The autoimmune disease, also known as diabetes mellitus type 1, affects far fewer people in Germany than diabetes mellitus type 2, with 400,000 people suffering from the disease.
What is diabetes mellitus type 1?
Even though diabetes melltius type 1 is not curable, patients are enabled to live a long life with a high quality of life because of the far advanced medicine. In the autoimmune disease diabetes mellitus type 1, the body’s immune system turns against the pancreatic cells that produce insulin and destroys them. Insulin production can no longer continue and the hormone is absent within a very short time. This process can have fatal consequences, because the hormone insulin is responsible for breaking down the sugar that has been absorbed into the blood through food and using it to produce energy. If the insulin cells are destroyed, the sugar backs up in the veins, causing blood sugar levels to skyrocket.
Causes
The causes of an autoimmune disease such as diabetes mellitus type 1 is usually an autoimmune reaction (destruction of the insulin cells of the pancreas). However, the reason why the immune system turns against the B cells for insulin production is still unclear. So far, it is assumed that certain hereditary factors play a role in this process. However, this assumption has not been sufficiently proven, which is why researchers also include in their investigations the environmental factors under which an autoimmune reaction can be induced. Accordingly, the onset of diabetes mellitus type 1 can be significantly favored by too early contact with cow’s milk, as well as some viruses.
Symptoms, complaints, and signs
If about 80 percent of the beta cells in the pancreas are destroyed, the body no longer has enough insulin to transport sugar into the cells as an energy supplier. The first symptoms become noticeable within days or a few weeks. The body excretes the increased amount of sugar remaining in the blood as a result of the insulin deficiency via the urine. An increased urge to urinate and a constant feeling of thirst are therefore among the typical symptoms of type 1 diabetes. In addition, the disturbed fluid balance can be reflected in dry, itchy skin as well as visual disturbances and headaches. As less and less sugar reaches the cells, the body draws on its fat reserves. This can lead to rapid weight loss, but also to cravings for sweets. Fatigue, listlessness and concentration problems are further complaints. In addition, diabetes affects the immune system, leading to increased susceptibility to infections and poorer wound healing. In type 1 diabetes, urine and breath smell sourly of acetone. Acute symptoms include life-threatening impaired consciousness. For example, the progressive lack of sugar in the cells can lead to diabetic coma (hyperacidity), which is heralded by nausea, vomiting and deep breathing (acetone odor). In turn, too high an insulin dose in an already diagnosed type 1 diabetes can end in diabetic shock (hypoglycemia), which is accompanied by sudden hunger, sweating, pallor, and palpitations.
Course
The autoimmune disease diabetes mellitus type 1 is particularly dangerous because it only becomes noticeable insidiously. It usually sets in during early childhood. However, the symptoms may not appear until years later, although the antibodies that destroy the insulin cells can be detected in the blood years before the first symptoms appear. The disease can be detected by a simple measurement of the sugar concentration. With the rise in blood glucose levels and glucose detections in the urine, the first symptoms of diabetes mellitus type 1 may also become apparent. These would include urinary urgency, thirst, fatigue, itching, weight loss, acetone odor, and gastrointestinal problems and diabetic coma. When the body has reached hyperacidity due to severe fluid loss as well as a rising ketone body level, it is noticeable by deep breaths to release carbon dioxide. In this condition, the patient must receive immediate specialist help, as the increasing dehydration of the brain will cause the patient to become comatose. If no therapy is given, the patient will fall into a diabetic coma due to the lack of fluids and hyperacidity.The disease must then be monitored in the intensive care unit, making it life-threatening.
When should you go to the doctor?
A doctor must be consulted as soon as at least one sugar coma (hyperglycemia) has occurred. The same applies if frequent hypoglycemia (low blood sugar) occurs. However, a general practitioner should already be contacted if an elevated glucose level is detected. This is especially advisable for children who suffer from obesity. The development of diabetes mellitus type I can still be averted by proper nutrition and healthy weight loss. Which doctor carries out treatment depends on the reason for which the disease has arisen. If there are reversible causes, a general practitioner can supervise treatment. However, if the disease appears suddenly, e.g. due to traumatic experiences, an internist specializing in diabetes should be consulted. Only a specially trained specialist can make an exact diagnosis. The latest findings show that there is also a non-adjustable type I with mixed forms. If this is suspected, a physician who knows about it should be consulted. Often it also requires multiple changes of doctors. This is not to be shied away from, otherwise wrong tips and negative effects such as weight gain and deterioration of health are to be feared.
Treatment and therapy
If the symptoms of type 1 diabetes mellitus are detected in time, adequate therapy can be used to relieve the symptoms and establish the usual quality of life. Various forms of therapy are used for treatment and must be continued throughout life. In conventional insulin therapy, the patient must inject himself twice a day with one short-acting and one long-acting insulin preparation. Meals are dependent on the dose of insulin injected. For safety, the patient must undergo regular blood draws and examinations. Intensified insulin therapy offers type 1 diabetes mellitus patients a certain degree of flexibility, because by injecting two long-acting doses, the patient is free to choose the timing of his or her meals. Modern insulin pump therapy makes it easier to dose the amount injected directly into the abdominal fat through the catheter. Because of this, this form of therapy is particularly suitable for young children.
Outlook and prognosis
Type 1 diabetes mellitus is not curable. Patients must receive medical care throughout their lives, regularly monitor their blood glucose levels, and depend on insulin supplementation. The complications that can be caused in particular by poorly controlled diabetes are decisive for the course of the disease. Overall, women and men have an increased risk of premature death from these complications compared to the normal population. Consequential damage to the cardiovascular system, such as heart attack or stroke, is one of the most common complications of diabetes mellitus. They contribute significantly to the reduction of life expectancy in diabetics. Another complication that can shorten life expectancy is kidney failure in diabetic nephropathy. Good kidney function has been shown to improve the prognosis of patients. Especially in younger years, when diabetes is not yet optimally controlled, the derailment of blood sugar with its consequences is a possible cause of death. This leads to hyperacidity of the blood due to insulin deficiency (diabetic ketoacidosis), which can quickly become fatal. Overall, however, life expectancy for type 1 diabetics has continued to increase over the past years and decades due to improved medication, close monitoring, and targeted training of those affected.
Prevention
For type 1 diabetes mellitus, unlike type 2, there is no prevention option. But measuring antibodies and sugar concentrations in the blood can predict whether someone will develop type 1 diabetes mellitus.
This is what you can do yourself
Diabetes mellitus type 1 is a genetic autoimmune disease that leads to the gradual destruction of the insulin-producing cells in the pancreas. This means that if the disease is not recognized, blood glucose levels will gradually rise to levels above normal due to insulin deficiency and can cause secondary damage.Self-help measures initially consist of attentive self-monitoring if other cases of type 1 diabetes are known in the family. If symptoms occur, such as an increased feeling of thirst for no apparent reason, frequent urination, weight loss and a general feeling of fatigue, it is advisable to have the blood glucose concentration measured and, if the suspicion is confirmed, to arrange for a detailed examination. If type 1 diabetes has already been diagnosed, the most important goal is to optimally adjust the blood glucose level by means of insulin therapy in order to prevent subsequent damage to the blood vessels, the retina, the coronary arteries and, above all, the kidneys or, if possible, to heal or at least stop the progression of existing damage. As an accompanying and supportive measure, it is recommended that blood pressure be set as low as possible, especially to support kidney function. Because type 1 diabetes, as a genetically caused disease, is not curable, lifelong insulin therapy is recommended, consisting of a combination of a long-acting and a short-acting insulin applied directly into abdominal fat.
