What is Type 1 Diabetes?
Type 1 diabetes affects millions of people worldwide, regardless of age or gender [1,2,3].
It is characterised by insulin deficiency and is caused by the immune system producing antibodies, which target the beta cells of the pancreas and then partially or entirely destroy these cells. [1,2,3,4,5,6,7].
Pancreatic beta cells produce insulin, an essential hormone that regulates blood glucose levels [3,7]. Their destruction causes a decrease in insulin production, resulting in a build-up of glucose in the blood, which results in hyperglycemia and an increased risk of other complications (heart disease, blindness, kidney failure ... ) if left untreated[ 2,3,7].
For this reason, people with type 1 diabetes are also categorised as insulin-dependent: insulin injections are essential to enable people living with type 1 diabetes to maintain stable glucose levels as the body can no longer produce insulin. [3,4,7].
Symptoms
Type 1 diabetes has two predominant symptoms:
- frequent urination (polyuria)
- excessive thirst. (polydipsia)
- dramatic weight loss
- extreme fatigue
Is it possible to prevent the onset of type 1 diabetes?
Despite numerous studies, a clear path to prevention of the onset of diabetes in people at risk has yet to be found, as, in its early stages of development, the condition does not present any symptoms. The duration of this asymptomatic period may vary considerably, spanning several months or years from one individual to another [5,7,8].
Causes
To fully understand the development of type 1 diabetes, a combined set of factors needs to be considered [2,3,8]. Although some individuals have a genetic predisposition to diabetes, the causes are wide-ranging, and the effects of non-genetic factors remain unclear [1,2,3].
The part played by heredity in type 1 diabetes has not yet been clearly defined. Only 13% of patients have at least one parent with type 1 diabetes. Although the risk increases if both parents are living with type 1 diabetes, this statistic suggests that environmental factors also trigger the condition [7].
Research in recent years has tried to identify which lifestyles, eating habits, and other environmental, perinatal or prenatal factors can be seen as potential triggers of type 1 diabetes [1,2,3].
Research in recent years has tried to identify which lifestyles, eating habits, and other environmental, perinatal or prenatal factors can be seen as potential triggers of type 1 diabetes [1,2,3].
Several studies have been carried out to investigate the effects of a wide range of factors, including:
- the mother's age at the time of pregnancy
- possible consequences of cesarean section
- diets low in fibre and high in gluten
- omega-3 and vitamin D deficiency
- exposure to viral infections
- pollution
- breastfeeding and the consumption of cow's milk [3].
However, the results obtained do not appear sufficiently conclusive to say with any certainty that they are likely causes of type 1 diabetes, and more studies are needed to determine their involvement if any [1,2,7].
Diagnosis
Do you or one of your children show signs of having type 1 diabetes? If so, contact your healthcare provider for investigative blood work to confirm a diagnosis [8].
A laboratory blood glucose level higher than 7.0 mmol/l during fasting indicates diabetes [8].
Another parameter that can also be measured is the concentration of glycated haemoglobin (HbA1c). If this level is greater than 6.5% or 48 mmol/mol, the person being tested has an increased risk of diabetes and requires further investigation by a healthcare provider [8].
Treatment
Treatment of type 1 diabetes via insulin injections has become increasingly widespread over the past 30 years and has greatly improved the life expectancy of people living with diabetes [1,4].
Recent technological advances have greatly improved quality of life for people with type 1 diabetes, particularly by enabling them to limit the risks of severe hypoglycemia [1]. Among the latest devices available are continuous glucose monitors (CGM) that enable continuous blood glucose monitoring [6,8] and insulin pumps that can provide regular subcutaneous administration of insulin [1,6].
Sources
- David M Maahs , Nancy A West, Jean M Lawrence, Elizabeth J Mayer-Davis. Epidemiology of type 1 diabetes. Endocrinol Metab Clin North Am. 2010 Sep;39(3):481-97.doi: 10.1016/j.ecl.2010.05.011.
- Jill M Norris , Randi K Johnson , Lars C Stene..Type 1 diabetes-early life origins and changing epidemiology. Lancet Diabetes Endocrinol. 2020 March ; 8(3): 226–238. doi:10.1016/S2213-8587(19)30412-7.
- Jeffrey A Bluestone, Kevan Herold, George Eisenbarth. Genetics, pathogenesis and clinical interventions in type 1 diabetes . Nature 2010 Apr 29;464(7293):1293-300. doi: 10.1038/nature08933.
- Wei Li, Edgar Huang, Sujuan Gao. Type 1 Diabetes Mellitus and Cognitive Impairments: A Systematic Review. J Alzheimers Dis 2017;57(1):29-36. doi: 10.3233/JAD-161250.
- Anette-G Ziegler, Ezio Bonifacio, Alvin C Powers, John A Todd, Leonard C Harrison, Mark A Atkinson. Type 1 Diabetes Prevention: A Goal Dependent on Accepting a Diagnosis of an Asymptomatic Disease. Diabetes 2016 Nov;65(11):3233-3239. doi: 10.2337/db16-0687.
- F S Wong, T I Tree..Historical and new insights into pathogenesis of type 1 diabetes. Clin Exp Immunol. 2019 Dec;198(3):292-293. doi: 10.1111/cei.13396.
- Simon E Regnell, Åke Lernmark. Early prediction of autoimmune (type 1) diabetes. Diabetologia. 2017 Aug;60(8):1370-1381. doi: 10.1007/s00125-017-4308-1. Epub 2017 May 26.
- Linda A DiMeglio, Carmella Evans-Molina, Richard A Oram Lancet. Type 1 diabetes. 2018 Jun 16;391(10138):2449-2462. doi: 10.1016/S0140-6736(18)31320-5.
- Jessica S Pierce, Chelsea Kozikowski, Joyce M Lee, Tim Wysocki. Type 1 diabetes in very young children: a model of parent and child influences on management and outcomes Pediatr Diabetes. 2017 Feb;18(1):17-25. doi: 10.1111/pedi.12351. Epub 2015 Dec 29.
