Type 1 diabetes mellitus is one of the most significant chronic metabolic diseases in children and adolescents, but can occur at any age. As an autoimmune disease, this form differs fundamentally from other types of diabetes.
What is type 1 diabetes mellitus?
Type 1 diabetes mellitus Diabetes mellitus type 1 is a chronic disease characterized by an absolute insulin deficiency. In contrast to type 2 diabetes, which is characterized by insulin resistance, the body no longer produces its own insulin in type 1 diabetes. This condition results from a malfunction of the immune system, which attacks the body's own structures.
The role of the pancreas and beta cells
The pancreas contains specialized cells called beta cells. These cells are responsible for producing insulin. The hormone insulin acts as a key in the body, opening the body's cells to absorb sugar from the blood. Without this hormone, sugar remains in the bloodstream while the cells suffer from a lack of energy.
The difference between type 1 and type 2 diabetes
A common misconception is to equate the different types of diabetes. Type 2 diabetes is often associated with lifestyle, obesity, and older age. In this case, the cells are less sensitive to insulin. In type 1 diabetes, however, lifestyle plays no role in the onset of the disease. It is a process in which the immune system irreversibly destroys the insulin-producing cells.
Causes and development of autoimmune diseases
The exact causes of type 1 diabetes are not yet fully understood. Scientists now believe that it is the result of a complex interaction between various factors. A key role is played by an autoimmune reaction in which the immune system identifies the body's own beta cells as foreign and destroys them.
Genetic factors and heredity
A genetic predisposition is often the basis for the development of the disease. Certain genetic characteristics increase the risk of the immune system developing a malfunction. Nevertheless, many people never develop the disease despite their genetic predisposition, which points to the importance of other influences.
Environmental factors and viral infections in diabetes
It is believed that environmental factors may act as triggers. These include viral infections, which activate the immune system and subsequently initiate cell destruction. Nutrition in early childhood and climatic conditions are also being discussed in research.
Symptoms: Recognizing warning signs early on
The onset of the disease is often gradual until a large proportion of the beta cells have been destroyed. As soon as insulin production falls below a critical level, blood sugar levels rise rapidly, leading to characteristic symptoms.
Classic signs in children and adults
One of the primary symptoms is extreme thirst. In order to excrete the excess sugar via the kidneys, the body produces more urine, which leads to frequent urination.
Other signs include:
- Unintentional weight loss despite normal food intake.
- Severe fatigue and exhaustion.
- Blurred vision.
- Dry skin and itching.
The danger of diabetic ketoacidosis
If insulin deficiency is not detected in time, there is a risk of life-threatening metabolic imbalance: diabetic ketoacidosis. Since the body can no longer burn fat for energy via sugar metabolism, it resorts to fat reserves. This produces acidic waste products called ketones. This leads to hyperacidity of the blood, which can result in vomiting, abdominal pain, and, in the worst case, diabetic coma.
Diagnostic procedures in diabetology
The diagnosis is made by measuring blood sugar levels in the blood. Diabetes mellitus is present when fasting blood sugar reaches a value above 126 mg/dl or random blood sugar is measured above 200 mg/dl.
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Differentiation through autoantibody testing
To confirm that it is type 1 diabetes, doctors test the blood for specific autoantibodies. These indicate ongoing immunological destruction of the beta cells. In borderline cases, a glucose tolerance test can provide additional certainty about sugar utilization in the tissue.
Modern diabetes therapy
Since people with type 1 diabetes suffer from an absolute insulin deficiency, they must receive lifelong external supplies of this vital hormone. According to the current state of scientific knowledge, a cure is not yet possible, but treatment has improved dramatically in recent decades.
Intensive insulin therapy (ICT)
With this form of therapy, patients inject themselves with insulin several times a day. A long-acting basal insulin covers the basic requirement, while a short-acting insulin is calculated and administered at mealtimes. This requires precise knowledge of the carbohydrate content of food.
The insulin pump and automated systems
An advanced alternative is the insulin pump. This device continuously delivers small amounts of insulin into the subcutaneous fatty tissue. This offers a high degree of flexibility, especially for children and adolescents. Modern hybrid closed-loop systems (AID systems) connect the pump to a sensor for continuous glucose monitoring (CGM). These systems can regulate insulin delivery largely automatically based on current blood sugar levels.
Living with diabetes: everyday life and lifestyle
Stable blood sugar levels are the goal of any treatment in order to maintain quality of life and prevent long-term damage. In addition to drug therapy, diet and exercise play a supporting role.
Nutrition and exercise for type 1 diabetes
There is no special "diabetic diet." People with diabetes can basically eat anything, but they must learn to correctly estimate the carbohydrates in their food in order to dose the appropriate amount of insulin. Exercise and physical activity are strongly recommended, as they improve the insulin sensitivity of the body's cells. However, athletes must closely monitor their blood sugar levels to avoid hypoglycemia.
Possible secondary diseases associated with persistently high levels
Chronically high blood sugar levels place a strain on the entire body. Over the years, this can damage blood vessels and tissue.
Damage to blood vessels and nerves
A permanently elevated blood sugar level damages the small blood vessels and the large vessels. This can lead to retinal diseases in the eye, which in the worst case can endanger vision. The kidneys are also often affected, as they have to filter out the excess sugar. Nerve damage often manifests itself in numbness or pain in the extremities.
Susceptibility to infection and wound healing
High blood sugar levels also impair the immune system. Diabetics are therefore more prone to infections. In addition, wound healing is often delayed because blood circulation is impaired and bacteria can grow faster in a sugar-rich environment. Meticulous skin care and regular check-ups with a doctor are therefore essential.
