Adult-onset Type 1 Diabetes And Pregnancy: Three Case Reports
Copyright © 2013 Barbara Bonsembiante et al. 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 From 5% to 10% of diabetic patients have type 1 diabetes. Here we describe three cases of adult-onset type 1 diabetes in pregnancy treated at our clinic between 2009 and 2012. Two patients came for specialist examination during pregnancy, the third after pregnancy. These women had no prior overt diabetes and shared certain characteristics, that is, no family diabetes history, age over 35, normal prepregnancy BMI, need for insulin therapy as of the early weeks of pregnancy, and high-titer anti-GAD antibody positivity. The patients had persistent diabetes after delivery, suggesting that they developed adult-onset type 1 diabetes during pregnancy. About 10% of GDM patients become pancreatic autoantibody positive and the risk of developing overt diabetes is higher when two or more autoantibodies are present (particularly GAD and ICA). GAD-Ab shows the highest sensitivity for type 1 diabetes prediction. We need to bear in mind that older patients might conceivably develop an adult-onset type 1 diabetes during or after pregnancy. So we suggest that women with GDM showing the described clinical features shall be preferably tested for autoimmunity. Pregnant patients at risk of type 1 diabetes should be identified to avoid the maternal and fetal complications and the acute onset of diabetes afterwards. From 5% to 10% of diabetic patients have type 1 diabetes, which results from an autoimmune destruction of pancreatic cells. Autoantibodies directed against insulin, islet cells, glutamic acid decarboxylase 65 (GAD), Continue reading >>
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What Is The Difference Between Type 1 And Type 2 Diabetes?
The majority of people with diabetes have type 2 diabetes. This is a disease where there are two different deficits. The body is not making enough insulin, and the body is resistant to the effects of the insulin that it does make. Type 2 diabetes typically affects older individuals. Most people with type 2 have a genetic risk that's aggravated by lifestyle issues such as lack of activity or dietary habits. Type 1 diabetes is an autoimmune disease. The body basically turns against its own pancreas and the cells that make insulin are no longer functional. So, these individuals always rely on insulin for treatment as opposed to type 2 patients, who can respond very successfully to pills or a combination of insulin and pills. Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider. Type 1 diabetes is, like type 2, a disease of high blood sugar, but there are some differences. In this video, endocrinologist Athena Philis-Tsimikas, MD, of Scripps Health, explains how type 2 diabetes differs in its symptoms and treatment. Diabetes is marked by high levels of sugar in the blood. Most of the 24 million Americans with this condition have type 2 diabetes, which occurs when the body becomes resistant to the effects of insulin (the hormone made by the pancreas that enables cells to draw sugar from the blood for energy) and does not produce enough insulin to overcome the resistance. Although the exact cause of type 2 diabetes isn't clear, one thing is certain: excess body fat is the No. 1 risk factor. T Continue reading >>
Is The End Of Insulin Jabs In Sight? New Treatment Made From Diabetics' Skin Could 'reboot' The Pancreas
Hundreds of thousands of diabetics could be freed from insulin injections thanks to a treatment made from their own skin. Scientists have found a way of turning skin cells into healthy pancreatic cells, which could replace those damaged in type 1 diabetes. The breakthrough could spell the end to the grind of insulin injections. A more natural treatment should also cut the odds of developing the disabling and deadly complications of the disease, which range from heart attacks, strokes and blindness to nerve and circulatory damage and amputations. In diabetes, the body struggles to produce or use insulin, a hormone needed to convert the sugar in food into energy - so new treatments are urgently needed. The U.S. research capitalises on a technique that allows scientists to use a cocktail of vitamins, genes and other compounds to turn one type of cell into another. The researchers, from the Gladstone Institutes and the University of California, San Francisco, found the right recipe to turn human skin cells into healthy, fully-functional versions of the pancreatic beta cells that are damaged in diabetes. Grafted into a mouse, these cells worked well enough to stop the animals from developing the condition, the journal Nature Communications reports. Although insulin-producing cells have been made before, the new technique is quicker and more practical. In future, a sliver of skin could be taken from a patient’s arm and used to make trillions of healthy pancreatic beta cells. A perfect match to the patient, these customised cells could be put back into their body to replace those damaged by their diabetes. Researcher Dr Matthias Hebrok said: ‘Our results demonstrate for the first time that human adult skin cells can be used to efficiently and rapidly generate functional pa Continue reading >>
Type 1 Diabetes
Type 1 diabetes is an auto-immune condition in which the immune system is activated to destroy the cells in the pancreas which produce insulin. We do not know what causes this auto-immune reaction. Type 1 diabetes is not linked to modifiable lifestyle factors. There is no cure and it cannot be prevented. Type 1 diabetes: Occurs when the pancreas does not produce insulin Represents around 10% of all cases of diabetes and is one of the most common chronic childhood conditions Onset is usually abrupt and the symptoms obvious Symptoms can include excessive thirst and urination, unexplained weight loss, weakness and fatigue and blurred vision Is managed with insulin injections several times a day or the use of an insulin pump. What happens to the pancreas? In type 1 diabetes, the pancreas, a large gland behind the stomach, stops making insulin because the cells that make the insulin have been destroyed by the body’s immune system. Without insulin, the body’s cells cannot turn glucose (sugar), into energy. People with type 1 diabetes depend on insulin every day of their lives to replace the insulin the body cannot produce. They must test their blood glucose levels several times throughout the day. The onset of type 1 diabetes occurs most frequently in people under 30 years, however new research suggests almost half of all people who develop the condition are diagnosed over the age of 30. About 10-15% of all cases of diabetes are type 1. What happens if people with type 1 diabetes don’t receive insulin? Without insulin the body burns its own fats as a substitute which releases chemical substances in the blood. Without ongoing injections of insulin, the dangerous chemical substances will accumulate and can be life threatening if it is not treated. This is a condition call Continue reading >>
Celiac Disease And Diabetes
The estimated prevalence of celiac disease in patients with type 1 diabetes is approximately 6%. Most patients with both conditions have asymptomatic celiac disease, or symptoms that may be confused for symptoms of their diabetes. For this reason, screening for celiac disease is recommended after a diagnosis of type 1 diabetes, as well as counseling for the signs and symptoms of type 1 diabetes after a celiac disease diagnosis. Type 1 Diabetes In cases of type 1 diabetes, the immune system attacks and destroys the specialized cells in the pancreas that produce insulin. When the body can no longer produce sufficient insulin (a protein that regulates blood glucose concentration) the resulting chronically high glucose levels in the blood (hyperglycemia) cause blood vessel and nerve damage. This can lead to serious complications, such as: stroke, heart disease, kidney disease, and amputation. Symptoms for diabetes include: frequent urination, thirst, hunger, weight loss, dry mouth, and fatigue. The exact cause that starts the autoimmune reaction in type 1 diabetes is still not understood. There are genetic and environmental factors that can increase the risk of developing diabetes, as well as certain drugs that lead to the specific destruction of the beta cells. The condition is usually diagnosed in children or young adults, which is why it was once called juvenile diabetes. Diabetes is much easier to test for than celiac disease. A blood test, usually done after a period of fasting, measures how much glucose is in the blood. If it is over a certain threshold, the person has diabetes or pre-diabetes. If caught early enough, the autoantibodies (antibodies that attack the body) can be tested for before the patient actually has diabetes or pre-diabetes. Treating diabetes typic Continue reading >>
Can You Be A Firefighter If You Have Diabetes?
Question we received last week from Brian in Bronx, NY. How can I become a firefighter with diabetes? Can someone handle the stress of the job? In this article, we will explore how one can pursue a career as a firefighter with diabetes. We have already looked at the likelihood of getting a job as a law enforcement officer, air traffic controller, a long distance truck driver, and an EMS/Paramedic with diabetes. We have also looked at whether or not one can be in the military with diabetes. Let us now look at the rules and regulations for becoming a firefighter with diabetes. There are many variables that affect whether or not one can become a firefighter with diabetes. These can be overcome. The main factor that affects it is the control that you have over your diabetes, as we have seen with many other careers and diabetes. One can join a local volunteer fire department or even a paid reserve if one has diabetes that is controlled. If you have Type 1 diabetes, you can work with an insulin pump and/or a continuous glucose monitor (CGM) to help avoid trending low blood sugars and achieve better control so that you can pass your yearly physicals and practice safety on the job. As one of our reader’s pointed out: it would be worth noting that different departments will have different requirements. It is important to check with your doctor and the department to make sure you are able to serve as a firefighter. There are also many other ways people can support their local fire department, including assisting with non-operational tasks such as fire prevention education, fundraising, administration, etc. People can check with their local department about support functions that may be available. A career as a firefighter, or any of the other careers that requires one to manage Continue reading >>
Type 2 Diabetes
What is type 2 diabetes Type 2 diabetes is a chronic condition that affects your body’s use of glucose (a type of sugar you make from the carbohydrates you eat). Glucose is the fuel your cells need to do their work. You need glucose for energy. You also need insulin, a hormone produced by the pancreas that helps glucose enter your cells so that it can be converted to energy. Here’s the problem: People with type 2 diabetes (also known as diabetes mellitus) can’t properly use or store glucose, either because their cells resist it or, in some cases, they don’t make enough. Over time, glucose builds up in the bloodstream, which can lead to serious health complications unless people take steps to manage their blood sugar. Type 2 diabetes affects more than 29 million Americans, including nearly eight million who don’t even know they have it. You may be at greater risk of developing type 2 diabetes if it runs in your family, if you are of a certain age or ethnicity, or if you are inactive or overweight. Type 2 diabetes vs. type 1 diabetes What’s the difference between type 1 and type 2 diabetes? Type 1 diabetes is an autoimmune disease in which the body does not produce insulin. The immune system destroys insulin-producing cells in the pancreas. Type 1 diabetes is usually diagnosed in children, teens, and young adults. People with type 1 diabetes need life-long insulin therapy. Type 2 diabetes is much more common. In type 2 diabetes, the body doesn’t use insulin properly or, in some cases, doesn’t make enough. It’s usually diagnosed in middle-aged or older adults, but anyone can develop type 2 diabetes. It can be managed through diet, exercise, and medication. Type 2 diabetes occurs when the body doesn’t use insulin as it should or when the pancreas doesn� Continue reading >>
How Serious Is Type 2 Diabetes? Is It More Serious Than Type 1 Diabetes?
A fellow caregiver asked... How serious is type 2 diabetes, and is it less or more serious than type 1 diabetes? My mom, just diagnosed with type 2 diabetes, keeps it under control without taking insulin. So is type 2 diabetes less of a problem than insulin-dependent type 1? Expert Answers No, definitely not. In fact, in some ways type 2 diabetes is a more serious disorder because your mom may have had it for years before she was diagnosed. So she may well have developed some of the long-term, debilitating complications linked to the condition without knowing it. In addition, since type 2 diabetes is a progressive disorder without a cure, over time her body may not be able to produce insulin or use it as well as it does now, and she may wind up needing insulin injections or pills. A person with type1 diabetes ignores it for a day at his own peril. He'll likely end up in the emergency room because his body can't absorb glucose without a continuous supply of insulin via injection or an insulin pump. People with type 1 diabetes typically develop such severe symptoms over a short time in childhood or early adulthood that they're forced to deal with it. Type 2 diabetes is a sneakier condition: Its harmful health effects can slowly build for years until full-blown complications, such as vision loss, heart disease, or foot problems, make it impossible to ignore. Plus it often comes with its own set of problems. For instance, people with type 2 diabetes are frequently diagnosed with high blood pressure and cholesterol along with high blood sugar. This damaging threesome can lead to progressive thickening of the arteries and reduced blood flow, putting your mom at greater risk for a slew of complications including heart disease, stroke, and nerve damage. If your mom is overweigh Continue reading >>
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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 >>
What Is Diabetes Mellitus?
Diabetes mellitus is a common disease where there is too much sugar (glucose) floating around in your blood. This occurs because either the pancreas can’t produce enough insulin or the cells in your body have become resistant to insulin. When you eat food, the amount of glucose in your blood skyrockets. That’s because the food you eat is converted into glucose (usable energy for your cells) and enters your blood to be transported to your cells around the body. Special cells in your pancreas sense the increase of glucose and release insulin into your blood. Insulin has a lot of different jobs, but one of its main tasks is to help decrease blood glucose levels. It does this by activating a system which transports glucose from your blood into your cells. It also decreases blood glucose by stimulating an enzyme called glycogen synthase in the liver. This molecule is responsible for making glycogen, a long string of glucose, which is then stored in the liver and used in the future when there is a period of low blood glucose. As insulin works on your body, the amount of glucose in the blood slowly returns to the same level it was before you ate.. This glucose level when you haven’t eaten recently (called fasting glucose) sits around 3.5-6 mmol/L (70-110 mg/dL). Just after a meal, your blood glucose can jump as high as 7.8mmol/L (140 mg/dL) depending on how much and what you ate. There are two types of diabetes mellitus, type 1 and type 2. In both types, your body has trouble transporting sugar from your blood into your cells. This leads to high levels of glucose in your blood and a deficiency of glucose in your cells. The main difference between type 1 and type 2 diabetes mellitus is the underlying mechanisms that cause your blood sugar to stray from the normal range. T Continue reading >>
What Is Diabetes?
Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesn’t make enough—or any—insulin or doesn’t use insulin well. Glucose then stays in your blood and doesn’t reach your cells. Over time, having too much glucose in your blood can cause health problems. Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy. Sometimes people call diabetes “a touch of sugar” or “borderline diabetes.” These terms suggest that someone doesn’t really have diabetes or has a less serious case, but every case of diabetes is serious. What are the different types of diabetes? The most common types of diabetes are type 1, type 2, and gestational diabetes. Type 1 diabetes If you have type 1 diabetes, your body does not make insulin. Your immune system attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age. People with type 1 diabetes need to take insulin every day to stay alive. Type 2 diabetes If you have type 2 diabetes, your body does not make or use insulin well. You can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes occurs most often in middle-aged and older people. Type 2 is the most common type of diabetes. Gestational diabetes Gestational diabetes develops in some women when they are pregnant. Most of the time, this type of diabetes goes away after the baby is born. However, if you’ve had gestational diabetes, you have a greater chan Continue reading >>
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Pre-diabetes And Type 1
Pre-Diabetes: Pre-Diabetes is a milder form of Diabetes that is sometimes called Impaired Glucose Tolerance. It can be diagnosed with a simple blood test. Symptoms: Blood sugar level is higher than normal Often there are no symptoms In certain populations (Hispanic, Native Americans and African Americans) a sign of Pre-Diabetes can be Acanthosis Nigricans, which is a skin disorder characterized by dark, thick, velvety skin in body folds and in creases Description: Likely to become Type 2 Diabetes within 10 years Ability to turn life around and keep yourself from developing Type 2 Diabetes 57 million people in the United States have Pre-Diabetes Type 1 Diabetes Usually diagnosed in children, most commonly between the ages of 6-12 years and young adults, known as Juvenile Diabetes. Symptoms: Increased thirst and frequent urination Extreme hunger Weight loss despite eating more than usual to relieve hunger Fatigue: If your cells are deprived of sugar, you may become tired and irritable Blurred vision: If your blood sugar level is too high, fluid may be pulled from your tissue. Description: Previously called Juvenile Diabetes and Insulin-Dependent Diabetes Pancreas doesn’t allow insulin production needed to turn sugar into energy No cure right now, but with treatment can be managed 5-10% of people with diabetes have Type 1 Risk Factors: Decreases of the Pancreas: Injury or diseases of the pancreas, a gland located near the stomach that makes insulin, can inhibit the ability to produce insulin, which can lead to Type 1 Diabetes. Infection or Illness: A range of relatively rare infections or illnesses can damage the pancreas and cause Type 1 Diabetes. Immunosuppression or Auto Immune Response: Immunosuppression involves an act that reduces the activation or efficacy of the Continue reading >>
Prediabetes
What Is Prediabetes? Prediabetes is a “pre-diagnosis” of diabetes—you can think of it as a warning sign. It’s when your blood glucose level (blood sugar level) is higher than normal, but it’s not high enough to be considered diabetes. Prediabetes is an indication that you could develop type 2 diabetes if you don’t make some lifestyle changes. But here's the good news: . Eating healthy food, losing weight and staying at a healthy weight, and being physically active can help you bring your blood glucose level back into the normal range. Diabetes develops very gradually, so when you’re in the prediabetes stage—when your blood glucose level is higher than it should be—you may not have any symptoms at all. You may, however, notice that: you’re hungrier than normal you’re losing weight, despite eating more you’re thirstier than normal you have to go to the bathroom more frequently you’re more tired than usual All of those are typical symptoms associated with diabetes, so if you’re in the early stages of diabetes, you may notice them. Prediabetes develops when your body begins to have trouble using the hormone insulin. Insulin is necessary to transport glucose—what your body uses for energy—into the cells via the bloodstream. In pre-diabetes, your body either doesn’t make enough insulin or it doesn’t use it well (that’s called insulin resistance). If you don’t have enough insulin or if you’re insulin resistant, you can build up too much glucose in your blood, leading to a higher-than-normal blood glucose level and perhaps prediabetes. Researchers aren’t sure what exactly causes the insulin process to go awry in some people. There are several risk factors, though, that make it more likely that you’ll develop pre-diabetes. These are Continue reading >>
The Deliberate Lies They Tell About Diabetes
By some estimates, diabetes cases have increased more than 700 percent in the last 50 years. One in four Americans now have either diabetes or pre-diabetes (impaired fasting glucose) Type 2 diabetes is completely preventable and virtually 100 percent reversible, simply by implementing simple, inexpensive lifestyle changes, one of the most important of which is eliminating sugar (especially fructose) and grains from your diet Diabetes is NOT a disease of blood sugar, but rather a disorder of insulin and leptin signaling. Elevated insulin levels are not only symptoms of diabetes, but also heart disease, peripheral vascular disease, stroke, high blood pressure, cancer, and obesity Diabetes drugs are not the answer – most type 2 diabetes medications either raise insulin or lower blood sugar (failing to address the root cause) and many can cause serious side effects Sun exposure shows promise in treating and preventing diabetes, with studies revealing a significant link between high vitamin D levels and a lowered risk of developing type 2 diabetes, cardiovascular disease, and metabolic syndrome By Dr. Mercola There is a staggering amount of misinformation on diabetes, a growing epidemic that afflicts more than 29 million people in the United States today. The sad truth is this: it could be your very OWN physician perpetuating this misinformation Most diabetics find themselves in a black hole of helplessness, clueless about how to reverse their condition. The bigger concern is that more than half of those with type 2 diabetes are NOT even aware they have diabetes — and 90 percent of those who have a condition known as prediabetes aren’t aware of their circumstances, either. Diabetes: Symptoms of an Epidemic The latest diabetes statistics1 echo an increase in diabetes ca Continue reading >>
Type 2 Diabetes
Overview Diabetes is a lifelong condition that causes a person's blood sugar 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 2 diabetes. Read more about type 1 diabetes. Another type of diabetes, known as gestational diabetes, occurs in some pregnant women and tends to disappear after birth. Symptoms of diabetes The symptoms of diabetes occur because the lack of insulin means 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. Typical symptoms include: feeling very thirsty passing urine more often than usual, particularly at night feeling very tired weight loss and loss of muscle bulk See your GP if you think you may have diabetes. It's very important for it to be diagnosed as soon as possible as it will get progressively worse if left untreated. Causes of type 2 diabetes Type 2 diabetes occurs when the body doesn't produce enough insulin to function properly, or the body's cells don't react to insulin. This means glucose stays in the blood and isn't used as fuel for energy. Type 2 diabetes is often associated with obesity and tends to be diagnosed in older people. It's far more common than type 1 diabetes. Treating type 2 diabetes As type 2 diabetes usually gets worse, you may eventually need medication – usually tablets – to keep your blood glucose at normal levels. Complications of type 2 diabetes Diabetes can cause serious long-term heal Continue reading >>
