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Type 1 diabetes: Signs and symptoms, causes, diagnosis and treatment
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Type 1 diabetes: Signs and symptoms, causes, diagnosis and treatment

Diabetes mellitus (DM) type 1 is characterized by absolute insulin deficiency in the body.
diabetes type 1
Representational image | Shutterstock

Diabetes mellitus (DM) type 1 is a genetic condition in which there is alteration of the immune system, characterised by an absolute deficiency of insulin in the body. 

It occurs when the body’s own immune system destroys the insulin-producing pancreatic cells. This deprives the body of insulin that aids in the conversion of food into energy. 

Children and young adults are usually diagnosed with this because it is hereditary and runs in the family. Previously, DM type 1 was referred to as insulin-dependent diabetes mellitus (IDDM) or juvenile diabetes. 

Signs and symptoms 

There are 3Ps that serve as identifiers for DM type 1:Polyuria (frequent urination, particularly at night) with chances of bedwetting, polydipsia (frequent thirst) and polyphagia (frequent feeling of hunger). 

Several other identifiers also exist, including: 

  • Weakness or fatigue 
  • Unexplained weight loss and muscle mass loss 
  • Itching all over the body, especially around the genitals 
  • Frequent episodes of thrush — a fungal infection in the mouth, throat or other parts 
  • Slow healing of cuts and wounds 
  • Blurred vision 
  • Pain, numbness or tingling in lower legs or sudden onset of a wound (gangrene) 
  • Dry skin 

Causes 

The exact cause of DM type 1 is not known yet. However, it is thought to be caused by autoimmune reactions that destroy the insulin-producing pancreatic cells. Autoimmune reactions are those in which the body’s immune system attacks its own healthy cells, mistaking them as foreign objects. 

However, individuals with a family history are at increased risk of getting DM type-1 and high blood pressure, sedentary lifestyle, and higher sugar and carbohydrate intakes just add a star to the genetic risk. 

Diagnosis 

A doctor can rule out the type and severity of the DM based on the collaborating inferences from physical examinations, signs and symptoms, and a series of laboratory tests. Early detection can help in better treatment outcomes. Pre-diabetics, those who are at risk of developing DM, should be more proactive when it comes to detection and therapy.
 

Diagnosis  HbA1c (Glycosylated hemoglobin)  Fasting Plasma Glucose Test (FPG) in mg/dl  Random Plasma Glucose Test (RBG) in mg/dl  Oral Glucose Tolerance Test (OGTT) in mg/dl 
Normal  Less than 5.7 %  Less than 100    Less than 140 
Pre-diabetes  5.7 – 6.4  100 – 125    140 – 199 
Diabetes Mellitus  Higher than 6.5%  126 or higher  200 or above  200 or higher 

Key:  

mg/dl: Milligram per deciliter 

HbA1c: Attachment of glucose in red blood cells after increased levels of blood glucose for more than five months 

FPG: Evaluation of glucose levels in the blood after eight hours of fastin 

RBG: Evaluation of blood glucose any time of that day 

OGTT: Evaluation of blood glucose two hours before and after giving 75grams of glucose in 100 ml of water  

Source: https://www.diabetes.org/diabetes/a1c/diagnosis 

Treatment 

In DM type 1, insulin is not produced by the pancreas. So, insulin should be injected to cope with the requirements in the body. Your doctor will decide the best insulin based on several factors such as activity levels, food habits, ability to manage the blood glucose levels, age, time taken by the body to absorb insulin and how long it stays active.
Your doctor will decide the preference of insulin based on three factors: 

  • Onset (time taken by insulin to begin its action) 
  • Peak time (the maximum strength of the insulin) 
  • Duration (how long the insulin stays active in the body) 
Insulin type  Onset  Peak time  Duration  Preference 
Rapid-acting  15 minutes  1 hour  2 – 4 hours  Taken right before a meal 
Regular/short acting  30 minutes  2 – 3 hours  3 – 6 hours  Usually taken 30–60 minutes before a meal 
Intermediate-acting  2 – 4 hours  4 – 12 hours  12 – 18 hours  Taken for half a day or overnight 
Long acting  2 hours  Does not peak  Up to 24 hours  Covers insulin needs for almost a full day 
Ultra-long acting  6 hours  Does not peak  36 hours or longer  Covers steady insulin for long periods; often used when needed 
Premixed  5 – 60 minutes  Varies  10 – 16 hours  Taken 10–30 minutes before breakfast and dinner 


Sources: https://www.cdc.gov/diabetes/basics/type-1-types-of-insulin.html ; https://www.diabetes.org/healthy-living/medication-treatments/insulin-other-injectables/insulin-basics
Moreover, physical activity and a balanced diet along with medications can help in better treatment outcomes.

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