketoacidosis, an acute, life-threatening complication of diabetes that is caused by a lack of insulin, can occur in people with Type 2 diabetes — not just in people with Type 1, as was previously thought. And while gestational diabetes is still diagnosed only in pregnant women, it is sometimes discovered that what is thought to be gestational diabetes is really Type 1 or Type 2 diabetes that happens to start during pregnancy. The incidence of diabetes has increased so greatly around the world in the past 25 years that health organizations and med Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Overview Diabetes is a lifelong condition that causes a person's blood sugar (glucose) level to become too high. The hormone insulin, produced by the pancreas, is responsible for controlling the amount of glucose in the blood. There are two main types of diabetes: type 1 – where the pancreas doesn't produce any insulin type 2 – where the pancreas doesn't produce enough insulin or the body's cells don't react to insulin These pages are about type 1 diabetes. Other types of diabetes are covered separately (read about type 2 diabetes, and gestational diabetes, which affects some women during pregnancy). Symptoms of diabetes Typical symptoms of type 1 diabetes are: feeling very thirsty passing urine more often than usual, particularly at night feeling very tired weight loss and loss of muscle bulk The symptoms of type 1 diabetes usually develop very quickly in young people (over a few days or weeks). In adults, the symptoms often take longer to develop (a few months). Read more about the symptoms of type 1 diabetes. These symptoms occur because the lack of insulin means that glucose stays in the blood and isn’t used as fuel for energy. Your body tries to reduce blood glucose levels by getting rid of the excess glucose in your urine. It's very important for diabetes to be diagnosed as soon as possible, because it will get progressively worse if left untreated. Find your local GP service Read about how type 1 diabetes is diagnosed. Causes of type 1 diabetes Type 1 diabetes is an autoimmune condition, which means your immune system attacks healthy body tissue by mistake. In this case, it attacks the cells in your pancreas. Your damaged pancreas is then unable to produce insulin. So, glucose cannot be moved out of your bloodstream and into your cells. Type 1 diabetes is o Continue reading >>

Type 1 Diabetes In Children

Type 1 Diabetes In Children

What is type 1 diabetes? Type 1 diabetes is an autoimmune disease that causes an unhealthy amount of a simple sugar (glucose) to build up in a person's blood. Someone with type 1 diabetes can't produce enough insulin, a hormone that moves glucose from the bloodstream into cells throughout the body, where it supplies energy and fuels growth. Normally, a child's immune system protects her body from diseases by destroying unhealthy cells and germs. But when a child has type 1 diabetes, her body also mistakenly attacks the healthy insulin-producing cells of the pancreas (a gland behind the stomach). Without these cells, her pancreas produces very little or no insulin, which leads to an abnormally high amount of sugar in her blood. Without proper care, type 1 diabetes can cause serious, wide-ranging health problems that can damage organs throughout the body over the long-term. If your child has been diagnosed with type 1 diabetes, it's understandable that you might worry. But diabetes can be kept under control by carefully monitoring your child's blood sugar and following her treatment plan. A team of doctors, nurses, and nutritionists can help your child be as healthy as possible and teach her to manage the condition so she stays that way. What are the symptoms of type 1 diabetes in children? Symptoms of type 1 diabetes include: Extreme thirst Peeing more than usual (You might notice more wet diapers if your child is very young, or "accidents" if your child is potty trained.) Extreme hunger Weight loss Unusual tiredness Crankiness Yeast infection or diaper rash If your child has one or more of these symptoms, call his doctor right away. Type 1 diabetes symptoms can start quickly and become very serious without treatment. Get medical care immediately if your child has any of Continue reading >>

The Type 1 Diabetes Diagnosis

The Type 1 Diabetes Diagnosis

How to Help Your Child Learn About, Accept, and Manage Type 1 Diabetes “Most parents are overwhelmed when their child is diagnosed with Type 1 diabetes,” according to Aaron Horowitz, a forerunner in the race to help children with Type 1 diabetes learn about the disease and the importance of self-care. He is co-founder and inventor of the cuddly, stuffed Jerry the Bear, which teaches children with Type 1 diabetes how to care for themselves by caring for Jerry. Like a child with Type 1 diabetes, Jerry the Bear can be hungry, drowsy, or thirsty. A short video, Jerry the Bear: Our Families, shares caregivers’ stories about the first symptoms they noticed in their children. The families are both surprised and concerned upon learning their children have been diagnosed with Type 1 diabetes. One father, with his child sitting next to him, says, “We thought he might have a bladder infection.” A mother, looking at her young slim daughter, says, “She ate the breakfast a nineteen-year-old boy would eat.” A classic symptom of Type 1 diabetes is addressed by another parent: “She was drinking a lot of water.” A child may have diabetes for a long time before a caregiver begins to notice because the symptoms can take a long time to develop and can mimic other diseases. Urinating frequently, abnormal thirst, increased appetite without weight gain, and tiredness are typical symptoms. However, there can be other signs that something is wrong, such as bedwetting, a vaginal yeast infection in prepubescent girls, stomach pain, nausea, vomiting, and fruity smelling breath. Clinicians and caregivers sometimes mistake these symptoms for the flu or appendicitis when, in fact, the child may have a serious condition: diabetic ketoacidosis, or DKA. What is Type 1 diabetes? Children Continue reading >>

How Does Type 1 Diabetes Develop?

How Does Type 1 Diabetes Develop?

WHAT DID BOTTAZZO PORTEND? The Bottazzo article (3) was unique in its form of presentation, in that the prose represented the equivalent workings of a legal stenographer recording the debate between two counsels: one for the prosecution (i.e., β-cell homicide) the other representing the defense (i.e., β-cell suicide). More important than the means for its presentation was the evidence noted for each case. Arguments for homicide included, but were not limited to, a theoretic scenario wherein type 1 diabetes was posed to be initiated by an ill-defined environmental attack resulting in the release of β-cell autoantigens (Fig. 1). Subsequently, those self-antigens were thought to be scavenged by macrophages, presented by major histocompatibility complex (MHC) class II molecules (i.e., HLA-DR), leading to the activation of helper T-cells, which would in turn activate B-cells to produce antibodies (e.g., islet cell cytoplasmic autoantibodies and complement-fixing autoantibodies) as well as activate killer cells and cytotoxic T-cells. Interestingly, Bottazzo did note the potential role for “suppressor T-lymphocytes” (i.e., a forerunner of today’s regulatory T-cell), but left them out of the equation because of their ill-defined nature at the time of his writing. Other prosecutorial arguments included seasonality for the disease onset, typical age of onset, and questions related to genetic susceptibility to this disease. FIG. 1. Bottazzo’s “Exhibit 5.” Diagram shows the hypothetical steps leading to activation of the immune system against the β-cell. A: The triggering events: 1) Environmental attack. 2) Release of autoantigens from the β-cell. 3) The macrophage processes them on its surface membrane. D/DR molecules present islet autoantigens to the helper T-cel Continue reading >>

Understanding Adult-onset Type 1 Diabetes

Understanding Adult-onset Type 1 Diabetes

When then 34-year-old Rebecca Gill was pregnant with her second child in 2004, high blood sugar levels led to a diagnosis of gestational diabetes, an often-temporary form of diabetes that can occur in pregnant women. After Gill’s son was born, her blood sugar levels returned to normal, and her doctors assumed that the diabetes was gone. But another blood test given several weeks after she gave birth showed that her diabetes problems had returned. She was referred to an endocrinologist who ran tests and eventually diagnosed her with latent autoimmune diabetes in adults, or LADA. “Thankfully, I was one of the lucky ones whose endocrinologist had experience with LADA,” says Gill, an internet marketing consultant in Commerce, Mich. LADA, also known as type 1.5 diabetes or double diabetes, is a form of diabetes in which an adult’s immune system destroys beta cells in the pancreas, cells that produce insulin. Insulin is a hormone that converts the body’s blood sugar to energy. Without enough insulin, blood sugar levels can become too high, resulting in nerve damage, blindness, and other problems if untreated. LADA is similar to type 1 diabetes in that both forms are caused by the immune system mistakenly attacking beta cells. However, most diabetics with LADA are diagnosed after age 30, while the most common form of type 1 diabetes usually develops in children or adolescents. LADA: A Different Diabetes Because LADA appears in adulthood, it may be initially mistaken for type 2 diabetes, but it is different. People who have LADA are often initially misdiagnosed with type 2 diabetes, says Priscilla Hollander, MD, PhD, an endocrinologist at Baylor University Medical Center in Dallas. “Many people with LADA present symptoms a little like type 2s,” Dr. Hollander expla Continue reading >>

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