Islets of Hope for persons with type 1 diabetes
Article by Lahle Wolfe, Founder, Islets of Hope.
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Diabetic Retinopathy: 24% of type 1 diabetics will develop retinopathy after 5 years, almost 60% after 10 years and 100% after 20 years. But research funded by JDRF at Melbourne's St Vincent's Hospital led by Prof. Richard Gilbert has found a new treatment that appears to be effective against diabetic retinopathy, macular edema and neuropathy - three typical complications of type 1 diabetes. Support JDRF
Even with a genetic predisposition for develop- ing diabetes most people still do not get it. This is why researchers focus on what environmental triggers contribute to the onset of diabetes in people. More people are diagnosed with type 1 diabetes during winter months as well as in colder climates in general, so cold weather is a suspected environmental trigger. Another trigger seems to be a virus, and diabetes is less common in breast-fed infants than those who started solid food at an early age.
People with diabetes often test positive (even years before onset) for a certain kind of autoanti- body. Antibodies are normally good; a protein that attack and destroy bacteria and viruses that invade the body. But in diabetes autoantibodies (“auto” meaning self) mistake healthy cells for bad ones and these autoantibodies attack and destroy the insulin producing beta cells in the pancreas.
There are genetic tests that can be conducted to help predict your child’s odds of developing type 1. Most Caucasians with type 1 have either HLA-DR3 or HLA-DR4 genes. If you and your child are Caucasian and share these genes, your child has greater risk of developing type 1 diabetes.
Important Medical Disclaimer
All material found on this site is intended for general informational purposes only. This site should not be used for self- diagnosis or as a substitute for professional medical care. IOH recommends that you seek the advice of a competent health professional for diagnosis and treatment options, or before making any changes to your current diabetes care plan.
Type 1 Diabetes - Section 1
What is Type 1 Diabetes?
There is more than one form of type 1 diabetes and each can develop for different reasons. Type 1 diabetes can result from hereditary deficiencies in the beta-cells of the pancreas (maturity onset diabetes of the young, or MODY), damage to the pancreas from trauma or drugs, another illness like hemochromatosis (iron overload) or cystic fibrosis that damages the pancreas, or will result when the pancreas is surgically removed.
The most commonly diagnosed form of type 1 diabetes is juvenile diabetes, or, insulin-dependent diabetes. People with juvenile type 1 diabetes have an inherited genetic predisposition towards developing diabetes (the genes are different for type 1 and type 2 but both have a genetic aspect involved). Many people have these genes but will never develop the disease. For those that do become diabetic, something triggers the body to attack and destroy the insulin producing beta cells in the pancreas.
Triggers for type 1 diabetes are thought in include certain viruses (including rotaviruses), chemical, or some other environmental factor. Visit our general diabetes information page for causes of diabetes, genetic transmission rates of diabetes for type 1 and type 2 diabetes, and other diseases and disorders that are associated with diabetes.
Other diseases that affect persons with diabetes at a higher rate than in the general population include Addison's Disease, Hashimoto’s Thyroiditis. celiac disease (sprue, or gluten intolerance), and polycystic ovarian syndrome. Anyone diagnosed with type 1 diabetes should also be tested for these.
Juvenile type 1 diabetes is an autoimmune disease. An autoimmune disease is when the body attacks and destroys good cells and tissues mistaking them as foreign intruders. With type 1 diabetes the insulin-producing beta cells in the pancreas are slowly destroyed and eventually they fail to produce insulin. When this happens a person will need to take insulin to live.
Other Names for Juvenile Type 1 Diabetes
Other names (most of which are considered outdated) include childhood diabetes, insulin-dependent diabetes mellitus (IDDM) (diabetes mellitus is a group of autoimmune metabolic disorders all of which include hyperglycemia), and ketone prone diabetes. It is important to note that type 1 diabetes and type 2 diabetes are not the same thing, however, some people can have both types, and people with type 2 can eventually become type 1 diabetic.
All type 1 diabetics must take insulin to live while only some type 2 diabetics require insulin. Type 1 onset is usually fast, over days or weeks, and although most often diagnosed in children can occur at anytime in life even in adulthood.
Subtypes of Type 1 Diabetes
Type 1 diabetes has several subtypes, including type 1A diabetes, type 1B (idiopathic diabetes), and latent autoimmune diabetes of adulthood (LADA). LADA may be initially misdiagnosed as type 2 diabetes because onset is usually much slower than in juvenile diabetes and diagnosis of LADA is most likely to be after age 25.
Maturity Onset Diabetes of the Young (MODY), another form of type 1 is not the same as juvenile type 1 diabetes, but is treated the same way (with blood glucose monitoring and insulin). Persons with MODY may require only very small amounts of insulin because their pancreas may still produce some insulin. It can be misdiagnosed as juvenile diabetes because it is so similar and usually occurs prior to age 25. Persons with MODY often test negative for thyroid antibodies and may have polycystic kidneys as part of the disease. There is more than one type of MODY and specific treatment varies.
Diagnostic Criteria for Type 1 Diabetes
A person with two fasting plasma glucose levels of 126 mg per dL (7.0 mmol per L) or greater is considered to have diabetes mellitus. Some doctors may use a postprandial (after eating) test instead where blood glucose is measured 2 hours after 75 g of glucose is given. Any 2-hour postprandial reading over 200 is considered diabetic. And any two casual readings of 200 mg/dL or higher is also considered diabetic.
The fasting glucose tolerance test is generally preferred for diagnosis, however, any two abnormal tests are sufficient to classify a person as diabetic. Additionally:
What is considered normal blood glucose range?
What if you are not in the normal range, but not in the diabetic range?
Blood glucose levels higher than normal, but lower than diabetic ranges, classify a person as having impaired glucose homeostasis, specifically as follows:
Both IFG and IGT are associated with an increase risk in developing type 2 diabetes and lifestyle changes, including weight loss and an exercise program, as well as possible oral medications such as Glucophage are sometimes indicated.
Persons with diabetes need to check their blood sugar no less than four times each day. The IOH is a strong advocate of tight diabetes control, especially with type 1, and believes that more frequent testing is necessary to help improve the odds of a healthier long-term outcome. Uncontrolled diabetes presents serious issues.
Daily Concerns With Type 1 Diabetes
Type 1 diabetes must be managed on a daily basis. This includes monitoring blood glucose frequently, following a healthy lifestyle and food plan, testing urine for ketones, and most importantly, thinking long term. How you manage your diabetes on a daily basis will have tremendous impact on health years down the road.
Daily concerns of type 1 diabetes include watching for, and dealing with, hypoglycemia (low blood glucose), and hyperglycemia. Both can present dangerous situations immediately, on unchecked, can also present possibility of long-term complications as well.
Hypoglycemia (think "O" is in too low) is when blood glucose becomes too low to be healthy or safe. Your doctor should help you determine what constitutes a mild versus a severe low. In children, a critical low may be set at 60 or 70 mg/dl, an adult might not be considered critical until a low of 50 mg/dl.
What is considered low varies between individuals as well as time of day, when insulin was last administered, and level of activity. Medically speaking, a reading of 40 mg/dl or lower is always considered critical for anyone with diabetes. If blood glucose becomes too low a person becomes disoriented, may experience seizures, loss of consciousness, and even death.
See "Hypoglycemia" for symptoms, causes, treatment, and prevention of low blood glucose.
Hyperglycemia (think HIGH-per) is too much blood glucose in the blood stream. Over time, hyperglycemia can cause serious damage, cells, and organs resulting in diabetes complications. It can also lead to a state called diabetic ketoacidosis (DKA) that can results in coma or death.
See "Hyperglycemia" for symptoms, causes, treatment, and prevention of high blood glucose.
The picture above shows damage to the nerves in the eye from neuropathy caused
Long-Term Complications of Diabetes
Complications of diabetes are grim and include heart disease, blindness, high blood pressure, nerve damage, diabetic retinopathy (which can lead to blindness), amputation, and kidney failure. But it is possible to maintain tight control over diabetes and help reduce the risk of long-term complications. High blood glucose over time destroys nerves (neuropathy) and tissues (see image below). Blood glucose kept in good target ranges will help preserve organs, eyesight and improve longevity. To better understand why it is important to test your blood glucose often (read diabetes statistics).
Page Updated 02/23/2006