DIABETES TYPE I
What is diabetes?
Diabetes mellitus (just called diabetes from now on) occurs when the level of glucose (sugar) in the blood becomes higher than normal. There are two main types of diabetes. These are called type 1 diabetes and type 2 diabetes.
FOR UNDERTANDING
After we eat, various foods are broken down into sugars in the gut. The main sugar is called glucose. This is absorbed through the gut wall into the bloodstream. Glucose is like a fuel which is used by the cells in the body for energy. To remain healthy, your blood glucose level should not go too high or too low.
So, when your blood glucose begins to rise (after eating), the level of a hormone called insulin should also rise. Insulin acts on the cells of your body and makes them take glucose into the cells from the bloodstream. Some of the glucose is used by the cells for energy, and some is converted into glycogen or fat (which are stores of energy). When the blood glucose level begins to fall (between meals, or when we have no food), the level of insulin falls. Some glycogen or fat is then broken down back into glucose and some is released back into the bloodstream to keep the blood glucose level normal.
Hormones such as insulin are chemicals that are released into the bloodstream and have an action on certain parts of the body. Insulin is made by special cells called beta cells which are part of little islands of cells (islets) within the pancreas.
Diabetes develops if you do not make enough insulin, or if the insulin that you do make does not work properly on the body's cells.
So, when your blood glucose begins to rise (after eating), the level of a hormone called insulin should also rise. Insulin acts on the cells of your body and makes them take glucose into the cells from the bloodstream. Some of the glucose is used by the cells for energy, and some is converted into glycogen or fat (which are stores of energy). When the blood glucose level begins to fall (between meals, or when we have no food), the level of insulin falls. Some glycogen or fat is then broken down back into glucose and some is released back into the bloodstream to keep the blood glucose level normal.
Hormones such as insulin are chemicals that are released into the bloodstream and have an action on certain parts of the body. Insulin is made by special cells called beta cells which are part of little islands of cells (islets) within the pancreas.
Diabetes develops if you do not make enough insulin, or if the insulin that you do make does not work properly on the body's cells.
WHAT IS THE TYPE I DIABETES
This is also known as juvenile, early onset, or insulin-dependent diabetes. It usually first develops in children or young adults. In the UK about 1 in 300 people develops type 1 diabetes at some stage
About 7 percent of people in the U.S. have some type of diabetes. Five percent to 10 percent of people with diabetes have type 1.
With type 1 diabetes the illness usually develops quite quickly, over days or weeks, as the pancreas stops making insulin.
OK. <<<<Why does the pancreas stop making insulin?!!!
In most cases, type 1 diabetes is thought to be an autoimmune disease. The immune system normally makes antibodies to attack bacteria, viruses, and other germs. In autoimmune diseases the immune system makes antibodies against part or parts of the body. If you have type 1 diabetes you make antibodies that attach to the beta cells in the pancreas. These are thought to destroy the cells that make insulin. It is thought that something triggers the immune system to make these antibodies. The trigger is not known but a popular theory is that a virus triggers the immune system to make these antibodies.
CAUSES OF DIABETES TYPE I
(The easiest way to explain the reasons)
Type 1 diabetes can occur at any age. However, it is most often diagnosed in children, adolescents, or young adults.
Insulin is a hormone produced by special cells, called beta cells, in the pancreas. The pancreas is found behind your stomach. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy. In type 1 diabetes, beta cells produce little or no insulin.
Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy. This leads to the symptoms of type 1 diabete …This kind of disorder can be passed down through families.
SYMPTOMS
Note: The rate of the body's natural sugar between 70-110 mg per 100 ml
These symptoms may be the first signs of type 1 diabetes, or may occur when the blood sugar is high:
- Being very thirsty
- Feeling hungry
- Feeling tired or fatigued
- Having blurry eyesight
- Losing the feeling or feeling tingling in your feet
- Losing weight without trying
- Urinating more often
For other people, these warning symptoms may be the first signs of type 1 diabetes, or they may happen when the blood sugar is very high (diabetic ketoacidosis)
- Deep, rapid breathing
- Dry skin and mouth
- Flushed face
- Fruity breath odor
- Nausea or vomiting, inability to keep down fluids
- Stomach pain
Low blood sugar (hypoglycemia) can develop quickly in people with diabetes who are taking insulin. Symptoms usually appear when the blood sugar level falls below 70 mg/dL.
- Headache
- Hunger
- Nervousness
- Rapid heartbeat (palpitations)
- Shaking
- Sweating
- Weakness
To illustrate the simplified and detailed
The symptoms that usually occur when you first develop type 1 diabetes are:
- You are very thirsty a lot of the time.
- You pass a lot of urine.
- Tiredness, weight loss, and feeling generally unwell.
The above symptoms tend to develop quite quickly, over a few days or weeks. After treatment is started, the symptoms soon settle and go. However, without treatment, the blood glucose level becomes very high and acids form in the bloodstream (ketosis). If this persists you will become dehydrated, and are likely to lapse into a coma and die. (The reason you make a lot of urine and become thirsty is because glucose leaks into your urine which pulls out extra water through the kidneys.)
DIAGNOSIS:
There are many methods and tests and tests to detect the presence of the disease, but the simplest and most common:
A simple dipstick test can detect glucose in a sample of urine. This may suggest the diagnosis of diabetes. However, the only way to confirm the diagnosis is to have a blood test to look at the level of glucose in your blood. If this is high then it will confirm that you have diabetes. Some people have to have two samples of blood taken and you may be asked to fast (have nothing to eat or drink, other than water, from midnight before your blood test is performed).
Is Type 1 diabetes inherited?
Type 1 diabetes is not inherited directly in the way that some other diseases are. However, it does seem to be related to genetic (inherited) factors. People who have a first-degree relative with type 1 diabetes are more likely to develop diabetes than the general population. A first-degree relative is a parent, brother, sister or child.
No specific "diabetes gene" has been found. But many genes have been linked to type 1 diabetes. The best-studied is a cluster of genes known as the HLA complex. Genes contain the blueprints for making proteins. Proteins from the HLA group affect how the immune system responds to foreign substances.
Certain combinations of HLA gene types are more common in people with type 1 diabetes. We still don't know why this is the case. And HLA gene types are clearly not the whole story. Many people who have HLA patterns associated with type 1 diabetes never develop the disease.
The patterns of this disease in families show that more than genes must be involved. Most people with type 1 diabetes don't have a first-degree relative with the disease. Also, when one identical twin has type 1 diabetes, the other twin, with identical genes, has less than a 50% chance of developing the disease.
Treatment
Your health care provider will review the results of your home blood sugar monitoring and urine testing. Your provider will also look at your diary of meals, snacks, and insulin injections.As the disease gets more stable, you will have fewer follow-up visits. Visiting your health care provider is very important so you can monitor any long-term problems from diabetes.You are the most important person in managing your diabetes. You should know the basic steps to diabetes management:
- How to recognize and treat low blood sugar (hypoglycemia)
- How to recognize and treat high blood sugar (hyperglycemia)
- Diabetes meal planning
- How to give insulin
- How to check blood glucose and urine ketones
- How to adjust insulin and food when you exercise
- How to handle sick days
- Where to buy diabetes supplies and how to store them
1-INSULIN
Insulin lowers blood sugar by allowing it to leave the bloodstream and enter cells. Everyone with type 1 diabetes must take insulin every day.
Insulin is usually injected under the skin. In some cases, a pump delivers the insulin all the time. Insulin does not come in pill form. Insulin types differ in how fast they start to work and how long they last. The health care provider will choose the best type of insulin for you and will tell you at what time of day to use it. More than one type of insulin may be mixed together in an injection to get the best blood glucose control. You may need insulin shots from one to four times a day.
People with diabetes need to know how to adjust the amount of insulin they are taking:
- When they exercise
- When they are sick
- When they will be eating more or less food and calories
- When they are traveling
2- DIET AND EXERCISE
People with type 1 diabetes should eat at about the same times each day and try to eat the same kinds of foods. This helps to prevent blood sugar from becoming too high or low
Regular exercise helps control the amount of sugar in the blood. It also helps burn extra calories and fat to reach a healthy weight.
Ask your health care provider before starting any exercise program. People with type 1 diabetes must take special steps before, during, and after intense physical activity or exercise
3-MANAGING YOUR BLOOD SUGAR
Checking your blood sugar levels at home and writing down the results will tell you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check.
A device called a glucometer can read blood sugar levels.
4-FOOT CARE
Diabetes damages the blood vessels and nerves. This can make you less able to feel pressure on the foot. You may not notice a foot injury until you get a severe infection.
Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger or deeper.
To prevent problems with your feet:
- Stop smoking if you smoke.
- Improve control of your blood sugar.
- Get a foot exam by your health care provider at least twice a year and learn whether you have nerve damage.
- Check and care for your feet EVERY DAY, especially if you already have known nerve or blood vessel damage or current foot problems.
- Make sure you are wearing the right kind of shoes.
5-PREVENTING COMPLICATIONS
Your doctor may prescribe medications or other treatments to reduce your chances of developing eye disease, kidney disease, and other conditions that are more common in people with diabetes
- Checking for early signs of complications; for example:
- Eye checks - to detect problems with the retina (a possible complication of diabetes) which can often be prevented from getting worse. Glaucoma is also more common in people with diabetes, and can usually be treated.
- Urine tests - these include testing for protein in the urine, which may indicate early kidney problems.
- Foot checks - to help to prevent foot ulcers.
- Blood tests - these include checks on kidney function, and other general tests. They also include checks for some autoimmune diseases which are more common in people with diabetes. For example, coeliac disease and thyroid disorders are more common than average in people with type 1 diabetes.
REFRENCE:
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