Type 1 diabetes is an auto-immune condition in which the body destroys the cells in the pancreas that produce insulin. This happens because the cells that make the insulin (beta cells) have been destroyed by the body’s own immune system. Insulin is the hormone that helps move sugar, or glucose, into your body’s tissues. Cells use it as fuel and also enables cells to use that glucose to produce energy.
Normal and damaged beta cells
Role of insulin in normal human body
Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas).
- The pancreas secretes insulin into the bloodstream.
- Insulin circulates, allowing sugar to enter your cells.
- Insulin lowers the amount of sugar in your bloodstream.
- As your blood sugar level drops, so does the secretion of insulin from your pancreas.
The role of glucose
Glucose, a sugar is a main source of energy for the cells that make up muscles and other tissues.
- Glucose comes from two major sources: food and your liver.
- Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.
- Your liver stores glucose as glycogen.
- When your glucose levels are low, such as when you haven’t eaten in a while, the liver breaks down the stored glycogen into glucose to keep your glucose levels within a normal range.
Malfunction of pancreas (Diabetes mellitus type 1)
In type 1 diabetes, there’s no insulin to let glucose into the cells, so sugar builds up in your bloodstream. This can cause life-threatening complications.
Damage to beta cells from type 1 diabetes throws the process off. Glucose doesn’t move into your cells because insulin isn’t there to do it. Instead it builds up in your blood and your cells starve. This causes high blood sugar, which can lead to:
- When there’s extra sugar in your blood, you pee more. That’s your body’s way of getting rid of it. A large amount of water goes out with that urine, causing your body to dry out.
- Weight loss. The glucose that goes out when you pee takes calories with it. That’s why many people with high blood sugar lose weight. Dehydration also plays a part.
- Diabetic ketoacidosis (DKA). If your body can’t get enough glucose for fuel, it breaks down fat cells instead. This creates chemicals called ketones. Your liver releases the sugar it stores to help out. But your body can’t use it without insulin, so it builds up in your blood, along with the acidic ketones. This combination of extra glucose, dehydration, and acid buildup is known as “ketoacidosis” and can be life-threatening if not treated right away.
- Damage to your body. Over time, high glucose levels in your blood can harm the nerves and small blood vessels in your eyes, kidneys, and heart. They can also make you more likely to get hardening of the arteries, or atherosclerosis, which can lead to heart attacks and strokes.
Causes of Diabetes mellitus type 1
- The exact cause of type 1 diabetes is unknown. Most likely it is an autoimmune disorder.
- This is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue.
- With type 1 diabetes, an infection or another trigger causes the body to mistakenly attack the cells in the pancreas that make insulin.
- The tendency to develop autoimmune diseases, including type 1 diabetes, can be passed down through families.
Some known risk factors for type 1 diabetes include:
- Family history. Anyone with a parent or sibling with type 1 diabetes has a slightly increased risk of developing the condition.
- The presence of certain genes indicates an increased risk of developing type 1 diabetes.
- The incidence of type 1 diabetes tends to increase as you travel away from the equator.
- Although type 1 diabetes can appear at any age, it appears at two noticeable peaks. The first peak occurs in children between 4 and 7 years old, and the second is in children between 10 and 14 years old.
Eventually, diabetes complications may be disabling or even life-threatening.
- Heart and blood vessel disease. Diabetes dramatically increases your risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of the arteries (atherosclerosis) and high blood pressure.
- Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs and eventually lose all sense of feeling in the affected limbs.
- Damage to the nerves that affect the gastrointestinal tract can cause problems with nausea, vomiting, diarrhea or constipation. For men, erectile dysfunction may be an issue.
- Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which requires dialysis or a kidney transplant.
- Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially causing blindness such as cataracts and glaucoma.
- Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections that may ultimately require toe, foot or leg amputation.
Diabetic foot ulcer
- Skin and mouth conditions. Diabetes may leave you more susceptible to infections of the skin and mouth, including bacterial and fungal infections. Gum disease and dry mouth also are more likely.
- Pregnancy complications. High blood sugar levels can be dangerous for both the mother and the baby. The risk of miscarriage, stillbirth and birth defects increases when diabetes isn’t well-controlled. For the mother, diabetes increases the risk of diabetic ketoacidosis, diabetic eye problems (retinopathy), pregnancy-induced high blood pressure and preeclampsia.
Signs and symptoms during high blood sugar (Hyperglycaemia)
The following symptoms may be the first signs of type 1 diabetes. Or they may occur when blood sugar is high.
- Being very thirsty
- Feeling hungry
- Feeling tired all the time
- Having blurry eyesight
- Feeling numbness or tingling in your feet
- Losing weight without trying
- Urinating more often (including urinating at night or bedwetting in children who were dry overnight before)
For other people, these serious warning symptoms may be the first signs of type 1 diabetes. Or, they may happen when 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
Life style care for treatment of type 1 diabetes
Certain lifestyle modifications may help people with type 1 diabetes stay healthy and better manage their disease. These include:
- Monitoring blood glucose levels by checking your glucose multiple times every day with glucose meters
BG monitoring device
- Eating a well-balanced diet and monitoring carbohydrate intake (carbs greatly affect blood glucose levels)
- Regular exercise, which can lower blood glucose and increase the body’s sensitivity to insulin
People with diabetes have a higher risk of developing foot problems, since the disease can damage nerves and blood vessels in the feet. This risk can be reduced by by:
- Not smoking
- Checking your feet every day, and getting regular foot exams throughout the year
- Treating athlete’s foot and other foot infections immediately
- Moisturizing the feet with lotion
- Wearing shoes designed to minimize diabetic foot problems