Definition
In addition to the much more common diabetes mellitus “type 2” (also known as diabetes of old age or affluence), there is also another form of diabetes mellitus, which is usually diagnosed in early childhood. We are talking about diabetes mellitus “type 1” (also known as juvenile diabetes, Dm1). In Dm1, a reaction of the immune system (autoimmune reaction) against the body’s own insulin-producing cells (so-called beta cells in the islets of Langerhans) in the pancreas leads to its destruction.
Insulin is an endogenous messenger substance that controls blood sugar. As soon as approx. 80% of these insulin-producing cells are destroyed, the body loses the function of self-regulating blood sugar levels and blood sugar rises unchecked after a meal. This can have far-reaching consequences for the person affected.
Causes
Diabetes type 1 is most often based on an autoimmune cause. This refers to a reaction of the body’s own immune system that is directed against its own body cells. This reaction takes place in the pancreas.
This is where the Langerhans’ islets are located. These contain, among other things, the so-called beta cells. Beta-cells are insulin-producing cells.
If they are destroyed, this leads to an absolute lack of insulin. Thus, no insulin is produced at all or only in insufficient quantities. The body thus loses the function of effectively lowering the blood sugar level, especially after a meal.
This reaction can occur idiopathically, i.e. without any significant reason. Nevertheless, researchers have found out that about 90% of the Dm1 affected children have a so-called HLA association. These are certain genes that are inherited and result in an increased risk of developing diabetes.
If parents are affected, a special human genetic test can be used to determine the likelihood of the risk of recurrence when trying to have children. In addition to the above-mentioned causes, it is often found that there are associations with other autoimmune diseases. This means that if the child is also ill with other autoimmune diseases (e.g. Addison’s disease, type A gastritis, Hashimoto’s thyroiditis, celiac disease), the risk of developing diabetes is increased.
Diagnosis
Several examination methods are suitable for diagnosis. The safest and also simplest is the examination of the sugar in the blood itself. It is not always necessary to take a venous blood sample.
Usually a small drop from the finger is sufficient. If there is a well-founded suspicion of the presence of diabetes, there are several possibilities. Firstly, the long-term blood sugar can be measured (HbA1c value).
Another frequently used method is the determination of the fasting blood sugar level. If the fasting blood glucose value is > 126 mg/dl, the diagnosis of diabetes is considered confirmed. Even if the occasional blood sugar level is > 200 mg/dl and typical symptoms are present, diabetes is considered confirmed. In addition, an oral glucose tolerance test (oGTT) can be performed. Your doctor will discuss with you which method is suitable for you.
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