Healthy Living and Fitness

Illness Care: Diabetes Type 1

Definition

Diabetes is a disease that causes an abnormally high level of sugar, (glucose), to build up in the blood. There are two major forms of diabetes, but both forms of diabetes share the common feature of elevated blood sugar levels due to a failure of the normal regulating mechanisms.

Insulin is a key regulator of the body's metabolism. After meals, food is digested in the stomach and intestines; carbohydrates are broken down into sugar molecules, of which glucose is one. The glucose is absorbed directly into the bloodstream, and blood glucose levels rise. Normally, this rise signals important cells in the pancreas -- called beta-cells -- to secrete insulin, which pours into the bloodstream. Insulin, in turn, enables glucose to enter cells in the body where, along with other hormones, it directs whether these nutrients will be burned for energy or stored for future use. As blood sugar falls to pre-meal levels, the pancreas reduces the production of insulin, and the body uses its stored energy until the next meal provides additional nutrients.

The two major forms of Diabetes are:

Type II (previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes.) which is caused when either the body does not make enough insulin, or the body's cells ignore the insulin which is produced, so that elevated blood sugar levels occur even though the body is producing sufficient insulin. - See the Type II Diabetes page.

Type I (previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes)

Type I Diabetes is much less common than Type II - accounting for only 7-10% of all diagnosed cases. It can occur at any age, but usually appears between infancy and late 30's - most typically in childhood or adolescence.

In type I diabetes, the insulin producing cells of the pancreas (beta cells) are gradually destroyed, until eventually no insulin is produced at all. Then, without insulin to move sugar from the bloodstream in to the body's cells, the blood sugar levels become very high - a condition known as hyperglycaemia. Because the body cannot utilise this sugar it spills over in to the urine and is lost. Patients become dependent on administered insulin for survival.

The most common reason for the destruction of the beta cells is an autoimmune response (although it can occur secondary to other factors such as drugs, surgery or infection). In an autoimmune response the immune systems T-cells (a type of white blood cell) begin to infiltrate and destroy the beta cells of the pancreas. Ordinarily, these T-cells fight infection, but in the case of diabetes, they are turned against the body's pancreatic tissue creating a condition known as insulitis. Progression from insulitis to full-blown diabetes can take up to seven years, and more than one half of those with insulitis do not go on to develop diabetes. Normally, by the time a person is aware that there is something wrong and goes to the doctor, more than 90% of the beta cells have already been destroyed

 

Return to our main Healthy Living and Fitness page