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Type 1 Diabetes

(Insulin Dependent Diabetes Mellitus; Juvenile-Onset Diabetes; Ketosis-Prone Diabetes; "Brittle" Diabetes; Diabetes Mellitus Type 1; Diabetes, Type 1)

Definition

Type 1 diabetes happens when the body does not make enough insulin to move glucose from the blood to the cells. This causes it to build up in the blood instead of being used by the cells for energy.

Causes

Causes of type 1 are:
  • An immune system that attacks healthy tissue in the pancreas and destroys the cells that make insulin
  • Genetics
The Pancreas
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Risk Factors

It is more common in children and young adults, but it can happen at any age. It is also more common in people who have family members with it.
Other things that may raise the risk are:
  • High birth weight
  • Obesity
  • Increased age of mother during pregnancy

Symptoms

Symptoms may be:
  • Urinating more often, especially at night
  • Bedwetting
  • Feeling tired and weak
  • Being very thirsty
  • Hunger
  • Weight loss
  • Belly pain
Ketoacidosis can happen when a person’s glucose gets very high. It can be deadly if it is not treated right away.

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.
Diabetes is diagnosed with blood tests that check for high glucose levels. More than one test may be done.
These blood tests will also be done to find out whether it is type 1 or type 2:
  • Insulin level or C-peptide tests to see how much insulin is being made by the pancreas
  • Tests that look for antibodies that are working against the pancreas

Treatment

The goal is to keep blood glucose levels at close to normal levels. This can be done with:

Medicine

All people with type 1 need to take insulin to replace the insulin hormone that their body does not make. It can be given by injection, inhaler, or by a pump that gives it in small amounts during the day.
Pamlintide may also be given to keep glucose from going too high after eating.

Healthy Habits

Healthy habits can help manage type 1, such as:
  • Testing blood glucose levels often
  • Working with a dietitian to make a meal plan that will help keep blood glucose levels normal
  • Getting regular exercise

Pancreatic Islet Cell Transplant

A pancreatic islet cell transplant may be done in people who are not helped by other methods. It transplants islet cells from a donor to a person with type 1. The new cells can make insulin. Some people may no longer need insulin after the transplant. Not all care centers offer this treatment.

Pancreas Transplant

A pancreas transplant may be done in people with who are not helped by other methods. It is often done with a kidney transplant. This surgery may cause other problems, such as infection or organ rejection.

Prevention

Type 1 diabetes cannot be prevented.

RESOURCES

American Diabetes Association
http://www.diabetes.org
National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES

Canadian Diabetes Association
http://www.diabetes.ca
Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References

American Diabetes Association. Standards of medical care in diabetes-2019. Diabetes Care. 2019. Jan; 42 (Suppl 1):S1-193.
Diabetes mellitus type 1. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/diabetes-mellitus-type-1-22 . Updated June 28, 2019. Accessed November 1, 2019.
Type 1 diabetes. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/type-1/?loc=DropDownDB-type1. Accessed November 1, 2019.
Type 1 Diabetes. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/type-1-diabetes. Updated July 2017. Accessed November 1, 2019.
9/11/2014 DynaMed Systematic Literature Surveillance https://www.dynamed.com/condition/diabetes-mellitus-type-1-22 : Tovote KA, Fleer J, et al. Individual mindfulness-based cognitive therapy and cognitive behavior therapy for treating depressive symptoms in patients with diabetes: results of a randomized controlled trial. Diabetes Care. 2014;37(9):2427-2434.

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