Last updated March 1, 2010

The Term Type 1 Diabetes was formerly known as insulin dependent diabetes. The full medical name of diabetes is Diabetes mellitus. Diabetes is a disease characterized by high levels of blood sugar and its resultant complications. Diabetes insipidus is a condition covered in a separate essay. This is subdivided into two subtypes - Type 1A and Type 1B.

Type 1 Diabetes (Juvenile Diabetes)

Introduction

This is the result of destruction of beta cells of the islets of Langerhans of the pancreas which produce insulin. This results in an absolute deficiency of insulin. These cases comprise about 5-10% of all diabetes cases in the western world. Patients with diabetes have both hyperglycemia (high blood sugar level) and predisposition to life-threatening complication called ketosis. Insulin is necessary for survival.

Genetics / Pathophysiology (What causes diabetes?)

There is an increase in DR3, DQ2 or DR4 and DQ8 or decrease in DR2. These abnormalities increase susceptibility of the islets of Langerhans cells to immunological injury. These patients have high levels of circulating antibodies such as islet cell antibodies, insulin autoantibodies and antibodies to glutamic acid decarboxylase.

Type 1A vs. Type 1B Diabetes

In general, Type 1A diabetes is immune mediated whereas Type 1B diabetes may not be immune mediated. Thus, circulating antibodies are likely to be present in Type 1A patients and are not present in Type 1B patients. However, absence of circulating antibodies in Type 1A patients may be due to diminution with time due to progression of disease. Both Type 1A and Type 1B diabetes patients are ketosis prone and require insulin.  

Clinical Presentation (Symptoms of Diabetes Type 1, Early Symptoms of Diabetes, Warning Signs of Diabetes)

Destruction of islet cells may antedate overt clinical diabetes by several years or decades. But there is abrupt development of hyperglycemia, occuring over several days or weeks. Weight loss, fatigue, polyuria, polydipsia, blurred vision and evidence of volume contraction are often present. Severe insulin deficiency should be suspected if ketosis develops. This is diagnosed before the age of 30 or 40 years, often in childhood. Hence the term Juvenile diabetes. Diabetes during pregnancy is termed Gestational Diabetes and it is covered in a separate essay.

Complications (Can you die from diabetes?)

Poor control of blod sugar levels increases complications such as retinopathy, nephropathy, atherosclerosis, cardiovascular and cerebrovascular diseases, problems during pregnancy and infection.

Newer Therapies (Diabetes Research)

These surgical treatments are generally reserved for patients who have failed medical (tablet) therapy and require insulin. 1. Whole pancreas transplantation. The advantage with this procedure is that, if the transplant takes (about half fail), there is no need for insulin injections or blood glucose monitoring.
2. Pancreatic islet cell transplantation  is usually done via the portal vein. There are more than eighty trials underway in the United States and other countries (http://www.ClinicalTrials.gov).

3. Coincommitant kidney evaluation and transplantation is also performed. 

Most clinical trials involve testing of immunosupressive drugs in post transplant patients.

There is at least one clinical trial underway which aims to test efficacy of autologous islet cell transplantation in the U.S. and one outside the U.S. which aims to evaluate role of stem cells. Thre studies are listed below to familiarize thew reader with these clinical trials.
1. Click here for the Clinical Islet Transplantation Consortium Web site
http://www.citisletstudy.org/
2. Islet and Pancreas Transplantation Screening Survey (Mayo Clinic)
3. Please refer to this study by its ClinicalTrials.gov identifier: NCT00768651
Incretin Effect and Use After Clinical Islet Transplantation
Contact: Peter Senior, MD, PhD 780-407-8852 petersenior@ualberta.ca Canada, Alberta, University of Alberta - Clinical Islet Transplant Program Recruiting
Edmonton, Alberta, Canada, T6G2C8; Contact: Janet Wright     780 407 8348     janet.wright@ualberta.ca

Diabetes Alert Day

March 23, 2010 is the American Diabetes Association Alert Day and November 14, 2010 is the World Diabetes Day.

These are events designed to increase awareness of the public and patients about diabetes. The theme of World Diabetes Alert Day is diabetes education and research. People get involved by:

3. Attend a Diabetes Alert Day event, or call 1-888-DIABETES (1-888-342-2383)

Conclusions
Diabetes patients are subdivided into various types based on etiology and requirement for insulin. Type 1 diabetes patients have a definite requirement for insulin.Copyright (c) 2009 A. N. Munsif.

References

1. Diabetes mellitus handbook, Morristown Publishing Company, P.O. Box 672, Livingston, New Jersey 07039, 2009.
2. Centers for Disease Control (CDC),MMWR 2008; 57(43);1169-1173 (http://cdc.gov).
3. Geiss LS, Pan L, Cadwell B, Gregg EW, Benjamin SM, Engelgau MM. Changes in incidence of diabetes in U.S. adults, 1997--2003. Am J Prev Med 2006;30:371-7 (http://www.ajpm-online.net/).
4. CDC. State-specific prevalence of obesity among adults---United States, 2007. MMWR 2008;57:7658 (http://www.cdc.gov/mmwr/).
5. Knowler WC, Barrett-Conner E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention. N Engl J Med 2002;346:393-403 (http://content.nejm.org/).
6. United Nations - Department for Economic and Social Information - Population Division. World urbanization prospects: the 1994 revision. Estimates and projections of urban and rural populations and of urban agglomerations. United Nations, New York, 1995. (http://www.un.org/esa/population/http://www.un.org/esa/population/http://www.un.org/esa/population/http://www.un.org/esa/population/http://www.un.org/esa/population/http://www.un.org/esa/population/http://www.un.org/esa/population/http://www.un.org/esa/population/http://www.un.org/esa/population/http://www.un.org/esa/population/http://www.un.org/esa/population/

publications/wup2007/2007wup.htm).7. American Diabetes Association has several diabetes diet recommendations, souces of diabetes supplies, etc. and description of activities scheduled on Diabetes Alert Day on its website.

References(2):
1. Diabetes Mellitus Handbook - Morristown Publishing Company, P.O. Box 672, Livingston, New Jersey 07039.
2. Centers for Disease Control - Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, U.S.A.

Keywords
Diabetes, Incidence, Prevalence, Obesity, Risk factors

Description

Dr. A. N. Munsif recommends that diabetics and their families familiarize themselves with the following information either through his book and newsletter or other publications. information about diabetes, symptoms of diabetes, american diabetes association, diabetes symptoms, diabetes alert day, what causes diabetes, early symptoms diabetes, diabetes research, diabetes diet, diabetes mellitus, type 2 diabetes, gestational diabetes, signs of diabetes, warning signs diabetes, diabetes symptoms quiz, type 1 diabetes, what is diabetes, diabetes insipidus, how is diabetes caused, history of diabetes, first signs of diabetes, diabetes supplies, type 2 diabetes diets, juvenile diabetes, preventing diabetes, type 2 diabetes food list, diabetes cure, diabetes test, who discovered diabetes, can you die from diabetes, what are the symptoms of diabetes, list of approved clinic locations for diabetes treatment in all fifty statyes and much more.

Category 1: Health/Diseases and Conditions/Diabetes
Category 2: Health/Medicine
Category 3: Health/Wellness

Reference URLs:    spartabk.com                   diseaseaid.com                  diseasaid.com  morristrownpublishing.com