One of the biggest health problems of the century, diabetes or diabetes mellitus has an increasing number of cases all over the world. A person affected by diabetes can’t use the sugar(glucose) from foods or drinks anymore because of insulin. In a diabetic person, insulin is either too low or depleted, especially in type 1 diabetes.
What is type 1 diabetes?
Type 1 diabetes is when the immune system begins to attack, destroy the beta cells in the pancreas. These beta cells normally produce insulin, which our body needs to process glucose(sugar) from what we eat and drink. In the absence of these beta cells, the pancreas is not producing any insulin so this is how type 1 diabetes settles in our body.
In some cases, the pancreas is affected by a certain disease or suffers a trauma that has the effect of destroying the beta cells. This unfortunate case is not an immune response from the body but the so-called secondary diabetes, which is similar in symptoms with type 1 diabetes. In any case, the real diabetes symptoms don’t show up until 80% or 90% of the beta cells in the pancreas have been destroyed.
In type 1 diabetes people are having to inject insulin daily to be able to live a healthy life. Their life is dependant on insulin treatment. If this treatment is stopped, usually for a couple of hours or days it can lead to a diabetic coma which is life-threatening.
What is glucose and glycemia?
Glucose is a simple sugar, but very important, as through its utilization it is responsible for the energy in our cells, in our body.
Glycemia means the presence of glucose in the blood. Normally our blood sugar levels should be between 70-110 mg/dl.
What are type 1 diabetes symptoms?
Type 1 diabetes symptoms can be mild or severe. Amongst them there are:
• Frequent urination – This is noticeable especially during the night when the kidneys are trying to eliminate the excess glucose in the blood. The kidneys are trying to eliminate more water, therefore, more urine. When your blood sugar is over 180mg/dl (10mmol/l) glycosuria appears and as the glucose concentration increases there will be an increased loss of water in the body
• Thirst – a permanent thirst feeling – because you urinate frequently the body dehydrates
• Weight loss – even if you eat very well you lose weight. This is because insulin is an anabolic hormone that helps in gaining weight. This weight loss however happens by losing muscle mass, vitamins, and minerals
• Increased hunger – your body is not processing calories normally
• Fatigue – glucose is the main source of energy in our bodies. Insulin is the only hormone that helps glucose enter the cells and utilize it.
• Dry mouth
• Nausea and vomiting – when the body doesn’t have enough insulin which is needed to process glucose into energy, the liver is producing ketones from fat at a very high rate eventually leading to diabetic ketoacidosis if untreated. This is life-threatening and needs medical attention
• Stomach pain
• Blurred vision – sugar deposits in the crystalline lens absorb water in excess. This modifies the crystalline lens’s shape and affects eyesight
• Frequent skin, urinary tract or vaginal infections
• Fruity or acetone breath – because of ketones in the blood
Type 1 diabetes symptoms usually evolve fast, during days or weeks, and are caused by hyperglycemia. At first, most people ignore the symptoms or mistake them for other conditions.
What are carbohydrates?
The food we eat every day is decomposed into carbohydrates, proteins or fat to be utilized by our bodies in various vital processes. The human body is built by millions of cells that use up carbohydrates(glucose) as fuel.
Almost all of the cells in our bodies, except for red blood cells and the brain need glucose to work. Glucose can’t get into the cells without insulin and if insulin supply is a problem, diabetes occurs.
Carbohydrates can be split into two types: simple and complex. Simple carbohydrates are found in fruits and sugar and can raise blood sugar levels rapidly – absorbed quickly. Complex carbohydrates are found in vegetables, grains, and animal products and are slowly processed during digestion, raising blood sugar levels slower.
What is insulin?
Insulin is the most important hormone in our bodies that processes glucose, sugars in the food we eat. Our body’s cells use glucose as fuel for energy to function normally.
First of all, insulin secretion in our bodies lowers blood sugar levels by delivering glucose to the cells so they can use it as fuel.
Beta-cell abnormalities in type 1 diabetes block this process. Glucose is not delivered to the cells, instead, it builds up in the blood.
High blood sugar levels is life threatening:
• Diabetic ketoacidosis
When the body doesn’t have enough fuel as glucose, it will start processing fats for fuel. This will release ketones in the blood. The liver which normally deposits glucose now releases it to help with the ketosis process. But the body can’t use insulin so the glucose builds up in the blood with ketones.
This combination of ketones, glucose, and dehydration is called ketoacidosis and is a life-threatening condition if it is not treated right away.
If there is an excess of glucose in the blood, the kidneys try to flush it out through urine. By urinating frequently our body also loses water leading to dehydration.
• Physical deterioration or serious conditions
In the long term, high levels of sugar in the blood can affect nerves and small blood vessels that feed the eyes, kidneys, or heart. This can decrease the elasticity of blood vessels and cause them to narrow, decreasing blood flow which in turn decreases the blood and oxygen supply and from there to heart attacks and strokes.
What is the cause of type 1 diabetes?
The main cause of type 1 diabetes is not well known by scientists, but it is known that genes have an important role. So it is either hereditary or a modification in our body during the course of our lives. Children and brothers or sisters of a diabetic are the most exposed to the risk of getting diabetes type 1. From the parents, it looks like the diabetic father is transmitting the condition more frequently compared with the diabetic mother. Currently, there is no way to prevent type 1 diabetes, but this condition can be treated.
The most important factors that contribute to the destruction of the beta cells are viruses, chemical or toxic substances, and some medicine. The connection between type 1 diabetes and viruses is suspected because in some people, after flu or a respiratory virus, symptoms of type 1 diabetes begin to appear.
On the background of genetic inheritance, viruses and other factors initiate the autoimmune response which destroys the beta cells.
Most of the people with type 1 diabetes can live a long and healthy life if they follow the doctor’s indications.
Who can get type 1 diabetes?
Type 1 diabetes is a rare form of the condition. Only about 5% of people with diabetes have type 1 diabetes. It affects men and women equally and it is more frequent in white people than Afro-Americans, Hispanics, or Asians. Although the condition settles with people under 20 years old, it can occur at any age.
Type 1 diabetes diagnostic
The diagnosis of diabetes is based on the determination of blood sugar (blood sugar concentration) in the venous blood (venous plasma to be exact). There are four ways to diagnose:
The presence of the classic symptoms of diabetes (high thirst, frequent and frequent urination, unexplained weight loss) + a blood sugar level ≥ 200 mg/dl collected at any time during the day, regardless of the time since the last meal or how copious it was. If fasting blood glucose in the morning, after 8 hours of fasting is ≥126 mg/dl, the diagnosis of diabetes can be made. In the absence of blood glucose at 2 hours in the glucose tolerance test ≥200 mg/dl or HbA1c ≥6.5%, the determination will be repeated in the following days to confirm the diagnosis. If fasting blood glucose in the morning, after 8 hours of fasting is less than 126 mg/dl then a so-called glucose tolerance test is done.
Thus, in the morning on an empty stomach (fasting for 8 hours) blood sugar test is collected from the vein, 75 g of glucose are drunk (in 300 ml of water, preferably with a little lemon) and the blood sugar is tested again in 2 hours, no smoking, no effort, etc.).
If the blood glucose is higher than 200 mg/dl 2 hours after glucose ingestion, the diagnosis of diabetes is made. In the absence of fasting blood glucose ≥126 mg/dl or HbA1c ≥6.5%, the determination will be repeated in the following days to confirm the diagnosis. If glycosylated hemoglobin (HbA1c) ≥6.5%.
The diagnosis of glycosylated hemoglobin (HbA1c) can only be used if the laboratory method is certified and validated according to the international standard (HPLC method).
In the absence of fasting blood glucose ≥126 mg/dl or 2-hour blood glucose in the glucose tolerance test ≥200 mg/dl. The determination will be repeated in the following days to confirm the diagnosis.