Type 1 diabetes

Diabetes mellitus type 1, commonly known as type 1 diabetes (T1D), and formerly known as juvenile diabetes, is an autoimmune disease that occurs when the body's immune system destroys pancreatic cells (beta cells). In healthy persons, beta cells produce insulin. Insulin is a hormone required by the body to store and convert blood sugar into energy. T1D results in high blood sugar levels in the body prior to treatment. Common symptoms include frequent urination, increased thirst, increased hunger, weight loss, and other complications. Additional symptoms may include blurry vision, tiredness, and slow wound healing (owing to impaired blood flow). While some cases take longer, symptoms usually appear within weeks or a few months. The cause of type 1 diabetes is not completely understood, but it is believed to involve a combination of genetic and environmental factors. The underlying mechanism involves an autoimmune destruction of the insulin-producing beta cells in the pancreas. Diabetes is diagnosed by testing the level of sugar or glycated hemoglobin (HbA1C) in the blood. Type 1 diabetes can typically be distinguished from type 2 by testing for the presence of autoantibodies and/or declining levels/absence of C-peptide. There is no known way to prevent type 1 diabetes. Treatment with insulin is required for survival. Insulin therapy is usually given by injection just under the skin but can also be delivered by an insulin pump. A diabetic diet, exercise, and lifestyle modifications are considered cornerstones of management. If left untreated, diabetes can cause many complications. Complications of relatively rapid onset include diabetic ketoacidosis and nonketotic hyperosmolar coma. Long-term complications include heart disease, stroke, kidney failure, foot ulcers, and damage to the eyes. Furthermore, since insulin lowers blood sugar levels, complications may arise from low blood sugar if more insulin is taken than necessary. Type 1 diabetes makes up an estimated 5–10% of all diabetes cases. The number of people affected globally is unknown, although it is estimated that about 80,000 children develop the disease each year. Within the United States the number of people affected is estimated to be one to three million. Rates of disease vary widely, with approximately one new case per 100,000 per year in East Asia and Latin America and around 30 new cases per 100,000 per year in Scandinavia and Kuwait. It typically begins in children and young adults but can begin at any age.

Infobox

Other names

Diabetes mellitus type 1, insulin-dependent diabetes, juvenile diabetes, T1D, childhood diabetes

Pronunciation

mw- /daɪəˈbiːtiːz/

Specialty

Endocrinology

Symptoms

Frequent urination, increased thirst, weight loss

Complications

Diabetic ketoacidosis, severe hypoglycemia, cardiovascular disease, and damage to the eyes, kidneys, and nerves

Usual onset

At any age; over days to weeks

Duration

Lifelong

Causes

Body does not produce enough insulin

Risk factors

Family history, celiac disease, autoimmune diseases

Diagnostic method

High blood sugar levels, autoantibodies targeting insulin-producing cells

Prevention

Teplizumab

Treatment

Monitoring blood sugar, injected insulin, managing diet

Prognosis

10-12 years shorter life expectancy

Frequency

9 million cases globally