Type 1 Diabetes is very common among men and women in today’s age. Let’s understand more facts about the condition. Diabetes means a ‘siphon’ or ‘running through’ and earlier it was used to describe the polyuria.
Diabetes mellitus, commonly referred as diabetes, is a group of metabolic disease in which there is high blood sugar levels over prolonged period. It is a clinical state, which is associated with flow of sugar in urine.
TYPES OF DIABETES MELLITUS
- TYPE 1 DIABETES– It results from the Pancreas’s failure to produce enough insulin.
- TYPE 2 DIABETES – It begins with Insulin resistance, a condition in which cells fail to respond to insulin properly.
- GESTATIONAL DIABETES – It occurs when pregnant women without a previous a history of Diabetes, develop high blood sugar.
PREDISPOSING FACTORS OF DIABETES
- HEREDITARY – the most common form of diabetes is hereditary idiopathic diabetes mellitus. TYPE 1 DM has main cause of genetically driven auto immune destruction of beta cells in pancreas.
- AGE – the disease is common with increasing age. However, type 1 DM is common in childhood and adolescence.
- OBESITY – A reliable indicator for body fat is Body Mass Index (BMI). BMI is body mass divided by the square of the body height. Adipose tissue in obese persons are more resistant to insulin actions than normal adipose tissue, which means, decrease ability of insulin to move glucose into the cells and to block the glucose release from the liver. Generally, obesity is common cause for type – 2 DM, but new research says that it may lead to type – 1 DM.
- SEDENTARY LIFESTYLE – Growing sedentary lifestyle these days is the major cause of diabetes in people. Sedentary lifestyle involving lack of exercise and more of sitting causes obesity and diabetes.
TYPE 1 DIABETES
Earlier it was known as insulin dependent diabetes mellitus or juvenile onset diabetes. It is mainly immune mediated diabetes, results from cellular mediated autoimmune destruction of the beta cells of the pancreas and mainly occurs in childhood and adolescence, but can occur in any age. In type 1 diabetes, other factors as infection or some other trigger factors can cause the destruction of cells in the pancreas that produce insulin. It mainly occur when the body’s own immune system which acts on the virus and bacteria, starts acting on the own body’s cells of pancreas.
Around 12% of people with type – 1 diabetes have clinical depression.
EPIDEMIOLOGY OF TYPE 1 DIABETES MELLITUS (1)
Over 700,000 people in United States have type – 1 diabetes. Type – 1 diabetes is usually diagnosed during childhood or early adolescence. It affects 1 in 600 children.
CAUSES OF TYPE 1 DIABETES MELLITUS
- ENVIRONMENTAL- it causes potential destruction of beta cells in the pancreas, which causes diabetes.
- VIRUS – virus can injure the beta cells. Virus like rotavirus, mumps virus, rubella virus and cytomegalovirus. Prime virus responsible for type – 1 diabetes is entero virus. This virus is more common in the siblings with diabetes type 1.
- CHEMICAL AND DRUGS- environmental factors cause inflammation in beta cells, promoting insulin resistance, disrupting endocrine glands, interfering with the immune system and promote auto immunity. Chemical exposure also causes weight gain and obesity. In a research, it has been found that in Pakistan children with diabetes type 1 had higher level of zinc, arsenic and lead.
- GLUTEN- generally it has been found that people with diabetes type 1 have celiac disease. Research also says that there may be genetic link between celiac disease and type 1 diabetes.
- POLYURIA- this means excessive urination. Patients have an urge for frequent urination. Generally, it has been seen, people with diabetes type 1 frequently urinate mostly during night. However, it is not restricted to night, it can occur any time of the day. Frequent passage of large volume of urine mostly 3 litres a day is defined as polyuria. Due to diabetes, glucose is excreted in the urine, water follows the glucose concentration and hence, there is high volume of urine output. Sometimes, there is less efficiency to empty the bladder completely.
- POLYDIPSEA – This means increased thirst. Normally one should drink adequate levels of water in a day. In case of diabetes, one feels more than normal thirst. Person feels dryness of mouth every time.
- POLYPHAGIA – This means increased hunger. Due to high glucose content in the blood, it cannot enter the cells due to insulin resistance and so unable to convert the food into the energy, so person feels hungry.
- DRY MOUTH – due to excessive thirst, one feels drying of the mouth and lips.
- FATIGUE– due to high blood glucose level there is inflammation in the vessels, which causes fatigue in the body.
- WEIGHT LOSS – there is weight loss and muscle bulk loss in diabetes.
- Orthopedic problems – in long standing cases of diabetes person suffers from ortho problems like frozen shoulder. This is because the capsules get thick due to high sugar content in the blood. There is pain, stiffness, lack of shoulder range. Both males and females are prone for this.
DIABETIC NEUROPATHY– long – standing diabetic can cause harm to your nerves. There is tingling, numbness, pain and burning sensations. People can suffer from nerve entrapment causing problems like carpal tunnel syndrome. There is lack of sensations in the limbs, which can cause permanent damage to the limbs. In severe cases, it may lead to amputation.
- REPRODUCTIVE PROBLEMS
MALES – according to a study, diabetes has affected male reproductive system by affecting their hypothalamus-pituitary- testicular axis. Usually low percentage of spermatozoa and its mobility has been recorded in the study. They also suffer from post ejaculatory dysfunction.(2)
Males are also unable to erect or hold the erection for long.
WOMEN – Female generally have less vaginal lubrication and orgasm. According to study, diabetes type 1 before menarche cause delay menarche and menses usually ceases. Amenorrhea and oligomenorrhea are more common with female with type 1 diabetes. There is dysfunction of hypothalamic- pituitary-ovarian axis.
- TYPE 1 DIABETES AND PREGNANCY – usually female with diabetes have more chances for fetal death and delivery by C – section. Babies born to women with pre- existing diabetes may suffer from breathing problems and jaundice, but they may be temporary.
- Slow healing of wounds and ulcers.
- LESSER COMMON SYMPTOMS – nose bleeding, fainting, mouth ulcers, head aches and genital itching.
- HYPOGLYCEMIA – improper control can cause blood sugar level to low called as hypoglycemia. This usually occurs during exercise or hunger state or when the body needs a change.
- KETOACIDOSIS – uncontrolled DM type – 1 leads to ketoacidosis. Lack of glucose in the cells cause the liver to compensate by releasing more glucose in the blood resulting in high blood glucose. Since cells are unable to use glucose they use fats. Fats break down to obtain energy and produce waste products ketones. This results in diabetic ketoacidosis. Individuals are unable to breathe properly, nausea, vomiting, stomach pain, fruity smell from body. In severe cases, it may lead to coma and death.
- Diabetic retinopathy– in long – standing diabetes, there is effect on retina of the eye which may cause destruction of retina leading to vision loss and eventually blindness.
- DIABETIC NEPHROPATHY– in long – standing diabetes there could be kidney failure.
- Guidelines for adolescent nutrition services 2005.
- Reproductive functions in male patients with type – 1 diabetes mellitus, 2015 – nov 3(6); 1082-87