- Risk Factors
The pathophysiology of type I diabetes is autoimmunity, which is a complex interplay between genetic predisposition and possible viral infection of the pancreas. Due to a faulty immune reaction, the immune system mounts an attack on the insulin-producing beta cells in the pancreas while killing the virus, causing beta cell annihilation and almost total insulin insufficiency.
Because glucose cannot enter cells without insulin, blood sugar stays high (hyperglycemia). This hyperglycemia along with cellular starvation (they do not get nutrition despite high blood sugar) is the cause of all symptoms and complications of type I diabetes mellitus. As a result, sugar stays in the blood, resulting in hyperglycemia (high blood sugar).
What are risk factors for type I diabetes?
Common risk factors for type I diabetes mellitus include
- Age: Type I diabetes mellitus is common in children and adolescents, although the disease can occur at any age. It is now understood to develop slowly over months or even years. The immune system gradually destroys more and more insulin-producing (beta) cells in the pancreas, eventually leading to the diagnosis of type I diabetes.
- Self-allergy (autoimmunity): Type I diabetes is more likely to develop if you have an autoimmune disorder. Doctors can screen for diabetes antibodies, particularly GAD65. Early detection of this antibody can help your doctor determine if you have type I or II diabetes.
- Genes: People with type I diabetes are more likely to have inherited genes that put them at risk. Over 50% of people diagnosed with type I diabetes have a close family with the condition.
- Environmental factors: Certain viral infections have been linked to an increased risk of type I diabetes.
It is not fully understood why some people get type I diabetes. Doctors and scientists believe that there is a genetic factor, but possessing diabetes genes is unlikely to be enough to cause the disease to develop. Scientists are investigating whether additional factors such as viral infections, birth weight, or nutrition may make someone who already has the genes for type I diabetes more likely to develop it.
What are signs of type I diabetes mellitus?
Type I diabetes can develop gradually or unexpectedly. Sometimes, symptoms may not be present and the disease is only diagnosed when blood or urine tests are performed for other reasons. Other times, the person lands in an intensive care unit due to a sudden loss of consciousness or diabetic coma.
Early signs of type I diabetes mellitus include:
- Weight loss or poor weight gain, even when eating a large amount of food
- Increased thirst
- Frequent urination
- Enuresis (bed wetting)
- Constant fatigue
- Fungal infections over the body
Later signs of type I diabetes mellitus include:
- Dry skin and mouth
- Difficulty breathing
- High blood sugar (above 126 mg/dL)
- Loss of appetite
- Fruity-smelling breath odor
- Stomach pain
According to the American Diabetes Association, 1.6 million Americans have type I diabetes, including 187,000 children and adolescents. Type I diabetes mellitus is less common than type II diabetes mellitus, accounting for 5%-10% of all diabetes cases in the United States.
What are treatment options for type I diabetes mellitus?
The objective of type I diabetes treatment is to keep your blood sugar levels as close to normal as possible to delay or prevent consequences. The goal is to keep your daytime blood sugar levels before meals between 80 and 130 mg/dL (4.44 to 7.2 mmol/L). Post-meal numbers should be no higher than 180 mg/dL (10mmol/L) two hours after eating.
Anyone with type I diabetes needs insulin therapy for the rest of their lives. Types of insulin available for treating diabetes include:
- Short-acting (regular) insulin
- Rapid-acting insulin
- Intermediate-acting insulin
- Long-acting insulin
Insulin cannot be administered orally to reduce blood sugar because stomach enzymes will break it down, preventing it from working. You will have to get it through injections or an insulin pump.
- Injections: To inject insulin under your skin, you can use a small needle or an insulin pen. Insulin pens resemble ink pens and are available in disposable or refillable forms. If you opt for injections, you'll most likely require a variety of insulin types to use during the day and night. Multiple daily injections of long-acting insulin mixed with rapid-acting insulin more closely replicate the body's natural utilization of insulin than prior insulin regimens requiring only one or two doses each day. A daily insulin injection schedule of three or more doses has been demonstrated to enhance blood sugar levels.
- Insulin pump: This can be worn on the exterior of your body. A tube links an insulin reservoir to a catheter implanted beneath the skin of your belly. Wireless pumps are also available. You wear a pod on your body that stores the insulin reservoir and has a small catheter implanted beneath your skin. The insulin pod can be worn on your stomach, lower back, leg or arm. Pumps are set to automatically deliver particular doses of rapid-acting insulin. This continuous dose of insulin is referred to as your basal rate, and it substitutes any long-acting insulin you were previously receiving. When you eat, you configure the pump with the number of carbs you're eating and your current blood sugar level, and it will provide a bolus dosage of insulin to cover your meal and correct your blood sugar if it's elevated. According to certain studies, an insulin pump may be more efficient than injections in regulating blood sugar levels in some people. However, many people attain normal blood sugar levels using injections.
- Artificial pancreas: The FDA has authorized the first artificial pancreas for people aged 14 years and older with type I diabetes. It is also known as closed-loop insulin delivery. The implanted gadget connects an insulin pump to a continuous glucose monitor, which examines blood sugar levels every five minutes. When the monitor shows that insulin is required, the device automatically provides the appropriate dose. There are currently more artificial pancreas (closed loop) devices in clinical testing.
What are possible complications of type I diabetes mellitus?
Possible complications of type I diabetes mellitus, if left untreated, include:
Untreated type I diabetes can cause organ failure, coma, and even death. Because the body can no longer convert glucose into fuel, it begins to burn fat, which creates ketones in the blood and urine. Too many ketones can alter the pH of the blood, resulting in a potentially fatal disease called diabetic ketoacidosis.
Can you prevent type I diabetes mellitus?
Type I diabetes is not preventable. However, some researchers believe it may be stopped at the latent autoimmune stage before the beta cells are destroyed:
- Immunosuppressive drugs:
- Cyclosporine A is an immunosuppressive drug that appears to slow beta cell death (based on lower insulin consumption), but its renal toxicity and other adverse effects render it unsuitable for long-term use.
- In people with newly diagnosed type I diabetes, anti-CD3 has shown indications of insulin production preservation (as evidenced by maintained C-peptide production). However, how long it is effective is unclear.
- Some research suggests that breastfeeding reduces the risk of islet cell autoantibodies later in life.
- Early introduction of gluten-containing cereals to the diet increases the risk of islet cell autoantibodies.
- Giving infants 2,000 IU of vitamin D per day for the first year of their lives is linked to a lower incidence of type I diabetes.
- Children who may be susceptible to type I diabetes mellitus may be given niacinamide (vitamin B3), because niacinamide (vitamin B3) may help delay the progression of type I diabetes mellitus.
- When followed properly, a gluten-free diet reduces diabetes symptoms and appears to prevent the development of long-term problems.
- Other dietary risk variables are being investigated, but no conclusive evidence has been discovered.
Latest Diabetes News
Daily Health News
Health Solutions From Our Sponsors
Type 1 Diabetes: https://www.webmd.com/diabetes/type-1-diabetes
Diabetes Mellitus Type 1: https://www.ncbi.nlm.nih.gov/books/NBK507713/
Type 1 Diabetes: Management Strategies: https://www.aafp.org/afp/2018/0801/p154.html
What Is Type 1 Diabetes? https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html
Type 1 Diabetes: https://www.diabetes.org/diabetes/type-1
Top Pathophysiology of Type I Diabetes Mellitus Related Articles
Diabetes Tips: Managing and Living With DiabetesIf you have either type 1 or type 2 diabetes, you need to approach life differently. Learn nutrition tips to control blood sugar, ways to manage your insulin, hyperglycemia triggers like stress, and what to do when traveling with diabetes. Discover the various symptoms of diabetes, how they put your body at risk, and steps you can take to live better with diabetes.
Can Type 1 Diabetes be Cured?Type 1 diabetes is a disorder of the pancreas. The organ doesn't make enough insulin. Learn what medical treatments can help ease your type 1 diabetes symptoms and speed up your recovery.
Body Blood Sugar LevelsHigh blood sugar can be a sign of diabetes or prediabetes. The drugs that treat it sometimes cause low blood sugar too. WebMD helps guide you through the effects of both.
Tips for Managing Type 1 and 2 Diabetes at HomeManaging your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information will enable you to mange your diabetes at home successfully.
Insulin for Diabetes Treatment (Types, Side Effects, and Preparations)There are a variety of types and preparations of insulin for the treatment of type 1 and type 2 diabetes, gestational diabetes, diabetes during pregnancy, metabolic syndrome, and insulin resistance. Human insulin preparations and regular insulin are made by recombinant DNA technology. Examples of preparations of insulin include rapid acting insulin (Apirda, Novolog, Humalog), short acting insulin (Novolin R, Humulin R), intermediate acting insulin (Humulin N, Novolin N, and long lasting insulin (Lantus, Levemir). Common side effects of insulin include hypoglycemia, headache, weight gain, rash, itching, flu-like symptoms, lipoatrophy, and reaction at the site of injection. Warnings, precautions, and drug interactions should be reviewed prior to taking insulin.
Insulin Pump for DiabetesAn insulin pump is designed to deliver insulin directly to a patient with diabetes. They are about the size of a standard beeper. The pump is attached to under the skin (usually on the abdomen). The amount of insulin required will depend on lifestyle (exercise, sleep patterns, activity level, and diet).
What Is the Pathogenesis of Types I and II Diabetes Mellitus?Diabetes mellitus is characterized by persistent hyperglycemia caused by abnormalities in insulin production, insulin action, or both. Learn about what causes type I vs. type II diabetes.
Diabetes: What Raises and Lowers Your Blood Sugar Level?Want to lower your blood sugar? Learn to better control your glucose levels by preventing blood sugar spikes and swings to avoid neuropathy and other diabetes complications. Find foods that lower blood sugar, and identify foods and activities that raise high blood sugar risks.
SGLT2 Inhibitors (Sodium-Glucose Co-Transporter 2)SGLT2 (sodium-glucose co-transporter 2) inhibitors is a class of drugs prescribed to treat type 2 diabetes in conjunction with diet and exercise. Review side effects, drug interactions, preparations, and pregnancy and breastfeeding safety information prior to taking any medication.
Type 1 Diabetes (Symptoms, Causes, Diet, Treatment, Life Expectancy)Type 1 diabetes mellitus (juvenile) is an auto-immune disease with no known cause at this time, although there are a few risk factors. Symptoms of type 1 diabetes include frequent urination, unintentional weight loss, dry and itchy skin, vision problems, wounds that heal slowly, and excessive thirst. Type 1 diabetes is diagnosed with blood tests. A healthy lifestyle and controlling blood glucose levels can improve life expectancy.
Type 1 DiabetesWhat is type 1 diabetes? There are new treatments for juvenile diabetes, and more people with diabetes can be treated than ever before. Learn the symptoms of T1D, the causes, and find ways to control your blood glucose levels naturally.
Type 1 Diabetes QuizWhat are the causes of type 1 diabetes? Take this quiz and challenge your knowledge of causes, symptoms, diagnosis and treatments for this common condition, formerly known as juvenile diabetes.
Diabetes Urine TestsUrine tests for individuals with diabetes is important to check for diabetes-related kidney disease and severe hypoglycemia. With proper monitoring of blood glucose levels, diabetic-kidney disease can be avoided.
What Is Type 1 Diabetes and How Do You Get It?What is type 1 diabetes? Learn the differences between type 1 and type 2 diabetes, as well as the symptoms and treatments for type 1 diabetes.
What Tests Are Done for Diabetes?Diabetes can cause serious complications if left untreated, which is why timely diagnosis is important. Learn about tests for type II, type I, and gestational diabetes.