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 >>
Family Relationships And Type 1 Diabetes
A diagnosis of Type 1 diabetes can affect the whole family. It’s important to listen to, and communicate with, all members of your family – especially any other children – and get help and support if you or anyone else needs it. Sibling rivalry While you’re getting to grips with your child’s diabetes, it’s easy to forget about the needs of your other children. But, they, too, will be affected by their sibling’s diagnosis. They may feel that their brother or sister is getting special treatment, worry that their sibling will get really sick or be scared that they’ll develop diabetes themselves. Rivalry and jealousy are common in most families, and a child with diabetes can cause upset between siblings. In the early days, after diagnosis, it’s only natural for you to be anxious and focus your attention and care on your child with diabetes. But, regular hospital visits, attention to diet and everything else that goes with diabetes has a longer-term impact on all the family. Advice for coping with sibling rivalry Try to listen to both sides equally and be sensitive to their claims that it’s ‘not fair’. Be clear about what you expect from each of them. Try to give them the same amount of attention. If you feel it’s appropriate, get siblings involved with diabetes management, so that they feel part of it. Try not to put family life on hold. Separated parents It can be a challenge to manage a child’s diabetes when they go from one home to another. Whatever your feelings about your ex, the two of you need to work together to make sure your child’s diabetes is well managed. making sure both of you learn about managing your child’s diabetes from your paediatric diabetes team – second-hand information can be confusing or inaccurate how you’ll kee Continue reading >>
I Chose Type 1 Diabetes And It Changed My Life For The Better
One of our Glu Ambassadors, Sandy Brooks, has been attended our in-person educational programs and been a big advocate for T1D Exchange for the past few years. Today she is sharing her very unique story of how and why she acquired type 1 diabetes. I’m a “surgical type 1” person with diabetes (PWD). I acquired my diabetes through having my pancreas removed due to hereditary chronic pancreatitis lasting for 27 years. I had my pancreas removed and an autologous islet cell transplant on my 52nd birthday. I didn’t plan to have the surgery on my birthday, but it has worked out perfectly because it really was a rebirth in so many ways. As a kid, I always had belly issues. My pediatrician called it a “nervous stomach.” This “nervous stomach” followed me through to high school and beyond. Things got worse as I got older. In my twenties, I decided to have this issue more thoroughly worked up. It took years to get a diagnosis of chronic pancreatitis (CP) because with this rare, chronic disease, there are no blood tests to definitively determine it. Also, there is a stereotype that only old alcoholics get pancreatitis, and I had never been one to drink. Plus, where I was so young, no one even considered this to be the issue. Finally, at 27 years old, I got my diagnosis of chronic pancreatitis and the stigma associated with it ensued. I was frequently accused of drug seeking due to my primary symptom being excruciating abdominal pain. When I gave in and sought help in the local ER, besides a little anemia, my blood work came back fine. The usual suspects of a raised amylase and lipase in acute pancreatitis are not raised in chronic pancreatitis. With CP, each flare or attack causes damage to the pancreatic cells and they eventually burn out and no longer produce thes Continue reading >>
Diabetes In The Family: Is It Inherited?
I’m asking this on behalf of a friend whose grandfather and father have diabetes. Is it more likely that my friend will get it too? Is diabetes fatal? Diabetes occurs in two forms; type 1 diabetes (insulin-dependent diabetes), which occurs in young people and is the more severe form, requiring insulin injections type 2 diabetes (non-insulin dependent diabetes), which is milder and occurs in older people and is usually controlled with diet and tablets. The details of whether diabetes can be inherited, and how this occurs, are not clear. About 10 per cent of people getting the more severe Type 1 diabetes have a close relative with this type of diabetes. That is not the same as saying that 10 per cent of people with affected relatives will get diabetes, but there is an unpredictable association. Type 2 diabetes also has a tendency to occur in families, but this is also not very strong and not predictable. In your friend’s case, if grandfather and father are affected, they probably have the milder Type 2 form of diabetes, so your friend has little risk of developing diabetes at a young age. It may be there is an increased risk of him developing diabetes in later life, but it would be the milder Type 2 form. I am a little confused that you say, ‘he takes pills and does a blood sugar test’. If you are referring to your friend then this probably means he has the mild form of diabetes already, and is probably an older person. You ask if you can get very ill with diabetes and die. Diabetes is a serious condition, but these days if patients follow their diet and take their pills or insulin treatment regularly, and keep their blood sugar within certain limits, they rarely get seriously ill and can live a long and active life. That is not to say there are no dangers with di Continue reading >>
Genetic Testing Of Newborns For Type 1 Diabetes Susceptibility: A Prospective Cohort Study On Effects On Maternal Mental Health
Abstract Background Concerns about the general psychological impact of genetic testing have been raised. In the Environmental Triggers of Type 1 Diabetes (MIDIA) study, genetic testing was performed for HLA-conferred type 1 diabetes susceptibility among Norwegian newborns. The present study assessed whether mothers of children who test positively suffer from poorer mental health and well-being after receiving genetic risk information about their children. The study was based on questionnaire data from the Norwegian Mother and Child Cohort (MoBa) study conducted by the Norwegian Institute of Public Health. Many of the mothers in the MoBa study also took part in the MIDIA study, in which their newborn children were tested for HLA-conferred genetic susceptibility for type 1 diabetes. We used MoBa questionnaire data from the 30th week of pregnancy (baseline) and 6 months post-partum (3-3.5 months after disclosure of test results). We measured maternal symptoms of anxiety and depression (SCL-8), maternal self-esteem (RSES), and satisfaction with life (SWLS). The mothers also reported whether they were seriously worried about their child 6 months post-partum. We compared questionnaire data from mothers who had received information about having a newborn with high genetic risk for type 1 diabetes (N = 166) with data from mothers who were informed that their baby did not have a high-risk genotype (N = 7224). The association between genetic risk information and maternal mental health was analysed using multiple linear regression analysis, controlling for baseline mental health scores. Information on genetic risk in newborns was found to have no significant impact on maternal symptoms of anxiety and depression (p = 0.9), self-esteem (p = 0.2), satisfaction with life (p = 0.2), or Continue reading >>
- Maternal obesity as a risk factor for early childhood type 1 diabetes: a nationwide, prospective, population-based case–control study
- Potato Consumption and Risk of Type 2 Diabetes: Results From Three Prospective Cohort Studies
- Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies
Acquired Non-type 1 Diabetes In Childhood: Subtypes, Diagnosis, And Management
Diabetes is the third most common chronic disease of childhood.1 Type 1, or autoimmune diabetes accounts for about 99% of cases. Type 1 diabetes is characterised by β cell destruction, an autoimmune pathological process, and absolute insulin requirement.2 Over the past 30 years it has been recognised that not all diabetes in childhood is type 1. Diabetes syndromes such as neonatal diabetes3and Wolfram syndrome have been described;4 genetic forms of diabetes such as maturity onset diabetes of the young have been defined;5 and more recently both iatrogenic and type 2 diabetes have been noted in childhood.6,7 These subtypes of diabetes are rare; in 2000 a UK national survey of clinicians looking after children with diabetes found only 0.7% of children with diabetes had non-type 1 diabetes, although this is likely to be an underestimate (table 1).8 These patients are important because they cause diagnostic uncertainty and often need different management. This review will discuss non-type 1 diabetes in childhood, and suggest a flow chart for diagnosis and treatment. Neonatal diabetes is a specialist management problem and beyond the scope of this article. DIAGNOSTIC SUBGROUPS Diabetes may present symptomatically or be an incidental finding. The World Health Organisation has laid down criteria for diagnosis of diabetes: a venous plasma glucose ⩾7 mmol/l fasted or ⩾11.1 mmol/l unfasted on more than one occasion.2 Diabetes in an asymptomatic child should never be diagnosed on a single test of plasma glucose, but a single measurement in excess of the established values in a child with symptoms of polyuria, polydipsia, and weight loss is sufficient for diagnosis.2 This review considers children at diagnosis in three categories: those that are unwell or have ketonuria, those Continue reading >>
Diabetes Mellitus Type 1
Diabetes mellitus type 1 (also known as type 1 diabetes) is a form of diabetes mellitus in which not enough insulin is produced.[4] This results in high blood sugar levels in the body.[1] The classical symptoms are frequent urination, increased thirst, increased hunger, and weight loss.[4] Additional symptoms may include blurry vision, feeling tired, and poor healing.[2] Symptoms typically develop over a short period of time.[1] The cause of type 1 diabetes is unknown.[4] However, it is believed to involve a combination of genetic and environmental factors.[1] Risk factors include having a family member with the condition.[5] The underlying mechanism involves an autoimmune destruction of the insulin-producing beta cells in the pancreas.[2] Diabetes is diagnosed by testing the level of sugar or A1C in the blood.[5][7] Type 1 diabetes can be distinguished from type 2 by testing for the presence of autoantibodies.[5] There is no known way to prevent type 1 diabetes.[4] Treatment with insulin is required for survival.[1] Insulin therapy is usually given by injection just under the skin but can also be delivered by an insulin pump.[9] A diabetic diet and exercise are an important part of management.[2] Untreated, diabetes can cause many complications.[4] Complications of relatively rapid onset include diabetic ketoacidosis and nonketotic hyperosmolar coma.[5] Long-term complications include heart disease, stroke, kidney failure, foot ulcers and damage to the eyes.[4] Furthermore, complications may arise from low blood sugar caused by excessive dosing of insulin.[5] Type 1 diabetes makes up an estimated 5–10% of all diabetes cases.[8] The number of people affected globally is unknown, although it is estimated that about 80,000 children develop the disease each year.[5] With Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
- Metabolic surgery for treating type 2 diabetes mellitus: Now supported by the world's leading diabetes organizations
Genetics Of Type 1 Diabetes
Abstract BACKGROUND: Type 1 diabetes, a multifactorial disease with a strong genetic component, is caused by the autoimmune destruction of pancreatic β cells. The major susceptibility locus maps to the HLA class II genes at 6p21, although more than 40 non-HLA susceptibility gene markers have been confirmed. CONTENT: Although HLA class II alleles account for up to 30%–50% of genetic type 1 diabetes risk, multiple non-MHC loci contribute to disease risk with smaller effects. These include the insulin, PTPN22, CTLA4, IL2RA, IFIH1, and other recently discovered loci. Genomewide association studies performed with high-density single-nucleotide–polymorphism genotyping platforms have provided evidence for a number of novel loci, although fine mapping and characterization of these new regions remain to be performed. Children born with the high-risk genotype HLADR3/4-DQ8 comprise almost 50% of children who develop antiislet autoimmunity by the age of 5 years. Genetic risk for type 1 diabetes can be further stratified by selection of children with susceptible genotypes at other diabetes genes, by selection of children with a multiple family history of diabetes, and/or by selection of relatives that are HLA identical to the proband. SUMMARY: Children with the HLA-risk genotypes DR3/4-DQ8 or DR4/DR4 who have a family history of type 1 diabetes have more than a 1 in 5 risk for developing islet autoantibodies during childhood, and children with the same HLA-risk genotype but no family history have approximately a 1 in 20 risk. Determining extreme genetic risk is a prerequisite for the implementation of primary prevention trials, which are now underway for relatives of individuals with type 1 diabetes. Type 1 diabetes (T1D),2 a multifactorial disease with a strong genetic compone Continue reading >>
Insulin Resistance Syndromes
Diagnosis Biochemical diagnostic thresholds for severe insulin resistance (IR) are arbitrary, and should ideally be defined relative to BMI-adjusted population normal ranges, however one set of approximate diagnostic criteria is as follows: A: Non-diabetic and B.M.I. <30 kg/m2 Fasting insulin above 150 pmol/l OR Peak insulin on oral glucose tolerance testing above 1,500 pmol/l B: Absolute insulin deficiency and B.M.I. <30 kg/m2 Exogenous insulin requirement > 3U/kg/day. C: Partial beta cell decompensation and/or B.M.I. >30 kg/m2 Insulin levels are more difficult to interpret in the context of obesity or pre-existing diabetes, where glucotoxicity, and mixtures of endogenous and exogenous insulin in the circulation confuse the biochemical picture. In these settings the clinical history and features such as acanthosis nigricans are particularly useful in making a diagnosis of likely monogenic severe IR. Subjective clinical judgement is also required. Generic clinical features of severe insulin resistance Severe insulin resistance (IR) usually presents in one of three ways: Persistent hyperglycaemia despite large doses of insulin in patients with diabetes - Note, however, that many cases are unrecognised in the prediabetic phase. Indeed, a very common early feature of severe IR is spontaneous and symptomatic postprandial hypoglycaemia which may require medical intervention. This may dominate the clinical picture for years before hyperglycemia supervenes, which only occurs in the face of beta cell decompensation. Acanthosis Nigricans - The commonest presentation of monogenic severe IR is with the skin condition acanthosis nigricans (Figure 1). Ovarian hyperandrogenism, or “Polycystic Ovary Syndrome” - This may be severe, and oligo- or amenorrhoea are frequently the first Continue reading >>
Is Type 2 Diabetes Caused By Genetics?
Diabetes is a complex condition. Several factors must come together for you to develop type 2 diabetes. For example, obesity and a sedentary lifestyle play a role. Genetics can also influence whether you’ll get this disease. If you’ve been diagnosed with type 2 diabetes, there’s a good chance that you’re not the first person with diabetes in your family. According to the American Diabetes Association, your risk of developing type 2 diabetes is: 1 in 7 if one of your parents was diagnosed before the age of 50 1 in 13 if one of your parents was diagnosed after the age of 50 1 in 2, or 50 percent, if both your parents have diabetes Several gene mutations have been linked to the development of type 2 diabetes. These gene mutations can interact with the environment and each other to further increase your risk. Type 2 diabetes is caused by both genetic and environmental factors. Scientists have linked several gene mutations to a higher diabetes risk. Not everyone who carries a mutation will get diabetes. But many people with diabetes do have one or more of these mutations. It can be difficult to separate genetic risk from environmental risk. The latter is often influenced by your family members. For example, parents with healthy eating habits are likely to pass them on to the next generation. On the other hand, genetics plays a big part in determining weight. Sometimes behaviors can’t take all the blame. Studies of twins suggest that type 2 diabetes might be linked to genetics. These studies were complicated by the environmental influences that also affect type 2 diabetes risk. To date, numerous mutations have been shown to affect type 2 diabetes risk. The contribution of each gene is generally small. However, each additional mutation you have seems to increase your Continue reading >>
What Causes Autoimmune Diabetes?
Autoimmune diabetes is influenced by genetics. What starts the autoimmune destruction is unknown, but it may be due to environmental factors. You may want to learn more about how type 1a diabetes develops. We know type 1a diabetes is caused by an autoimmune process in the body that mistakenly destroys the insulin-producing cells, or beta cells and occurs in genetically predisposed individuals. What starts the autoimmune destruction is unknown, but it may be due to environmental factors. In this section, you can learn more about: What is the Immune system? An overview of the different cells and organs in the immune system and how the immune system works Autoimmunity and diabetes: Current ideas about how the immune systems destroys insulin producing cells Continue reading >>
Type 1 Diabetes
happens when your immune system destroys cells in your pancreas called beta cells. They’re the ones that make insulin. Some people get a condition called secondary diabetes. It’s similar to type 1, except the immune system doesn’t destroy your beta cells. They’re wiped out by something else, like a disease or an injury to your pancreas. Insulin is a hormone that helps move sugar, or glucose, into your body's tissues. Cells use it as fuel. Damage to beta cells from type 1 diabetes throws the process off. Glucose doesn’t move into your cells because insulin isn’t there to do it. Instead it builds up in your blood and your cells starve. This causes high blood sugar, which can lead to: Dehydration. When there’s extra sugar in your blood, you pee more. That’s your body’s way of getting rid of it. A large amount of water goes out with that urine, causing your body to dry out. Weight loss. The glucose that goes out when you pee takes calories with it. That’s why many people with high blood sugar lose weight. Dehydration also plays a part. Diabetic ketoacidosis (DKA). If your body can't get enough glucose for fuel, it breaks down fat cells instead. This creates chemicals called ketones. Your liver releases the sugar it stores to help out. But your body can’t use it without insulin, so it builds up in your blood, along with the acidic ketones. This combination of extra glucose, dehydration, and acid buildup is known as "ketoacidosis" and can be life-threatening if not treated right away. Damage to your body. Over time, high glucose levels in your blood can harm the nerves and small blood vessels in your eyes, kidneys, and heart. They can also make you more likely to get hardening of the arteries, or atherosclerosis, which can lead to heart attacks and strok Continue reading >>
Want To Find Out If Diabetes Is Hereditary? Here's Your Answer
Diabetes is the sweet disease that can lead to many health problems including heart diseases, stroke and even gout. Diabetes is becoming a very common disease not only in the Western world, but also in developing countries. Researchers are searching for answers that lead to concrete causes of diabetes. Many times, it is seen that diabetes runs in families. It is a condition that develops when the body is not able to produce or use the stored glucose in the body. This causes the blood sugar or glucose levels in the body to rise. When sugar or starchy foods are eaten they are broken down into glucose. This glucose is then converted into energy by the body with the help of insulin. This is a hormone produced by the pancreas. If there is an insufficient amount of insulin in the body, it will lead to improper absorption of glucose by the body. Thus, the level of glucose in the blood rises leading to increase in blood sugar level. There are two types of diabetes that can affect people. Type 1 diabetes, also called juvenile onset or insulin dependent diabetes and Type 2 diabetes, or adult onset or non-insulin dependent diabetes are the two types. Type 1 diabetes affects children and young adults, as their body does not produce any insulin. Thus, making them dependent on insulin injections for survival. Type 2 diabetes occurs in people over 40 and those who are obese, have a family history of diabetes and unhealthy lifestyle. Diabetes is a disease that is commonly seen in adults as well as children and young adults these days. Most of the time, if one or both or the parents have diabetes, their children seem to develop diabetes during some time of their life. This is very common and people often think diabetes runs in their families. Genes are passed on from parents to their ch Continue reading >>
Environmental Triggers And Determinants Of Type 1 Diabetes
Type 1 diabetes is perceived as a chronic immune-mediated disease with a subclinical prodromal period characterized by selective loss of insulin-producing β-cells in the pancreatic islets in genetically susceptible subjects. A series of evidence supports a critical role of exogenous factors in the development of type 1 diabetes, such as 1) the fact that <10% of individuals with HLA-conferred diabetes susceptibility do progress to clinical disease, 2) a pairwise concordance of type 1 diabetes of <40% among monozygotic twins, 3) a more than 10-fold difference in the disease incidence among Caucasians living in Europe, 4) a several-fold increase in the incidence over the last 50 years, and 5) migration studies indicating that the disease incidence has increased in population groups who have moved from a low-incidence to a high-incidence region. This article discusses the trigger-booster hypothesis claiming that the diabetic disease process is triggered by an exogenous factor with definite seasonal variation and driven by one or several other environmental determinants. In addition, there are a series of modifying factors affecting the fate and pace of the process. Accordingly, progression to clinical type 1 diabetes typically requires the unfortunate combination of genetic disease susceptibility, a diabetogenic trigger, and a high exposure to a driving antigen. Clinical type 1 diabetes represents end-stage insulitis, and it has been estimated that at the time of diagnosis, only 10–20% of the insulin-producing β-cells are still functioning. Environmental factors have been implicated in the pathogenesis of type 1 diabetes both as triggers and potentiators of β-cell destruction (1–3), although the contribution of any individual exogenous factor has not yet been definit Continue reading >>
Type 1 Diabetes
Type 1 diabetes is the type of diabetes that typically develops in children and in young adults. In type 1 diabetes the body stops making insulin and the blood sugar (glucose) level goes very high. Treatment to control the blood glucose level is with insulin injections and a healthy diet. Other treatments aim to reduce the risk of complications. They include reducing blood pressure if it is high and advice to lead a healthy lifestyle. What is type 1 diabetes? What is type 1 diabetes? Play VideoPlayMute0:00/0:00Loaded: 0%Progress: 0%Stream TypeLIVE0:00Playback Rate1xChapters Chapters Descriptions descriptions off, selected Subtitles undefined settings, opens undefined settings dialog captions and subtitles off, selected Audio TrackFullscreen This is a modal window. Beginning of dialog window. Escape will cancel and close the window. TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal Dialog End of dialog window. Diabetes mellitus (just called diabetes from now on) occurs when the level of sugar (glucose) in the blood becomes higher than normal. There are two main types of diabetes. These are called type 1 diabetes and type 2 diabetes. Type 1 diabetes usually first develops in children or young adults. In the UK about 1 in 300 people develop type 1 diabetes at some stage. With type 1 diabet Continue reading >>
