Diabetes type 1

summary type 1 diabetes

The causes are still not fully known, however there is a strong genetic component behind the disease, and also an environmental factor (viral infection).
Thus, the main risk groups for the disease include people with cases of type 1 diabetes in the family, women and Caucasians.

The main symptoms include hunger, fatigue, heavy urination, sweating and extreme thirst.
The diagnosis is made through blood tests that measure the total level of glucose and also the percentage of glycated hemoglobin. If diabetes is not controlled, it can cause several complications, such as vision loss and heart and vascular problems.

Treatment for type 1 diabetes is based on insulin injection. The doctor also prescribes medication to control cholesterol and high blood pressure. Some medicinal plants and homeopathic treatments help to control homeopathy and the complications of the disease.

It is important for the patient with diabetes to have a controlled diet based on fruits, vegetables and whole grains. Keep an eye on your weight, blood sugar levels and avoid alcohol and cigarettes. Exercise often and avoid stress.

Definition

Type 1 diabetes, also known as insulin-dependent diabetes or juvenile diabetes, is an autoimmune metabolic disease, which manifests itself mainly during childhood and adolescence.
Type 1 diabetes, however, is more difficult to treat than type 2 diabetes , as the patient’s pancreas is incapable of synthesizing (=manufacturing) insulin naturally and must inject it, in addition to correctly monitoring his blood glucose (rate of blood sugar) to avoid any complications (hypo or hyperglycemia). Despite numerous research into type 1 diabetes, the disease still has no cure.
We emphasize that insulin is a hormone produced by the pancreas (a gland) that allows the entry of sugar into cells. The lack of insulin can be deadly, as the body is no longer able to insert sugar (which has a carburetor role) into the body. We can compare this to a car that has gasoline leaking from the reservoir. Type 1 diabetes must therefore be very well treated to avoid short-term (hyperglycemia) and long-term complications.

Epidemiology

In the United States, about 18,000 children are diagnosed with type 1 diabetes each year, according to the National Institutes of Health (NIH) .

Causes

The cause of type 1 diabetes is related to a lack of insulin production by the pancreas. The question then is to know the reason for this. Type 1 diabetes is an autoimmune disease, this means that the body attacks its own cells, in this case the beta cells in the islets of Langerhans (a tissue in the pancreas) which are destroyed by the body’s own attacks. In a person who does not suffer from type 1 diabetes these islets are responsible for the synthesis of insulin.

The exact cause of the production of these autoantibodies by the body is still unclear. It is estimated that at the beginning, hereditary (genetic) causes may explain the autoimmune process of this metabolic disease. The gene that confers greater susceptibility is on chromosome 6p.

Some scientists believe that type 1 diabetes may be viral in origin, in some cases an enterovirus called Coxsackie B4. A favorable genetic environment would be necessary to develop and cause type 1 diabetes, that is, the presence of certain genes is necessary for the virus to attack the pancreas.

At the biological level, it is estimated that enteroviruses infect beta cells (which synthesize insulin) in the pancreas, resulting in inflammation that causes an imbalance in the immune system. The beta cells are attacked by the immune system’s own cells (autoimmune response) and thus causes a drop in insulin production.

According to a Swedish study published on April 28, 2015 in the journal “Diabetologia”, type 1 diabetes is more common in sons and daughters of obese mothers. The study showed that children born to women who are obese (BMI over 30) during the first trimester of pregnancy had a 33% increased risk of suffering from type 1 diabetes compared to children born to women of normal weight ( BMI between 18.5 and 25).

Groups of risk

Type 1 diabetes is still an unknown disease in many ways, so there are no well-defined risk factors or groups for the disease. Some of the known spots are:

– People with a family history of type 1 diabetes.

– Children born to an obese mother (also read under causes)

– Presence of some genes indicate an increased risk of developing type 1 diabetes.

– People living in Finland or Sardinia have a high incidence of developing type 1 diabetes.

Some possible risk factors for developing the disease include:

– Exposure to certain viruses such as Epstein-Barr and cytomegalovirus can trigger autoimmune reactions.
– Low levels of vitamin D have been pointed out as factors for the development of type 1 diabetes.
In addition, other factors are still being studied as protectors or triggers of type 1 diabetes. nitrates, among others.

Prenatal factors also seem to influence the onset of the disease. We can mention, for example, pregnancy before the age of 25 and pre-eclampsia during pregnancy.

Symptoms

The symptoms of type 1 diabetes, before diagnosis and medical treatment, are typical symptoms of hyperglycemia:

– fatigue , frequent urge to urinate, nausea, thirst, blurred vision, itching in the genital area.

– weight loss, exacerbated hunger.

Here is some interesting information after starting treatment (usually insulin-based) after the diagnosis of type 1 diabetes:

Type 1 diabetes crisis symptoms

– Confused state or possible memory loss (if this occurs, stand aside and call for help)

– Hypoglycemia (take sugar or soda as soon as possible)

Diagnosis

The tests to verify whether or not the patient has type 1 diabetes can be summarized below:

– Glycated hemoglobin test (AC1) : this test indicates the blood sugar levels in the last 2-3 months. The test measures the percentage of sugar linked to hemoglobin. The higher the blood sugar level, the higher the percentage of glycated hemoglobin. Levels above 6.5% on 2 separate tests indicate that the patient has diabetes. Results between 5.4 and 6.5% indicate a state of pre-diabetes.

– Fasting blood glucose test : In this test, blood samples are collected and the global sugar level is measured in mg/dL or mmol/L. Levels above 126 mg/dL indicate diabetes. Levels between 100 and 125 mg/dL indicate a pre-diabetic state, and below 100 mg/dL is considered normal.

– Urinalysis : if type 1 diabetes is suspected, the doctor can quantify ketone bodies in the urine.

After the diagnosis of diabetes, the patient must undergo periodic blood tests to assess the evolution of the disease and the effectiveness of treatments. In addition, cholesterol levels are also measured, as well as kidney function and the presence of celiac disease. The doctor will also measure your blood pressure and need for increased insulin doses.

Complications

Type 1 diabetes can affect many organs in your body, such as your heart, liver, kidney, nerves and blood vessels. You need to keep blood glucose levels under control at all times. In the long term, some of the consequences of diabetes are:

– Microangiopathy , which is a disease that affects small vessels with ocular diseases . This can affect the retina and cause blindness or the kidney vessels causing kidney failure.

– Macroangiopathy or heart problems: type 1 diabetes increases the risk of developing various heart problems, such as angina, heart attack , narrowing of the arteries and hypertension .

– Kidney problems : diabetes can affect the kidney’s filtration systems, causing kidney failure and the need for hemodialysis.

– Problems in the region of the nerves , decreased nerve sensitivity, deep pain, foot problems. We call this diabetic neuropathy.
Damage to the feet : blood supply problems in the foot regions and lack of nerve sensitivity increases the risk of complications, known as “diabetic foot”. This increases the risk of infections and can lead to partial or complete amputation.
– Skin and mouth problems: Diabetes leads to an increase in skin problems, such as increased infections and gingivitis.

–  Osteoporosis

– Pregnancy complications

– Hearing problems

All these complications can be avoided with good medical follow-up.

Treatments

Diet

In case of  diagnosis (usually in childhood) of type 1 diabetes, the first measure to be taken with your doctor is to follow an adapted diet, that is, consume more prolonged-release sugars (such as pasta and bread), more fiber and increase the intake of polyunsaturated fatty acids (olive and sunflower oil, vegetable oils instead of oils of animal origin).

Insulin

The second measure is to start a drug treatment under medical prescription. Most of the time it must be an insulin-based treatment, which can be taken in different ways: as an intravenous, intramuscular or subcutaneous injection, and recently there are new forms of administration, as a spray to be taken once or several times a day.
We distinguish between Ultra-fast insulins (the effect of the insulin occurs after 15 minutes and its duration is 6 hours), Fast (effect after 30 minutes and duration of 8 hours), Intermediate/slow (effect after 30 minutes, 1h30 or 2h30 and duration of 24 hours) and Ultra-slow (effect after 4 hours and duration of 28 hours) for further information, consult a specialist.

The ultimate goal of treatment is to stabilize the blood glucose level.

Advice on insulin treatments

– Change the injection site every day by at least 2 cm. Store in the refrigerator, but be careful, if the temperature is below 15°C there will be pain at the injection site.
– Classic side effect of insulin-based treatments: mainly hypoglycemia (<2.8 mmol/L) with the following symptoms: profuse sweating, tremors, palpitations, anxiety, hunger, irritability, fatigue.

In case of hypoglycemia it is necessary to immediately give 15 g of sugar (eg grape sugar) or glucagon if necessary.
– Interaction: Insulin may have interactions with beta-blockers.

Other medications besides insulin are for oral use

– Pramilintide: this medication must be injected before meals and delays the absorption of sugars.

– Medications to control hypertension: even if the patient does not have high blood pressure, the doctor will prescribe medication for prevention, such as angiotensin II inhibitors.

– Cholesterol controllers: as well as hypertension medications, the doctor will indicate so that your cholesterol does not increase during diabetes.

pancreas transplant

In some very specific cases of type 1 diabetes, the doctor may recommend a pancreas transplant. As the procedure does not always lead to the expected success and presents significant risks for the patient, it is reserved especially for people who cannot control their diabetes as specified by the American reference clinic Mayo Clinic .

Herbal medicine

Some medicinal plants may prove beneficial in the treatment of diabetes. They include:

– Astragalus

– Olive or olive
– Chicory
– Reishi mushroom
– Dandelion
– Fennel

– Ginseng
– Cow leg

Many of these plants help control blood sugar levels or reduce absorption. Look for a doctor and ask about natural treatments for diabetes and never self-medicate without the guidance of a professional or stop using insulin.

Tips

Some of the tips help to control blood sugar levels and, consequently, to have a better quality of life: 

– Adopt a healthy diet (rich in fruits, slow sugars, whole grains and fiber), avoid drinking soft drinks, favor pasta or rice (slow sugars) and eat only at mealtimes, that is, do not “nibble”.

– Maintain a healthy weight.

– In case of insulin-based treatment, change the injection site by about 2 cm every day.

– foot ulcers

Wash your feet regularly and check that there are no injuries or sores, even small ones. Indeed, poorly treated diabetes can cause serious complications in the feet after an interruption in the blood supply to the capillaries. In advanced cases it is called diabetic foot ulcers which are open sores. Sores develop because diabetes damages the nerves and blood vessels in the feet.

It is important to know that a diabetic may have less sensitivity in the feet than a person who does not suffer from the disease. Hence the importance of regularly observing the feet or other suspicious regions of a person suffering from diabetes, even if they do not feel pain. In case of a suspicious foot injury, consult a doctor directly.

In advanced cases, foot ulcers are so severe that they can lead to amputation. In a study carried out by the University of Leeds and published November 20, 2017 in the scientific journal Diabetic Medicine (DOI: 10.1111 / dme.13537), more than half of the 299 patients studied did not see their foot ulcer healed for a year or more, one in seven patients had to have some or all of their feet amputated. In this study, it was also possible to observe that foot ulcers are slow to heal and prone to infections. In the UK, foot ulcers affected around a quarter of the 3.3 million people with diabetes in 2017, according to a press release released in November 2017 by the University of Leeds.

– Limit alcohol consumption as it can make diabetes worse.

– Exercise regularly. Physical activity helps lower blood sugar levels, even long after you’ve finished exercising.

– Monitor your blood glucose constantly and keep a record of the values ​​throughout the day, before and after meals, under the effect of insulin or not. Even with the use of insulin, sugar levels can fluctuate a lot and vary according to the type of food, physical activity, alcohol consumption, other diseases and medications, stress level and, in the case of women, hormone levels influence the rate glycemic.

– Watch out for signs of hypoglycemia. These can be: sweating, tremor, hunger, anxiety, dizziness, fatigue, headaches, blurred vision, irritability, pale skin, fast heartbeat and weakness.

Beware of hypoglycemia. This condition, characterized by low blood sugar levels, can happen at any time, such as when you are driving or operating a heavy machine. Before engaging in certain types of activity, measure your glucose level and make sure it is high enough.

In case of hypoglycemia, always have something to eat and rest for 15 minutes. After that time, measure your blood glucose again.

– Talk to your doctor if you intend to become pregnant. Pregnancy of people with type 1 diabetes can present complications and the doctor will indicate the best course of action to adopt. Medications to lower high blood pressure and cholesterol should be stopped.

– Strictly control diabetes during pregnancy. The risk of the baby being born with malformation is greater in women who have uncontrolled diabetes.

– Be alert to the signs of hyperglycemia, i.e. an increase in blood sugar levels. These could be: frequent urination, fatigue, blurred vision, increased thirst, difficulty concentrating, and nausea.

– Keep an eye on the level of ketones in your urine. These compounds are produced when sugar does not enter the cell and the body begins to consume fat. Increased ketones in the body can cause nausea, vomiting, abdominal pain and weight loss. Check your urine ketone levels with specific drugstore tests. Always have a medical follow-up in case of any changes.

– Have your vaccinations up to date. High sugar levels can lower your immunity and make you more susceptible to infections.

– Take care of your oral health: diabetes increases the incidence of gum infections.

– Quit smoking: Smoking increases the incidence and risk of diabetes complications.

– Manage stress and learn relaxation techniques. This will help keep your blood glucose levels under control.

Fontes:
Mayo Clinic, Diabetic Medicine (DOI: 10,1111 / dme.13537)

 

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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