Chủ Nhật, 12 tháng 1, 2014

Diabetes Mellitus Type 1

Diabetes Mellitus Type 1 Type 1 diabetes mellitus also known as juvenile diabetes is a chronic medical condition that strikes a person in young age. It starts even in childhood or during adolescence. In this type, the pancreas becomes deficient to produce sufficient quantities of insulin which is responsible for converting sugar particles into simpler substances for producing energy.


Genetics and other factors can cause Type 1 diabetes and there is no permanent cure for this disorder. However the symptoms can be managed by taking regular medications. More than 90% of the people having diabetics will have Type 2 diabetes and only less percentage suffer from diabetes mellitus of Type 1. Complications of diabetes can either be acute or chronic. If the levels of blood sugar goes very high it can cause hyperglycemia and abnormally low blood sugar levels cause hypoglycemia.


Chronic conditions of diabetes can affect the blood vessels and cause serious damage to the eyes, heart, kidneys and feet. Type 1 diabetes can occur on anyone including lean person and weight does not play a role in this type of diabetes like that in Type 2.


What happens to pancreas?


In Type 1 diabetes mellitus, the body’s own immune system attacks the beta cells present in the pancreas thereby disabling them to produce insulin. Certain type of cells called beta cells are responsible for secreting insulin hormone which is necessary for converting food particles into simpler substances of sugar molecules like fructose. When these cells are attacked by the antibodies of the immune system, the pancreas stops producing insulin or produces it in less quantity thereby increasing the sugar component in the blood. But what produces abnormal antibodies to destroy the beta cells is not understood.


Certain types of viral infections or genetic factors can trigger formation of antibodies to attack the beta cells of pancreas to stop insulin production. Anti insulin antibodies or anti glutamic decarboxylase antibodies are produced to block insulin production. Very often Type 1 diabetes is seen in young children or adolescents. But some adults and even older patients can get this type of diabetes which is known as LADA (latent autoimmune diabetes in adults).


Symptoms :


Some of the common signs of Type 1 diabetes are loss of weight, hunger, thirst drive, frequent urination, extreme tiredness and blurred vision. Increase in blood sugar level can cause profuse sweating, thirstiness, hunger, weakness, shakiness, anxiety, dizziness, headache, irregular heartbeat, blurred vision and irritation. Low blood sugar (Hypoglycemia) can cause intense symptoms like loss of consciousness. Hence it is advisable to carry fast acting sugar substance like candy with you. You can also take a shot of glucagon which is a hormone that releases blood sugar into the blood.


Causes :


As described above, it is the antibodies produced by the immune system blocks the production of insulin from beta cells of pancreas. Here the islet cells are completely destroyed by the antibodies so that it cannot produce insulin. Insulin is a hormone that controls the amount the sugar in the bloodstream. If the blood contains more of sugar, then more quantities of insulin are secreted and vice versa.


Glucose for the body comes from the food you eat and also from your liver which acts as a warehouse. Liver releases glucose particles whenever the body needs sugar and maintains the glucose level in normal range. In type 1 diabetes since no insulin is produced, it builds up large volumes of glucose in your bloodstream causing serious complications. This situation is different in Type 2 diabetes where the body becomes resistant to insulin.


Who are at risk?


People with family history of Type 1 diabetes and people living in areas far away from the equator are prone to develop this disorder. The world’s highest number of Type 1 diabetes is found in Finland and Sardinia which is about 4-5 times greater than that of rates of USA or any other country. Individuals exposed to Epstein Barr virus or similar virus may get this problem. Congenital (by birth) jaundice and congenital respiratory infection may also increase the risk of getting Type 1 diabetes.


Complications :


Type 1 diabetes can affect the blood vessels of your heart, kidneys and eyes. Actually complications from diabetes does not develop overnight and it takes long years for the entire process of affecting any organ. As long as you are keeping the blood sugar under control nothing wrong is going to happen. The major risk/complication associated with diabetes is peripheral neuropathy. Excess blood sugar can injure the capillaries of the nerves in your legs causing tingling sensation or numbness.


The individual may not even realize any wound on his foot due to loss of feeling. Similarly nerve damage can affect GI tract and also erectile dysfunction in men. The same problem can occur on your kidneys thus affecting the routine function of the kidneys. Any nerve damage in the retina of your eyes can cause partial loss of vision and even blindness. Diabetes can affect your skin making it prone to bacterial infection. It can lower the bone density causing osteoporosis. A diabetic pregnant woman is putting her baby’s life to risk causing serious birth defects and miscarriage (in early stages).


Diagnoses :


Average blood sugar is taken through glycated hemoglobin test which indicates the blood sugar level for the last 3 months. A1C test score of more than 6.5% indicates that you have diabetes. Random blood sugar test is taken at any time. For severe cases, fasting blood sugar is done for checking whether the person is in pre-diabetic stage.


Treatment :


Treatment for type 1 diabetes depends on the intensity of blood sugar level. Once recognized with diabetes the person should take medications and follow healthy lifestyle for lifelong. He/she should monitor the blood sugar levels regularly even after starting insulin. The ultimate aim of the treatment is to maintain the blood sugar level in normal position.


Initially oral pills are given followed by insulin injection. Your doctor may give rapid acting insulin or long acting insulin based on your health condition. Humulin, Novolin, insulin lispro, Novolog, glargine and detemir are some of the common forms of insulin given for managing diabetes. People with diabetes can develop blood pressure and hence it is essential to monitor BP closely. Your doctor can also prescribe medications like statins for lowering cholesterol.


Lifestyle Changes :


People with Type 1 diabetes or Type 2 diabetes should stay on healthy diet including lots of fruits and vegetables and high fiber content. You should restrict intake of sweets and white bread. Practice regular aerobic exercise to maintain your weight, since obesity may increase the risk of stroke and heart attack. You need to monitor your blood sugar levels regularly after taking medications since very low blood sugar can cause more serious problems than high levels of blood sugar.


Increased stress can directly increase blood sugar level. Hence keep your stress under control. For women change in hormone levels during menstrual cycle can increase blood sugar. Women with Type 1 diabetes have high risk while getting pregnant. You should consult your doctor when you have plans for becoming pregnant so that your medications for high blood pressure and cholesterol may be reduced.


Invasive Procedures :


For some people with Type 1 diabetes, pancreas transplantation is done but the procedure involves high risk. It is recommended for people with severe blood sugar levels and those who do not respond to medications. By careful management of taking medications and sticking on to the schedule of physical exercise, you can reduce the risk of life threatening complications.


Get committed to manage your disease. Identify yourself by wearing a tag to show that you are diabetic. Monitor blood sugar levels and go for regular eye checkups. Pay attention to your legs and more particularly your feet. Check your blood pressure and cholesterol. Restrict the amount of alcohol and take help from your doctor to quit this habit. Maintain healthy weight and be optimistic.


Prevention :


There is no way to prevent Type 1 diabetes. Medical faculties are conducting research on this issue and may be they will come out with suitable methods shortly.


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