Type 1 diabetes is an autoimmune disease in which affected individuals produce little or no insulin naturally in the body. Why this happens has not yet been clearly explained scientifically. This form of diabetes often occurs in childhood or adolescence. According to the German Diabetes Aid, there are around 300 people in Germany with type 1 diabetes.000 people with type 1 diabetes, of which more than 30.000 children and adolescents under 20.
Definition: What is diabetes type 1?
In this type of diabetes, the immune system attacks the pancreas and
destroys the cells that produce insulin, the so-called beta cells. In this case, physicians speak of "absolute insulin resistance". Without the hormone insulin, the dietary sugar no longer reaches the body's cells, but instead accumulates in the blood. As a result, blood glucose levels rise, which can have serious effects on various organs, nerves, and blood vessels if no countermeasures are taken. People with type 1 diabetes therefore have to inject insulin and monitor their blood glucose levels throughout their lives. Apart from this, however, they can lead a completely normal life.
How do diabetes type 1 and diabetes type 2 differ??
Although both diseases are grouped together under the term "diabetes mellitus" or colloquially "diabetes", they are otherwise fundamentally different.
– is the rarer form of diabetes compared to diabetes type 2, with about 7 million people affected. – usually occurs at a young age, while type 2 diabetes only becomes apparent at an advanced age. – usually develops more rapidly, type 2 over many years. – is the result of an insulin deficiency. In type 2 diabetes, on the other hand, the sensitivity of the body's cells to insulin is reduced (insulin resistance). – requires lifelong insulin injections, whereas a change in diet (possibly a change in the diet of the patient) is not necessary. in combination with medication) can be sufficient as a therapy for diabetes type 2, at least for a while.
What promotes type 1 diabetes: risk and other influencing factors
Experts ame that the Genes in the development of type 1 diabetes play a certain role. Statistically, ten to 15 percent of diabetes type 1 patients under the age of 15 have a first-degree relative who also has the disease. According to current research, there are about 20 gene mutations that can cause type 1 diabetes, but only if several of them occur at the same time. The HLA system, which is responsible for monitoring and regulating the immune system, appears to play a special role in the development of this form of diabetes.
Viruses, for example the pathogens of mumps, rubella or measles are also thought to be able to "confuse" the body's defense system. Researchers from the U.S. and Canada have also found that damaged nerve cells in the pancreas can also increase the risk of developing type 1 diabetes.
Diabetes type 1: examination and therapy
If you suspect that you have type 1 diabetes, you should consult your family doctor. He or she will have a detailed discussion with you and will then be able to diagnose you by means of Urine and blood test a diabetes test perform. Decisive for him is the sugar concentration in the blood at a diagnosis for diabetes type 1. By definition, diabetes is present when
– at any time, the blood glucose value is 11.1 mmol/l or more – the fasting blood glucose value in venous plasma (the blood from the vein) is 7 mmol/l or more – the long-term blood glucose value (HbA 1c), i.e. the average blood glucose value over the past weeks is higher than 48 mmol/l
On the basis of these results, the attending physician will suggest an appropriate therapy.
Living with type 1 diabetes
Although diabetes type 1 is currently not curable. Thanks to modern treatment methods, however, the daily life of those affected is hardly restricted. If the disease is diagnosed early, the insulin dosage is well adjusted and the blood glucose level is controlled regularly, most complications as well as the risk of diabetes-related secondary diseases (kidney/nerve diseases, diabetes foot, dialectical retina) can be mitigated or prevented altogether.
Diabetics Can perform most occupations and can even drive a car, As long as the blood glucose level is on target. Women who already have type 1 diabetes before pregnancy and want to have a child should talk to their gynecologist beforehand in order to adjust the therapy accordingly if necessary and to strengthen blood glucose control.
Gestational diabetes, on the other hand, is something else. It only occurs during pregnancy and usually disappears afterwards.
What are typical symptoms of diabetes type 1?
The noticeable symptoms of type 1 diabetes usually appear abruptly. However, this does not mean that the autoimmune disease, which is usually diagnosed in childhood or adolescence, only appears when there is. Rather, by then it has more or less quietly begun its destructive work in the body.
Acute signs of diabetes only occur when so many insulin cells have died that the blood sugar level becomes very high. Then diabetes type 1 makes itself felt, for example, in the form of great thirst, dry skin and fatigue noticeable – or sufferers constantly have to go to the toilet. It is important to know these diabetes type 1 symptoms and, if in doubt, to interpret them correctly, because if the disease is left untreated, it can cause serious consequential damage to the bloodstream, nerves and various organs, and lead to unconsciousness and even death.
A doctor should be consulted immediately if you or your child notice one or more of the typical symptoms of diabetes type 1.
Type 1 diabetes: symptoms caused by elevated blood glucose levels
In type 1 diabetes, the body's own immune system destroys the cells of the pancreas that produce insulin. Because this hormone can now no longer do its job of distributing dietary sugar to the cells, blood glucose levels rise. There are Hyperglycemia, also known as high blood sugar in medicine called. This can cause a variety of symptoms:
excessive thirst: it occurs when the sugar in the blood mixes with water and withdraws it from the body
frequent urination: this phenomenon, also known as polyuria in technical jargon, occurs because above a certain concentration, the kidneys begin to filter sugar from the blood and excrete it through the urine
fatigue: since the sugar does not reach the cells, those affected lack energy. You feel listless and tired
visual disturbances: Fluctuating blood glucose levels can cause the lens in the eye to swell up. This is how visual acuity changes. Refractive power of the eye. The visual disturbances usually subside after a few hours
dry, itchy skin: Is caused by high fluid loss, but stress hormones could also be partly to blame. Namely, the adrenal gland secretes adrenaline and cortisol when blood glucose levels fall out of normal range (3.3-5.5 mmol/l before eating; 5-7.8 mmol/l after eating). Changes in the blood vessel walls can also be the cause of dry skin and itching
Weight loss: if the scale suddenly shows less, this may be due to fluid loss. In type 1 diabetes, however, it is more common for the body to use fat deposits to produce energy, since sugar is no longer available for this purpose
Halitosis: acetone is formed when fat is metabolized. This is noticeable in breath that smells like rotten fruit or nail polish remover
A hypoglycemia, also known medically as hypoglycemia occurs when the blood sugar level drops sharply. This happens when the insulin concentration in the blood was previously too high, for example when
– insulin or other antidiabetic drugs are dosed too high – meals are skipped or too few carbohydrates are consumed – the patient has exerted himself physically – alcohol is drunk – the patient vomits or has diarrhea
hypoglycemia manifests itself in paleness, sweating, shakiness (soft knees), ravenous appetite, and even palpitations and feelings of anxiety. If you notice these symptoms in yourself or your child, glucose or an injection (glucogen) can help to raise blood sugar levels again.
Caution: if blood sugar levels drop, the brain no longer gets enough energy. Even after a comparatively short time, the nervous system can suffer damage as a result. Severe hypoglycemia can lead to impaired consciousness, unconsciousness, coma and even death.
Alarm signs before a diabetic coma
Since fatty acid metabolism is also disturbed in diabetes, the acidity of the blood can increase. If it becomes overacidic (acidosis), this can cause diabetic coma. In diabetics with type 1 disease, this is also called dialectical ketoacidosis. It can be life-threatening! This makes it all the more important to recognize the signs, for example:
Type 1 diabetes: symptoms affecting nerves, blood vessels and organs
If blood glucose levels are not well controlled, or if type 1 diabetes is left untreated, it can affect the nervous system and blood vessels, and thus a wide variety of body parts and functions.
nerves: Both the nerves that control the muscles (motor nervous system) and those responsible for sensation (sensitive nervous system) and the organs can be affected. Accordingly, those affected have problems coordinating their movements, for example, or have an altered sense of pain.
Blood vessels: if blood glucose levels are too high, the risk of "calcifications" on the inner walls of the blood vessels (arteriosclerosis) increases. These damages and bottlenecks can lead to circulatory disturbances up to heart attack or stroke and leave some organs undersupplied, for example:
the eyes: a high blood glucose level damages the small vessels in the retina. Those affected then see flashes, blurred and/or colors only to a limited extent. In the worst case, the retina can detach, which can lead to visual field loss and even blindness. tie there. Damage to. As a result of this so-called diabetic nephropathy, the kidneys filter the blood more poorly (renal insufficiency) and may fail completely.
the feet: "About 30 percent of all diabetics develop nerve disorders, which usually first show up in the feet," says prof. Dr. Dr. Hans-Georg Joost, Scientific Director of the German Institute of Human Nutrition (DifE). The so-called diabetic foot causes chronic wounds that heal poorly. The fact that the feet in particular and the skin in general are more susceptible to infections and that wound healing is impaired is due to minor damage to the skin vessels.
However, if the symptoms of type 1 diabetes are recognized in good time and appropriate therapy is initiated, the chances are good that these secondary diseases will not occur, or at least not very pronouncedly.
What is the therapy for type 1 diabetes??
Insulin is mandatory in the treatment of type 1 diabetes. Unlike type 2 diabetes, this form of diabetes destroys the insulin-producing cells. In recent years, type 1 diabetes therapy has developed considerably, especially technical aids such as blood glucose meters and pumps and pens for insulin administration. Accordingly, it is easier for those affected to control this disease at home and on the road without constant medical support, so that a life (almost) without restrictions is possible.
The standard treatment for type 1 diabetes is the so-called Intensified conventional insulin therapy (ICT) and insulin pump therapy. According to the German Diabetes Aid, around 10 people in Germany suffer from diabetes.000 children and adolescents with an insulin pump. However, at around 95 percent, the insulin pen is the most common method of insulin administration. Type 1 diabetes cannot be prevented. There is also no cure. However, keeping it in check in such a way that the quality of life is preserved. Patients with type 1 diabetes usually manage their therapy independently in everyday life. Children often get a little help from their parents. Patients usually learn what they need to know about self-treatment in special courses. Conventional therapy for type 1 diabetes usually consists of three components:
1. Controlling blood glucose levels 2. Insulin injection 3. Calculate dietary carbohydrates
1. control blood glucose levels
This is necessary to calculate the amount of insulin required. The blood glucose level is checked especially before meals, but also before sports, bedtime, in the event of illness or when the first signs of hypoglycemia appear (e.g., when the blood glucose level is too high). B. tremors, weak knees, pallor) may occur. The blood glucose level is determined by pricking a finger with a lancet and extracting a drop of blood from it, which is then used by a special measuring device to determine and display the current value.
Flash glucose monitoring (FGM) is a relatively new alternative. In this case, the patient wears a device directly on the body that continuously measures the sugar in the tie by means of a sensor. With Continuous Glucose Monitoring (CGM), diabetics also wear a sensor on their body, but this automatically warns them if their blood glucose falls outside the desired range. Some health insurance companies already cover the costs.
2. Inject insulin
Because the body can no longer produce its own insulin in type 1 diabetics, it must be administered externally. This is done by means of a device that looks like a fountain pen and is therefore called a "pen", or by means of an insulin pump that is worn on the body and constantly delivers small amounts of insulin.
“Diabetics don't have to follow a strict diet plan, but healthy eating is important,” says Prof. Dr. Dr. Hans-Georg Joost, Scientific Director of the German Institute of Human Nutrition (DIfE). This means that those affected do not have to give up any food – not even sugar – nor are special diabetic products necessary. Basically, the same dietary recommendations apply to diabetics as to healthy people, except that the former have to coordinate their insulin therapy with their meals. Above all, you must keep an eye on the carbohydrates, because they have the greatest effect on blood glucose levels.
People with type 1 diabetes cannot achieve an improvement in the disease through the diet, however, but they need to calculate the carbohydrate content of their food in order to know how much insulin they need to correct it. The carbohydrates contained in food are indicated in the diabetes therapy of with “bread unit (BE)” or “carbohydrate unit (KE)”. One BE is twelve grams of carbohydrates, one KE is ten.
Therapy through exercise?
In contrast to type 2 diabetes, exercise cannot improve the values in type 1 diabetes. However, exercise can help to reduce stress and cope better with everyday life. In addition, physical activity makes the muscles respond better to insulin. Talk to your doctor beforehand to adjust your therapy accordingly to physical activity.
What the doctor does
After the doctor has diagnosed diabetes, the patient is usually hospitalized for a few days, where it is determined which insulins, insulin amounts and which form of administration is best suited to the individual case. Therapy goals such as “keeping blood glucose levels within the normal range,” “achieving or maintaining a normal body weight,” “eating a diet appropriate for diabetes,” and “preventing secondary and concomitant diseases” are also set and reviewed at regular checkups.
Sometimes the doctor also intervenes surgically. Especially in younger diabetics with advanced kidney weakness, in rare cases the pancreas is transplanted. If the treatment is successful, diabetics can then live a largely normal life without having to inject themselves with insulin. However, they must take medication for life that dampens the immune system to prevent the body from rejecting the transplanted organ.
Basically, affected persons must first get used to a life in which they must eat (carbohydrate) more consciously and plan more foresightedly. Even an insulin pump is often initially perceived as a foreign body. Nevertheless, modern therapy methods allow a largely unrestricted life, even with diabetes type 1.