I call type 1 diabetes (T1D) civilization disease because statistically, its more prevalent in the developed countries. However, there are exemptions; for example, Japan, which is one of the most developed states of the world, has a low incidence of childhood T1D (2.4/100,000). Finland has the highest prevalence of T1D (57.6/100,000), and Venezuela has the lowest (0.1/100,000).
Decades ago, type 1 diabetes had a very low incidence, or it was virtually none in the underdeveloped world. However, things have changed, and the cases for type 1 diabetes is increasing worldwide. The occurrence of T1D in the last 40 years increased fourfold. In the USA, 1.25 million people live with it. There are over 40 thousand new cases each year.
What diabetes mellitus means?
It means “sweet urine.” Diabetes means siphon, and “mellitus” means honey.
Some reference to blood sugar levels measured by finger pricking blood test between meals:
- Dangerously low blood sugar level is below 1 mmol/liter (Hypoglycemia) can cause coma and death
- Very low blood sugar level is below 2 mmol/liter
- Low blood sugar level is 2-4 mmol/liter
- Normal blood sugar is 4-6 mmol/liter
- Higher than normal is 6-10 mmol/liter
- High is 10-16 mmol/liter
- Very high is over 16 mmol/liter (Hyperglycemia) can cause diabetic ketoacidosis if not taken down by insulin to the normal level
- Dangerously high is over 24 mmol/liter and cause diabetic ketoacidosis in a short time if not taken down by an extra dose of insulin to the acceptable level
To convert mmol/liter to mg/dl, multiply it by 18.
The first mention of diabetes was in 1552 B.C. when an Egyptian physician documented frequent urination as a symptom of a disease. Before the discovery of insulin, diabetes, without a doubt, led to death within months from the onset of the symptoms. Frederick Banting, a physician in Canada, first had the idea to use insulin to treat diabetes in 1920. Banting and his team successfully treated a diabetic patient with insulin in 1922. He got the Nobel Prize in Medicine for the discovery of diabetes treatment.
The role of insulin to life
A particular area in the pancreas, the beta cells in the islets of Langerhans, produces a hormone called insulin. Cells in the body need insulin to utilize glucose in the blood. The liver converts excess glucose to glycogen and then store it. When the glucose in the blood inadequate due to fasting, the liver release the glucose into the blood. Insulin regulates the glucose level in the blood and keeps it within a healthy level.
Type 1 diabetes occurs when the beta cells of the pancreatic islets that are producing insulin are destroyed by the immune system. Therefore glucose is not taken up from the blood into the cells to be utilized there. Consequently, glucose accumulates in the blood.
The causes of the type 1 diabetes
Type 1 diabetes is an autoimmune disease and can onset at any age but most often in children and teenagers. The cause of the disease is not apparent. An autoimmune response mistakenly attacking the insulin-producing cells in the Langerhans islets is the starting point. Virus infection is one of the triggers that cause an immune response. The predisposition for the disease is, to some extent, can be inherited. People living closer to the poles have a higher chance of developing T1D.
When the lack of insulin in the blood reduces glucose uptake into the cells and glucose level increases in the blood, the following physiological effects occur:
- The body cells do not get fuel and starving
- The volume of glucose in the blood increases, causing the kidneys to reabsorb water. Therefore urine production increases.
- The tissues of the vital organs begin to break down muscle cells for energy, causing weight loss and muscular dystrophy.
The symptoms are a consequence of these processes.
The disease starts suddenly. Usually, children or young people are attacked by the disease often after a viral infection. The lack of insulin causes a high level of blood sugar.
Early symptoms of type 1 diabetes:
- Increased urine production
- Abnormally increased thirst
- An increased appetite
- Feeling extremely tired and weak
- Rapid weight loss
- Impaired vision
If the blood sugar level remains high and is not stabilized to a reasonable value by insulin, there will be an accumulation of the chemical in the body called ketones. This condition is diabetic ketoacidosis (DKA), which is a severe condition and can lead to coma and death. The signs of ketoacidosis are:
- The smell of acetone from the mouth
- Pain in the stomach
- Rapid breathing
- High pulse rate
In the long term, diabetes can severely destroy blood vessels. Thus causing complications that include heart disease, stroke, kidney failure, foot ulcers, and damage to the eyes. You can help prevent or delay the complications of diabetes by managing your blood glucose, blood pressure, and cholesterol, and following your self-care plan.
Treatment and self-care
There is no cure for type 1 diabetes. The only available treatment is 3-5 daily subcutaneous insulin injections for life. You must take insulin because your body no longer makes this hormone. You need to use two types of insulin. Different types of insulin start to work at different speeds (fast or slow-release) and the effects of each last a different length of time (short or long duration). Common options include a needle and syringe, an insulin pen, or an insulin pump.
The objective of the management is to keep the blood sugar level as close to normal as possible. At least most of the time, below under 10 mmol/liter, but under 8 mmol/liter is a much better chance to avoid the long term complications.
Daily blood tests to monitor the blood sugar level to check the correct dosage of insulin, also exercise and controlled dietary carbohydrate intake is an integral part of the treatment. Another essential part of the therapy is the strict control of sugar and carbohydrates intake in the diet so that it is in harmony with the dose of injected insulin.
Over time, high blood glucose can lead to health problems
- heart disease
- kidney disease
- dental disease
- nerve damage
- foot problems
- sleep apnea
Developments in type 1 diabetes treatment:
Implanting islet cells in the pancreas is an experimental treatment and requires immunosuppressant drugs to prevent rejection. Another experimental procedure is to implant stem cells in the pancreas that can develop into new insulin-producing cells. How Immunotherapy Could Stop and Prevent Type 1 Diabetes
Supplementing the treatment
There are natural supplements in the market that can help to normalize the blood sugar level. Those supplements can’t heal or treat the disease or replace insulin injections, but they can contribute to regulating the blood sugar level.
These products contain minerals, such as chromium, that are components of enzymes that stimulate glucose metabolism in the body. Some of them also include herbs that have been used for a long time in traditional medicine to regulate the glucose level and that have proven their effects in scientific studies.
Reference: “Type 1 Diabetes” NIH https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/type-1-diabetes