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Type 1 Diabetes Autoimmune Disease

Diabetes Mellitus Type 1

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 >>

Paleo And Type 1 Diabetes

Paleo And Type 1 Diabetes

When most people think of “diabetes,” they think of Type 2 Diabetes – that’s the kind that you (usually) get as an adult after a lifetime of eating junk food and sitting on the couch. Type 2 is the “diabetes” that goes along with the rest of the metabolic syndrome (obesity, high blood pressure, and high cholesterol). Type 1 Diabetes is a completely different problem. It’s related to diet (more on this below), but it’s not a “lifestyle disease” and it’s not caused by a poor diet the way Type 2 is. In Type 1, an autoimmune attack on the pancreas prevents them from producing the hormone insulin. Insulin is necessary for metabolizing carbs and protein (more on insulin here), so people with Type 1 Diabetes have to inject insulin every time they eat a meal. Type 1 Diabetes Type 2 Diabetes NOT part of the metabolic syndrome; patients with Type 1 Diabetes are often thin. Part of the metabolic syndrome; closely connected to obesity (although not all people with Type 2 are obese). Not enough (if any) insulin is produced, so your body can’t metabolize carbohydrates or protein on its own. Insulin is being produced (too much of it, actually), but your body is “deaf” to the insulin signal so it doesn’t work properly. Common in children Rare in children; usually develops in adults after a lifetime of bad eating. Not caused by eating junk food and not exercising. Can be caused by eating junk food and not exercising. Autoimmune disease May have an autoimmune component, but is not primarily an autoimmune disease. It’s easy to see how a Paleo approach to diet and lifestyle could be safe and effective for Type 2 Diabetes – if a disease is caused by eating too much junk food and not exercising, then eating real food and taking up a gym habit can only be hel Continue reading >>

Autoimmunity

Autoimmunity

Type 1 Diabetes Autoantibodies islet cell antigen (ICA) antibodies (present in 90% of people with type 1 at diagnosis); antibodies to insulin and pro-insulin (present in 23 and 34% of patients at diagnosis, respectively); glutamic acid decarboxylase (GAD) antibodies (present in 73% of patients at diagnosis); protein tyrosine phosphatase (IA-2) antibodies (present in 75% of patients at diagnosis); and Zinc transporter 8 (ZnT8A) antibodies (more newly discovered). Exposures During Development The doses required to produce an effect during development of the immune system are significantly lower than those required to affect an adult. The effects of the exposures depend on timing of the dose, if given during a critical period of immune system development. The effects of exposures on a fetus, or during early childhood, can be different from those seen in adults. The perinatal period (the months before and after the time of birth), is a sensitive time for the developing immune system. Adult exposure, therefore, does not necessarily predict the effects of exposure to a fetus, during the perinatal period, or in early childhood. The effects of early life exposures often last long after the exposure, sometimes having lifelong effects. And, early exposures may be "latent" and invisible, until stressed later in life (for example, by a virus), causing abnormal immune responses. Response can differ by gender; there are many cases where males and females have differing immune responses to early environmental exposures. The Timing Makes the Poison Regulatory T-Cells and the Thymus How might early exposure to environmental factors lead to autoimmune diseases such as type 1 diabetes later in life? There are a number of possible mechanisms, many of which are too complicated to describe h Continue reading >>

Extended Family History Of Diabetes And Autoimmune Diseases In Children With And Without Type 1 Diabetes

Extended Family History Of Diabetes And Autoimmune Diseases In Children With And Without Type 1 Diabetes

OBJECTIVE To determine the extended family history of diabetes or autoimmune diseases in families with and without children having type 1 diabetes. RESEARCH DESIGN AND METHODS Three hundred case families and 381 control families were interviewed using structured questionnaires. RESULTS The proportion of case children having at least one relative with type 1 diabetes outside the nuclear family was higher than that of control children (50.3 vs. 31.8%, P < 0.001). The proportions of case and control children having relatives with type 2 diabetes or gestational diabetes were similar. Other autoimmune diseases occurred more frequently among the case children (9.7 vs. 1.1%, P < 0.001), in the case nuclear families (22.0 vs. 12.9%, P = 0.002) and in relatives outside the case nuclear family (72.0 vs. 62.2%, P = 0.007). CONCLUSIONS Type 1 diabetes and autoimmune diseases not only cluster in the nuclear families of children with type 1 diabetes but are also overrepresented in their extended families. First degree relatives of patients with type 1 diabetes clearly have an increased disease risk (1–5), but little information is available about the occurrence of type 1 diabetes outside the nuclear family (6). It is also unclear whether type 2 diabetes and gestational diabetes are more frequently present in the families of children with type 1 diabetes (7–9). Type 1 diabetes is known to be associated with other autoimmune diseases, but there is a scarcity of data on the frequency of autoimmune diseases among other family members (10). RESEARCH DESIGN AND METHODS All families having a child with type 1 diabetes being treated at the Department of Pediatrics, Oulu University Hospital in September 2003 were invited to participate in this study (n = 306). Six families refused. The pa Continue reading >>

Effect Of Associated Autoimmune Diseases On Type 1 Diabetes Mellitus Incidence And Metabolic Control In Children And Adolescents

Effect Of Associated Autoimmune Diseases On Type 1 Diabetes Mellitus Incidence And Metabolic Control In Children And Adolescents

BioMed Research International Volume 2016 (2016), Article ID 6219730, 12 pages Department of Pediatric Endocrinology and Diabetology, Medical University of Lublin, 6 Professor A. Gebali Street, 20-093 Lublin, Poland Academic Editor: Liping Yu Copyright © 2016 Aleksandra Krzewska and Iwona Ben-Skowronek. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases developing in childhood. The incidence of the disease in children increases for unknown reasons at a rate from 3 to 5% every year worldwide. The background of T1DM is associated with the autoimmune process of pancreatic beta cell destruction, which leads to absolute insulin deficiency and organ damage. Complex interactions between environmental and genetic factors contribute to the development of T1DM in genetically predisposed patients. The T1DM-inducing autoimmune process can also affect other organs, resulting in development of additional autoimmune diseases in the patient, thereby impeding diabetes control. The most common T1DM comorbidities include autoimmune thyroid diseases, celiac disease, and autoimmune gastritis; additionally, diabetes can be a component of PAS (Polyglandular Autoimmune Syndrome). The aim of this review is to assess the prevalence of T1DM-associated autoimmune diseases in children and adolescents and their impact on the course of T1DM. We also present suggestions concerning screening tests. 1. Introduction Diabetes is the most common chronic metabolic disease diagnosed in children and adolescents. Although it is not contagious, the disease is the Continue reading >>

Immune Mechanisms In Type 1 Diabetes

Immune Mechanisms In Type 1 Diabetes

There are three prerequisites for development of the autoimmune disease type 1 diabetes (T1D). First, β cell-reactive T cells need to be activated; second, the response needs to be proinflammatory; and finally, immune regulation of autoreactive responses must fail. Here, we describe our current understanding of the cell types and immune mechanisms involved in each of these steps leading to T1D. Novel findings regarding β cell involvement in its own destruction, the importance of the microbiota for instruction of the immune system, and recent data from studies in T1D patients are discussed. In addition, we summarise therapeutic approaches to T1D, and how these relate to the immune mechanisms involved in disease development. To access this article, please choose from the options below Continue reading >>

The Pathogenesis And Natural History Of Type 1 Diabetes

The Pathogenesis And Natural History Of Type 1 Diabetes

Abstract The purpose of this article is to provide an overview that summarizes much in the way of our current state of knowledge regarding the pathogenesis and natural history of type 1 diabetes in humans. This information is presented to the reader as a series of seminal historical discoveries that, when advanced through research, transformed our understanding of the roles for the immune system, genes, and environment in the formation of this disease. In addition, where longitudinal investigations of these three facets occurred, their roles within the development of type 1 diabetes, from birth to symptomatic onset and beyond, are discussed, including their most controversial elements. Having an understanding of this disorder’s pathogenesis and natural history is key for attempts seeking to understand the issues of what causes type 1 diabetes, as well as to develop a means to prevent and cure the disorder. Type 1 diabetes (T1D) is a disorder that arises following the autoimmune destruction of insulin-producing pancreatic β cells (Atkinson 2001; Bluestone et al. 2010). The disease is most often diagnosed in children and adolescents, usually presenting with a classic trio of symptoms (i.e., polydypsia, polyphagia, polyuria) alongside of overt hyperglycemia, positing the immediate need for exogenous insulin replacement—a medicinal introduction to the disorder whose therapeutic practice lasts a lifetime. These introductory facets having been said, many other etiological and typology-based aspects for this disease remain either unclear or subject to significant debate within the medical research community. Among these are questions related to the percentage of T1D cases that are diagnosed in adults, a figure whose estimates range from a low of 25% to as much as 50% (Thu Continue reading >>

People With Type 1 Diabetes Often Have Another Autoimmune Disease

People With Type 1 Diabetes Often Have Another Autoimmune Disease

It has been known that people with type 1 diabetes develop additional autoimmune diseases at higher rates but researchers looked to find out more details such as prevalence and additional factors in a recent study. According to Endocrine Today, a “diagnosis of at least one other autoimmune disease was found for 27% of participants; most had one additional diagnosis (20%) followed by 5% with two and less than 1% with three, four or five.” Janet B. McGill, MD, FACE, professor of medicine at the Washington University School of Medicine in St. Louis and Endocrine Today Editorial Board member and team used data they obtained from 25,759 participants with type 1 diabetes who were enrolled in the T1D Exchange Registry. They analyzed the types and frequency of autoimmune diseases in these participants including their relationships to gender, age, and race/ethnicity. Diagnosis of autoimmune diseases were obtained from medical records of the Exchange Registry participants. Who Develops Additional Autoimmune Diseases? Of all the T1D Exchange participants, half were female, 82 percent non-Hispanic white, with a mean age of 23 years and a mean duration of diabetes of 11 years. Endocrine Today reports that the mean A1c was 8.4 percent. Of these participants 6,876 or 27 percent were diagnosed with at least one autoimmune disease on top of the type 1 diabetes. The frequency of 2 or more autoimmune diseases went up from 4.3 percent in participants under age 13 to 10.4 percent in those 50 or older. Which Autoimmune Diseases are Most Common? The most common autoimmune disease for the participants were thyroid related at 6,097 or 24 percent. The next most common were gastrointestinal at 1,530 or 6 percent and collagen vascular diseases at 432 or 2 percent. The researchers stated that A Continue reading >>

Type 1 Diabetes And Autoimmunity

Type 1 Diabetes And Autoimmunity

Go to: Type 1 Diabetes and Autoimmune Thyroid Disease It is well known that T1D is frequently associated with other organ-specific autoimmune diseases, including autoimmune thyroid disease (AITD), pernicious anemia, and idiopathic Addison’s disease (4). Table 1 summarizes the prevalence of organ-specific autoimmune disease complicating T1D in Japanese and Caucasoid patients (5). In Japanese patients with T1D, the most common coexisting organ-specific autoimmune disease is AITD (> 90%). The prevalence of anti-thyroid autoantibodies in children with T1D at disease onset is about 20%, and anti-thyroid autoantibodies are particularly common in girls. Furthermore, it is reported that the prevalence of anti-thyroid antibodies increases with increasing age and that the presence of anti-thyroid antibodies at diagnosis of T1D predicts the development of future thyroid disease (6). Patients with anti-thyroid antibodies are 18 times more likely to develop thyroid disease than patients without anti-thyroid antibodies (7) (Fig.1). Therefore, for early detection of AITD in children with T1D, Glastras et al. suggested measurement of anti-thyroid antibodies and TSH at T1D onset and in yearly intervals after the age of 12 yr. Furthermore, the International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus Clinical Guidelines recommend the screening of thyroid function by analyzing circulating TSH at the diagnosis of diabetes and, thereafter, every 2nd yr in asymptomatic individuals without goiter and more frequent if goiter is present. To characterize the T1D patients complicated with AITD (autoimmune polyendocrine syndrome type 3 variant, APS3v), we have analyzed the clinical characteristics of patients with APS3v who were consecutively diagnosed at Nagasaki University Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Type 1 diabetes Type 1 diabetes – previously known as insulin dependent or juvenile diabetes – is an autoimmune disease that occurs when the pancreas is no longer able to produce the insulin needed, because the cells that produce the insulin have been destroyed by the body’s immune system. Usually diagnosed in childhood, teen and young adult years, type 1 diabetes can occur at any age. Lifestyle choices don’t cause type 1 diabetes. Symptoms of Type 1 diabetes People with type 1 diabetes usually have sudden onset of symptoms, which may include: Going to the toilet frequently to pass urine Excessive thirst and drinking a lot of fluids Unexplained weight loss Fatigue (tiredness) Mood changes Skin infections Oral or vaginal thrush Abdominal pain Excess hunger Weakness Irritability Type 2 diabetes Type 2 diabetes is a chronic condition that occurs when the pancreas does not produce enough insulin and / or the insulin does not work effectively to meet the body’s needs. Type 2 diabetes: represents 85 to 90% of all cases of diabetes, is more likely to develop in people with a family history of type 2 diabetes or from particular ethnic backgrounds, usually develops in adults over the age of 45 years but is increasingly occurring in younger age groups, can be delayed or prevented in 58% of cases. Symptoms of Type 2 diabetes Symptoms of type 2 diabetes often go undiagnosed as they occur gradually. For some the first sign may be a complication of diabetes such as a heart attack, vision problems or a foot ulcer. Symptoms may include blurred vision, skin infections, slow healing, tingling and numbness in the feet. Sometimes no symptoms are noticed at all. Continue reading >>

Type 1.5 Diabetes: An Overview

Type 1.5 Diabetes: An Overview

Type 1.5 Diabetes (T1.5D) is also known as Latent Autoimmune Diabetes of Adults (LADA). LADA is considered by some experts to be a slowly progressive form of Type 1 Diabetes (T1D) while other experts in the field consider it a separate form of Diabetes. LADA or T1.5D is sometimes thought of as T1D that is diagnosed in adults over the age of 30—T1D is commonly diagnosed in children and younger adults. T1.5D is often found along with Type 2 Diabetes (T2D): up to 25% of individuals with T1.5D also have characteristics of T2D.1 This is sometimes called “double diabetes”. Individuals with T1.5D are all eventually dependent on insulin for treatment, and have a very high risk of requiring insulin within months or years (up to six years) after the initial diagnosis. This is in contrast to people with T1D—these people tend to need insulin within days or weeks of diagnosis.2 Individuals diagnosed with T2D relatively rarely require insulin treatment. Current recommendations are to treat individuals with T1.5D immediately with insulin, though this is not universally accepted (see below). The Causes of T1.5D Just as with other forms of diabetes, we don’t truly understand the underlying cause(s) of T1.5D. There are autoimmune components in Types 1, 1.5 and 2 diabetes with some overlap in the types of antibodies formed, so it is clear that as in T1D, the immune system has become “confused” and begins to act against the beta cells of the pancreas—the source of the insulin needed to control blood sugars. Both T1D and T1.5D have antibodies to glutamic acid decarboxylase or anti-GAD antibodies. As with T1D, individuals with T1.5D tend not to be obese, whereas in T2D, most individuals are overweight or obese. Genetics and Environmental Susceptibility Individuals with T1.5D Continue reading >>

Can Synthetic Biology Finally Cure The Autoimmune Disease?

Can Synthetic Biology Finally Cure The Autoimmune Disease?

Lev Dolgachov/Thinkstock Type 1 diabetes is a discouraging disease. Despite the availability of synthetic insulin and increasingly sophisticated monitoring technology, it’s still a condition that requires incessant vigilance: Diabetics must constantly track their blood sugar levels and carefully use that information to calibrate drug doses. Even if you manage to do all of that well, bad days remain almost inevitable. Take too much insulin, and you can spiral into a hypoglycemic delirium. Take too little, and your glucose levels will rise, filling the body with dangerous levels of ketones. Less immediately frustrating—but no less familiar for diabetics—is the state of diabetes research. Possible cures routinely pop up only to fade from view, their benefits never quite surpassing the simple efficacy of an insulin injection. More recently, though, the field of synthetic biology—a hybrid discipline that aims to construct or redesign biological components and systems—has shown the potential to produce a novel set of treatments. The solutions remain speculative, but they do offer cautious reasons for hope. “Type 1 diabetes, in theory, should be relatively easy to solve. That has been the mantra of researchers for the last 30 years. And I still take insulin every day.” John Glass, a researcher working on one such new effort, knows how maddening false hope can be, having lived with the disease for decades. “Type 1 diabetes, in theory, should be relatively easy to solve,” he told me over the phone. “That has been the mantra of type 1 diabetes researchers for the last 30 years. And I still take insulin every day.” I had originally called Glass, a synthetic biologist with the J. Craig Venter Institute, in the hopes of better understanding how his burgeoning f Continue reading >>

Type I (insulin-dependent) Diabetes Is A Th1- And Th2-mediated Autoimmune Disease

Type I (insulin-dependent) Diabetes Is A Th1- And Th2-mediated Autoimmune Disease

Antigen-specific activation of naive CD4+ T cells requires two signals. The first signal is imparted by interaction of the multimeric T-cell receptor (TcR)-CD3 complex with processed antigen expressed in conjunction with major histocompatibility complex class II protein by antigen-presenting cells (APC). The second signal is provided by costimulatory molecules which complement TcR-CD3 signals in augmenting T-cell activation ( 26 , 29 ). At least three major signal transduction pathways operate as a consequence of T-cell activation: (i) phospholipase C-1 pathway, resulting in the hydrolysis of phosphatidylinositol 4,5-bisphosphate ( 18 ) and the generation of 1,4,5-inositol trisphosphate and diacylglycerol ( 53 , 69 ), (ii) p21ras/RAF kinase pathway, also referred to as the classical mitogen-activated protein kinase pathway ( 38 ), and (iii) the phosphatidylinositol 3-OH kinase/GDP-Rac, referred to as the alternative MAPK-signaling pathway ( 12 ). Depending on the intensity of the signal generated, duration of stimulation, and the contribution of costimulatory molecules, coupling to more than one signal transduction pathway is possible, which determines the outcome of the functional response ( 17 , 42 ). Engagement of the TcR in the absence of appropriate costimulation results in a transient activation with very little interleukin-2 (IL-2) production, followed by a sharp decline in activation ( 19 ). The provision of secreted ( 49 , 62 ) and cell-bound ( 7 , 51 ) costimulatory molecules, in synergy with TcR-CD3 signals, significantly augments cytokine expression at the transcriptional and posttranscriptional levels. This results in stabilization of IL-2 and other cytokine mRNA transcripts ( 50 , 51 ), abrogation of anergy ( 31 ), and enhancement of cell viability as a r Continue reading >>

Obesity, Type 1 Diabetes, And Psoriasis: An Autoimmune Triple Flip

Obesity, Type 1 Diabetes, And Psoriasis: An Autoimmune Triple Flip

Abstract Obesity, type 1 diabetes, and psoriasis are wide-ranging health problems. Genetics, epigenetics, and environmental factors together with immune disturbances are involved in these diseases. The white adipose tissue is an active endocrine organ, secreting a wide variety of soluble mediators called adipokines that have a central role in the relationship between adipose tissue and immune system. Inflammatory cytokines, including the IL-23/IL-17 and IL-18 axes, and microRNAs are involved in many processes, including immunity and inflammation, thus having a major role in the onset of these three diseases. In this review, we present an overview of the roles of adipokines, cytokines, and microRNAs in the pathogenesis and the progression of these three diseases. © 2016 S. Karger AG, Basel Introduction The pathophysiology of autoimmune diseases involves genetics, epigenetics, and environmental factors, together with immune disturbances. Many literature data concerning the association between diet and the risk of developing autoimmune diseases are available [1]. The ‘Western lifestyle' and a diet characterized by the use of high-fat, high-sugar, high-salt foods are involved in the development of autoimmunity, and the lack of physical activity in combination with excess calorie intake causes a high prevalence of obesity in developed societies [2,3]. Obesity, in turn, predisposes to different diseases, and it is becoming increasingly clear that the dietary habits in Western societies and a high body mass index (BMI) also constitute risk factors for autoimmune diseases [4]. Once considered as an inactive energy storage tissue, the white adipose tissue has been discovered as an active endocrine organ, secreting a wide variety of soluble mediators termed ‘adipokines' or Continue reading >>

Type 1 Diabetes Mellitus Associated With Autoimmune Thyroid Disorders In Iranian Children: A Review

Type 1 Diabetes Mellitus Associated With Autoimmune Thyroid Disorders In Iranian Children: A Review

To Cite : Zamanfar D, Aarabi M, Sadeghian I. Type 1 Diabetes Mellitus Associated With Autoimmune Thyroid Disorders in Iranian Children: A Review, J Pediatr Rev. 2015 ;3(1):e157. doi: 10.5812/jpr.157. Context: Type one diabetes mellitus (T1DM) is an autoimmune disorder that is yet the most common type of diabetes in children and adolescents. Several genetic risk factors have been associated with T1DM, auto immune thyroiditis and other autoimmune disorder. Among autoimmune disorders, autoimmune thyroid disease (ATD) is the most frequent disorder associated with T1DM. Its prevalence varies depending on age, sex and ethnic origin of the subjects and is considerably higher than the general population and increases with duration of T1DM. The aim of this study was to review the prevalence of ATD in Iranian children with T1DM compared with other countries. Evidence Acquisition: We conducted a review on all papers published on the association between autoimmune thyroiditis and T1DM, which was available on Google Scholar, Scientific Information Database (SID), Magiran and Iran Medex databases up to June 2014. Both Persian and English articles were checked. The searched terms were: diabetes mellitus, autoimmune thyroiditis, prevalence, frequency, Iranian children and adolescents. All papers which were done on patients with age under 20 years old and have used Anti-TPO and Anti-TG to evaluate patients were included. Results: Six papers met all the criteria. A total of 736 participants were included in this review. After review of all the papers, the prevalence of Anti-TPO was reported between 8% and 30% and Anti-TG was reported 6.06% to 23.6% in diabetic children in Iran. Conclusions: Autoimmune thyroid disorders are the most prevalent immunological diseases in patients with type 1 Continue reading >>

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