Type 1 Diabetes

Type 1 Diabetes Mellitus Causes, Symptoms and Complications

Type 1 diabetes meaning

Diabetes mellitus type 1 also called as juvenile diabetes or insulin-dependent diabetes mellitus, an autoimmune disease resulting in the destruction of insulin-producing pancreatic beta cells, leading to low or no insulin production. Insulin is a necessary hormone that regulates protein, glucose, lipid, and mineral metabolism, as well as growth. 

Type 1 diabetes causes

The pinpoint reason for beta cells damage is idiopathic (unknown), but researchers believe that there is a genetic predisposition (hereditary) with a strong relationship with specific HLA (DR and DQ) alleles, specifically DRB103-DQB10201 and DRB 10401-DQB10302H.

Without a family history, the risk of having type 1 diabetes is about 0.4%, while the risk is between 1% to 4% in children of afflicted mothers, 3% to 8% in children of affected fathers, and as high as 30% in children of both affected parents.

Type 1 diabetes symptoms

Diabetes mellitus type 1 symptoms in adults are of sudden onset that may include the following:

• Increase in frequency of urination
• Nocturnal enuresis (bed-wetting) in children
• Feeling very weak and hungry
• Mood fluctuations 
• Excessive thirst
• Blurred vision
• Weight loss
• Vaginal infections

Symptoms of type 1 diabetes in children

Diabetes mellitus type 1 symptoms in children usually develop quickly and may include

• Reduction in weight
• Increase urine frequency/bedwetting (in children more than four years)
• Feeling excess hunger and thirst
• Bad breath/ Fruity- smell
• Feeling tired or lack of energy

Type 1 diabetes risk factors

Several risk factors may increase the likelihood that a person may acquire type 1 diabetes, that includes

• Age
• Family history
• Genetics
• Viral exposure (in children)

• Age: Young individuals and children (less than 14 years) are more prone to develop type 1 diabetes. The initial peak might occur between the ages of 4 and 7 years. The second occurs in youngsters aged 10 to 14 years.
• Family history: The developing of type 1 diabetes risk is higher in people who have a parent or sibling with the condition. The risk is increased if both parents have type 1 diabetes.
• Genetics: The presence of specific genes may increase the risk of developing type 1 diabetes.
• Viral exposure: The autoimmune destruction of islet cells may be triggered by the presence of viral infections (enterovirus infection)

Type 1 diabetes complications

Diabetes mellitus type 1 complications that can occur over time, affects key organs.

• Diabetic neuropathy
• Heart and blood vessel disease
• Diabetic nephropathy
• Diabetic retinopathy
• Skin and mouth infections
• Pregnancy complications
• Diabetic ketoacidosis

Type 1 diabetes treatment

Diabetes mellitus type 1 treatment includes the use of synthetic insulin as a source of replacement for low insulin caused by the destruction of pancreatic beta Langerhans. There are several forms of insulin available. Depending on the patient’s need, the diabetologist prescribes single or in combination.

Type 1 diabetes insulin: There are various types of insulin available depending on its onset, peak time and duration of action in the body. These are as follows:

1. Rapid-acting
2. Rapid-acting inhaled
3. Short-acting
4. Intermediate-acting
5. Long-acting
6. Ultra-long acting
7. Combination (Premixed)

• Rapid-acting: As the name defines, the onset (time taken to show drug effect) is15 minutes post-administration with a peak time of 1 hour and exists for 2 to 4 hours in the body. It is taken before a meal.
• Rapid-acting inhaled: It has an onset time of 10-15 minutes with a peak time of 30 minutes and exists for 3 hours in the body. It is taken before a meal and can be given along with injectable long-acting insulin.
• Short-acting: The onset time is 30 minutes with a peak time of 120 to 180 minutes and exists for 3 to 6 hours in the body. It is taken one hour before a meal.
• Intermediate-acting: The onset time is 2 to 4 hours with a peak time of 4 to 12 hours and exists for 12 to 18 hours in the body. It is taken with rapid or short-acting insulin.
• Long-acting: The onset time is 2 hours and exists up to 24 hours. It is taken once daily, which covers the entire day’s insulin.
• Ultra-long acting: The onset time is 6 hours and lasts more than 36 hours. Similar to long-acting, it is also taken once a day which covers the insulin needed for the entire day.
• Combination (Premixed): It is a combination of intermediate and short-acting insulin that is usually taken before breakfast and dinner. The onset time is 5 to 60 minutes with a varied peak time and exists for 10 to 16 hours in the body. 

Insulin alternatives for type 1 diabetes:

Insulin can be administered through the following route:

• Subcutaneous: In this type, the insulin is inserted either through a needle or pen or pumped directly into the subcutaneous layer (fat layer under the skin).
• Inhalation: An oral inhaler is used to administer ultra-rapid-acting insulin via inhaled insulin before meals. Inhaled insulin is combined with a long-acting insulin injection.