Diabetes mellitus type 1Diabetes mellitus type 1 is a disease of the blood sugar metabolism Disease of the sugar metabolism. It is also called insulin-dependent diabetes mellitus. In this case Autoimmune disease. This means that the body's own defense system, for reasons that are still unclear, is directed against the insulin-producing cells of the pancreas and destroys them. This affects the production of insulin. In the course of time, it then comes to the complete Loss of insulin production. Mostly this form of diabetes occurs in children or younger people, but it can also occur at any other time, i.e. also in older people. In Germany, there are an estimated 350.000 people with type 1 diabetes.
Diabetes mellitus type 1 cases in Germany
50.979 cases in 2019
51.797 cases in 2022 ( prognosis )
Symptoms of diabetes mellitus type 1
When about 80% of the insulin-producing cells of the pancreas are destroyed, the insulin that is still present is no longer sufficient to metabolize sugar adequately. Within days to weeks, the typical symptoms of type 1 diabetes appear:
– unquenchable thirst – heavy urine production – weight loss – fatigue – frequent infections
With increasing metabolic derailment, coma can occur. Acetone odor in the breath can also indicate type I diabetes.
Causes and risk factors
Many possible causes for the development of the disease have been discussed so far – including genetic, environmental and nutritional factors. However, a great deal is still unclear here. Intensive subject of research.
How does insulin deficiency cause elevated blood glucose levels in the blood?
Insulin is a messenger substance that is produced by the beta cells in the pancreas and released into the bloodstream. Insulin plays a role in Regulation of blood glucose a prominent role. It is the body's only hormone that lowers blood glucose levels.
Insulin controls carbohydrate metabolism in a very complex way. Among other things, it allows sugar to be absorbed from the blood into muscle and fat tie after food intake. Furthermore, insulin inhibits the production of sugar by the liver, for example.
Various hormones in the body counteract the effects of insulin on carbohydrate metabolism. These include glucagon, which is also produced in the pancreas, the stress hormones adrenaline and hydrocortisone, and growth hormone. This ensures an adequate supply of sugar to the organs as fuel in situations where there is an increased demand for energy (z. B. stress, sports, fever) ensures an adequate supply of sugar as fuel for the organs. If this fine interplay of hormones is disrupted by a Failure of insulin production out of balance, this leads to a drastic increase in the blood glucose level. In this case, the disease is referred to as diabetes mellitus – diabetes.
How to detect diabetes mellitus?
Specialists in the treatment of diabetes are specialists in the field of diabetology. The diagnosis of diabetes mellitus can be made unequivocally on the basis of clearly elevated Fasting blood glucose levels (in case of repeated measurement). Even one Significantly increased HbA1c level, which expresses the long-term glucose level in the blood, can be an expression of diabetes mellitus. Likewise, a sugar load test (oral glucose tolerance test) can be performed to diagnose diabetes mellitus. Here, the course of the blood glucose level in the blood is measured after drinking a standardized sugar solution.
Due to the relatively rapid manifestation of the disease, type 1 diabetics are usually conspicuous by their highly elevated blood glucose levels. Patients often already have pronounced symptoms that point to the disease. In addition to the elevated blood glucose level, type 1 diabetics also very frequently have specific Autoimmune marker in the blood, Furthermore, low insulin levels in relation to blood glucose or. insulin cleavage products (so-called. C-peptide). This makes it possible to distinguish this disease from other forms of diabetes, which is important for therapy.
Treatment of type 1 diabetes mellitus
The short-term treatment goal in type 1 diabetes is to prevent metabolic derailments and relieve associated symptoms. This means that both sharp increases in blood glucose levels and "hypoglycemia" should be avoided. As there is an absolute insulin deficiency in type 1 diabetes, the treatment is carried out by the administration of insulin, which must be administered to the patient for life.
This is usually done by injections or occasionally by an insulin pump. In addition, in individual cases, other procedures are also used for insulin therapy (z. B. islet cell transplantation) is used.
Furthermore, experimental therapy methods ("artificial islet cell organ") are being developed.
The long-term goal of insulin therapy is to prevent secondary diseases (damage to eyes, feet, kidneys, blood vessels, and nerves) of diabetes mellitus. For patients with type 1 diabetes, diet plays a role in that the amount and time of insulin injected must be adjusted to the food eaten. Proper and conscious nutrition is therefore a lifelong component of diabetes therapy. For this reason, the diet should be varied and tasty so that it is followed consistently.
Islet cell transplantation
Islet transplantation is a form of therapy for the "natural" treatment of cancer Replacement of insulin production in diabetics, by transferring isolated insulin-producing cells ("islets") from a donor organ.
Who is eligible?
Patients with an absolute insulin deficiency (predominantly type 1 diabetics) who cannot be adequately treated with insulin doses or an insulin pump and who suffer from frequent and severe derailments, in particular hypoglycemic episodes.
How does islet isolation and transplantation work??
The islets are isolated from a donor organ through a complex digestion process and then purified. The islets, which are tested according to strict criteria (purity, sterility, function), are injected into the patient's liver via the hepatic vein, where they settle and start producing insulin.
What happens after transplantation?
The immune system of the recipient recognizes the transplanted cells as "foreign. This would normally result in rejection of the transplant. To prevent this, islet recipient immunosuppressive drugs take. The most important therapeutic goal of islet cell transplantation is to regain basal endogenous insulin production, which can stabilize glucose metabolism. In some cases, it is even possible to remain insulin-independent for several years.