Definition of "Type 1 diabetes"

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Type 1 diabetes (aka diabetes [mellitus] type 1, T1D[M], formerly insulin[-dependent] diabetes, juvenile diabetes) is DM that results from autoimmune destruction of the insulin-producing beta cells in the pancreas.

Patient information

What is type 1 diabetes, and why is it also called juvenile diabetes?
It's called that because you get it as a kid. It's an autoimmune type thing. Specifically, the body attacks it's own beta cells in the pancreas.

What does the beta cells do? What does the pancreas do?
The pancreas secretes digestive enzymes. But it also creates some important hormones, one of which is insulin. Specifically, insulin is created by the beta cells of the pancreas.

What is insulin?
It's a hormone, that helps convert glucose in blood, to be stored as fat. It also helps the body use blood sugar.

  • Polyuria (frequent urination)
  • Polyldipsia (increased thirst)
  • Polyphagia (increased hunger)
  • Weight loss
  • Subsequent lack of insulin causes increased blood and urine glucose
  • Cause of type 1 diabetes is unknown
  • To distinguish type 1 [from type 2] diabetes:
    • Autoantibody testing
    • C-peptide assay, which measures endogenous insulin production

Patient information

How can you tell whether high blood sugar, is due to problems making insulin by the beta cells of the pancreas, or the body not responding to insulin as it should?
A blood test might show the presence of particular autoantibodies, that target the beta cells. You can also test for C-peptide, which is released as part of the body's production of insulin. Obviously, this will be low in type 1 diabetes, because insulin isn't being produced.


Insulin therapy, including:

  • Insulin injections, is ESSENTIAL for survival. It must be continued INDEFINETELY and doesn't usually impair normal daily activities. It must be prescribed externally, as it is no longer produced internally
  • Insulin pump, is a way through giving short acting insulin 24 hours a day through a catheter placed under the skin

Patient information

What can you do if high blood sugar, is due to problems making insulin?
You can give insulin. Which makes sense because the body's having problems making insulin.

  • Pt's are usually trained to Mx their diabetes independently, however, for some this can be challenging
  • Untreated, diabetes can cause many complications
  • Acute complications:
    • Diabetic ketoacidosis (the type 1 version of nonketotic hyperosmolar coma)
    • Hypoglycemia (low blood sugar) caused by excessive Tx
  • Long-term complications, are serious, some of which have an autoimmune basis too, including:
    • Heart disease
    • Stroke
    • Kidney failure
    • Foot ulcers
    • Diabetic neuropathy
    • Diabetic retinopathy (damage to the eyes)

Patient information

What can happen, as a result of having high blood sugar, due to problems making insulin?
There's stuff that happens in the short run, as well as in the long run. In the short run, insulin can become so unavailable, that the body is unable to use blood glucose, and switches to burning fat. This produces ketone bodies, which would be fine except they're acidic. This causes blood to become acidic. Like type 2 diabetes, blood sugar can get so high, that dehydration causes a coma.

You mentioned that having high blood sugar, can cause low blood sugar... how does this work?
It's not that high blood sugar causes low blood sugar. It's that when you treat high blood sugar, if a proper balance isn't made, you can get low blood sugar if you go overboard.

  • Other autoimmune disease, including:
    • Autoimmune thyroiditis (hypothyroid known as Hashimoto's, or hyperthyroid known as Graves'
    • Celiac disease (of the small intestine, causing immune reaction to gluten protein in wheat)
    • Addison disease (of the adrenal glands, and therefore glucocorticoids and mineralocorticoids)
  • Eating disorders, especially diabulimia, where T1DM patients give themselves less insulin that they need, for the purpose of weight loss. This can also occur alongside bulimic behavior
  • Depression and anxiety
  • Impact on school

Source: NIH

  • Type 1 diabetes accounts for 7% of diabetes
  • Globally it is estimated that 80k kids develop type 1 diabetes annually
  • Lowest rates of new cases are in Japan and China at 1 per 100k, up to 35 per 100k in Scandinavia
See also

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Definition of Type 1 diabetes | Autoprac

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