Type 1 diabetes: everything you need to know about this disease
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Type 1 diabetes: everything you need to know about this disease

Do you know about type 1 diabetes? Do you think you have it?

Then consult all the information gathered in our sheet.

What is type 1 diabetes?

Type 1 diabetes accounts for 5-10% of all diabetes cases. This form of the disease most often appears during childhood or adolescence, hence its ancient name of “juvenile diabetes”.

At the very beginning, type 1 diabetes causes no symptoms because the pancreas remains partially functional. The disease only becomes apparent when 80-90% of the insulin-producing pancreatic cells are already destroyed.

This is because individuals who have type 1 diabetes produce very little or no insulin due to an autoimmune reaction that partially or entirely destroys the beta cells of the pancreas. The latter has the role of synthesizing insulin, which is essential for the use of blood glucose by the body as a source of energy.

In this type of diabetes, it is absolutely necessary to take insulin regularly, hence the name it is often given “insulin-dependent diabetes (IDD)”. In fact, this disease was fatal before it could be controlled with insulin.

Type 1 diabetes: the causes of the disease

It’s unclear exactly what causes the immune system to respond to beta cells. Some individuals would be predisposed to the disease, by their heredity. A family history of type 1 diabetes is found in just under 10% of cases.

It is likely that the disease results from a combination of genetic and environmental factors. Exposure to certain viruses or foods early in life could, for example, play a role in the onset of disease.

Type 1 diabetes: possible complications

For information on acute complications (hypoglycemia and hyperglycemia caused by treatment adjustment; ketoacidosis in untreated diabetics), see our Diabetes fact sheet (overview).

In the long term, type 1 diabetes increases the risk of several health problems: cardiovascular disease, kidney disorders, loss of sensitivity in the fingers and feet, vision problems that can lead to blindness, etc.

The best way to prevent these complications is to regularly monitor blood sugar, blood pressure, and cholesterol regularly. For more information, see our Diabetes Complications fact sheet.

Beware of celiac disease

Celiac disease is especially common in people with type 1 diabetes: 20 times more common than in the general population, according to a study.

Celiac disease is another autoimmune disease whose symptoms (mainly digestive) are triggered by the consumption of gluten, a protein contained in several cereals.

Therefore, screening for celiac disease is recommended in type 1 diabetics, even in the absence of obvious symptoms.

The symptoms of type 1 diabetes are numerous.

To know them, consult our complete and detailed sheet on this subject below.

Type 1 diabetes: symptoms

  • Excessive elimination of urine (it is common to get up at night to urinate);
  • increased thirst and hunger;
  • severe fatigue;
  • weight loss
  • blurred vision.
Remark. More frequent infections, slower wound healing, or loss of foot sensitivity are some of the possible signs of complications. It is then necessary to consult your doctor without delay. See also our Diabetes Complications fact sheet.

Some people are at higher risk of developing type 1 diabetes. Also, risk factors favor its appearance.

Discover them here.

Type 1 diabetes: people at risk

People with a hereditary predisposition (family history). When a close relative has type 1 diabetes (father, mother, brother, or sister), the risk of developing it also ranges from 5% to 10%. In identical twins, when one of the two is affected, the other develops the disease in 30% to 50% of cases.

As epidemiological studies indicate, type 1 diabetes is more common in populations living far from the equator. Thus, in Finland, the disease is 2 to 3 times more common than in the United States, and 400 times more common than in Venezuela. Inadequate intake of vitamin D, the manufacture of which depends on sun exposure, could partly explain this phenomenon.

Type 1 diabetes: risk factors

There is no established risk factor. Here are some hypotheses.

Cow’s milk

Early consumption of cow’s milk in infants may contribute to the development of allergies and type 1 diabetes in children with a family history of diabetes.3

Public health authorities advise not to give cow’s milk to newborns before the age of 12 months. Type 1 diabetes is rarer in individuals who have been breastfed.

Early introduction of cereals

Introducing cereals too early (before 4 months of age) could contribute to the disease; Do not give it to the baby before the age of 6 months.

Respect the recommended age for the introduction of food to a baby.

Viral infection

Infection with Epstein-Barr virus, Coxsackie virus, or cytomegalovirus, for example, could trigger an autoimmune reaction against the pancreas.

Some preventive measures can be put in place to prevent the onset of type 1 diabetes.

Discover them in this article.

Type 1 diabetes: prevention measures

Basic preventive measures

To prevent type 1 diabetes, the destruction of cells in the pancreas responsible for insulin production in individuals at high risk of developing the disease should be prevented.

According to the Canadian Diabetes Association, there is still no effective and safe way to prevent this disease, even if you consult very early in the life of a child considered at risk.

Therefore, any steps to prevent type 1 diabetes should be done in close collaboration with a physician and, in some cases, as part of an experimental study.

Current research

Vitamin d

Several observational studies have shown that vitamin D supplementation in young children significantly lowers the risk of developing type 1 diabetes (daily dosages ranged from 400 IU to 2,000 IU).

However, no clinical trials have yet confirmed this.11 Given the lack of risks associated with taking vitamin D and its many health benefits, some doctors recommend it as a preventive measure.

Immunotherapy

This is the most promising path and the one in which scientists invest the most. Immunotherapy aims to allow the immune system to “tolerate” the cells in the pancreas responsible for producing insulin.

Several forms of immunotherapy are being tested, for example:

  • a vaccine composed of pancreatic antigens of the person to be treated;
  • an autologous immune cell transplant.

This autologous transplant would remove destructive cells and allow the development of new tolerant cells and the transfusion of blood taken from the umbilical cord at the time of birth (in young children).

Vitamin B3

In vitro data and animal, tests have supported the hypothesis that niacinamide (vitamin B3) may have a protective effect on pancreatic beta cells. A few preliminary clinical trials have also fuelled this hope.6

However, larger studies have not yielded convincing results. For example, the European Nicotinamide Diabetes Intervention Trial (ENDIT)7 gave high doses of niacinamide or placebo to 552 people at risk of type 1 diabetes (close relative, presence of autoantibodies against the pancreas and normal glucose tolerance test). Niacinamide did not reduce the risk of developing diabetes.

Injection of low doses of insulin

One of the preventive approaches tested is to administer small doses of insulin to people at risk. This approach was evaluated in the Diabetes Prevention Trial – Type 18.9.

Insulin therapy did not have a preventive effect, except in a high-risk subgroup, in which the onset of diabetes was slightly delayed.

One of the challenges in research is targeting people most likely to develop the disease. The appearance in the blood of antibodies against pancreatic beta cells (autoantibodies) is one of the indicators studied.

These antibodies may be present years before the onset of the disease. Since there are several types of these antibodies, it is a question of discovering which ones are the most harbingers of the disease, and from what quantity.

Measures to prevent complications

In type 1 diabetes, certain treatments and complementary approaches can effectively treat the disease.

Check out the full list below.

Type 1 diabetes: medical treatments

Diabetics can hope to lead an active, autonomous and dynamic life provided they respect, throughout their lives, strict discipline by:

  • monitoring blood glucose levels using a blood glucose meter;
  • an appropriate diet;
  • a physical exercise program.
  • a pattern of glucose uptake;
  • a table of glycemic values for adolescents and adults with diabetes;
  • a feeding plan;
  • suggestions for physical exercises;
  • ways to better manage stress.

People with type 1 diabetes often need to be treated for health problems that may be associated with this condition.

Medication

People with type 1 diabetes need to inject insulin to compensate for the pancreas’ inability to produce insulin. Injecting rather than taking insulin by mouth is necessary because it is destroyed by digestive juices. Since treatments are daily (often several times a day), the patient must learn to administer the injections himself.

The dosage and type of insulin used vary according to the subject’s actual insulin needs at each time of the day. Hence the need for close medical monitoring. At the beginning of treatment, it may take a little while to find the right dosage.

There are various types of insulin, with varying rapidities of action. The majority of patients give 3 to 5 injections a day, or use an “insulin pump”, a small device installed on the body and designed to provide a continuous infusion of insulin 24 hours a day. The goal is to ensure, at all times, that blood sugar is as close to normal as possible.

In this way, the incidence and severity of complications associated with type 1 diabetes are significantly reduced. Long-acting insulins, which require only 1 injection per day, are also available. The choice of insulin type should be made by the attending physician.

Surgery

In recent years, researchers have become increasingly interested in the therapeutic benefits of pancreas or islet transplantation in type 1 diabetics.

Because of the risks, pancreas transplantation is reserved for cases where diabetes cannot be controlled by insulin injections or in case of serious complications.

Less expensive and less risky, islet transplantation is still in the experimental stage.

Image Credit: Image by xb100 on Freepik

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