BENGALURU: Type 1 diabetes usually starts in childhood, but can occur in adults (30 to 40-year-olds). In this type of diabetes, the pancreas produces very little insulin. When the pancreas cannot make enough insulin, sugar starts to build up in the blood. Individuals with type 1 diabetes must take some form of insulin for the rest of their lives.
When the body’s immune system destroys beta cells in pancreas, type 1 diabetes develops. Beta cells produce insulin. Researchers are not sure why a person’s immune system attacks its own insulin producing cells. Although type1 diabetes can develop at any age, about two-thirds are diagnosed in individuals under the age of 19 in early childhood and at puberty. Male and female are equally affected.
Insulin as Treatment
Every person with type 1 diabetes needs to take insulin to help their body process sugar in the blood. Most take insulin in the injectable form and may require several shots per day. Insulin is a hormone from the pancreas that allows sugar to enter the cells. Insulin also lowers the amount of sugar in the bloodstream. Without insulin, sugar is unable to enter the cells. This means that cells that make up muscles and other tissues will not be able to receive their main source of energy.
There are different types of insulins available. Rapid-acting insulin starts to work within a few minutes and lasts for a couple of hours. Regular or short-acting insulin takes about 30 minutes to work and lasts 3-6 hours. Intermediate-acting insulin takes 2-4 hours to work and lasts up to 18 hours. Long-acting insulin can work for an entire day.
Side effects of insulin must be watched-out. Insulin is bound to cause low blood sugar, headache, flu-like symptoms, weight gain when you first start using insulin, lumps, scars, or rash at injection site and shock.Although insulin is a wonderful drug that helps people with diabetes, it needs to be used carefully. If a person takes too much insulin it is possible the blood sugar level will lower into dangerous levels. This situation is termed an insulin reaction (low blood sugar due to excessive insulin) severe hypoglycemia.
Low Blood Sugar
Some signs and symptoms of low blood sugar include fatigue, excessive yawning, mild confusion, decreased coordination, sweating, muscle twitching, and pale skin. As these symptoms get progressively worse, seizures, loss of consciousness and even death may occur.
People with type 1 diabetes, are advised to carry about 15 grams of a source of instantly available sugar, glucose biscuits, juices. These carbohydrates may resolve mild to moderate insulin reactions. For severe reactions, a drug called glucagon should be injected under the skin by a family doctor.
Type 1 and Pregnancy
Planning ahead, even before conception, to control blood sugar levels can lower the risk of miscarriage and birth defects.During pregnancy, keep your A1c below 7 per cent. Preeclampsia is a condition that 18-30 per cent of pregnant women with diabetes develop after the 20-week mark and is characterized by high blood pressure and proteins in the urine. if untreated it may harm the baby and put the mother at risk for stroke and seizures. While mother is breastfeeding, it is important for her to check her glucose levels frequently.
Artificial Pancreas
This device is a combination of an insulin pump and continuous glucose monitoring system controlled by a computer program. Some early trials have shown promising results.Pancreatic Islet Cell Transplant: Although there are benefits to pancreas transplantation, there are also drawbacks including medications with serious side effects that must be used to prevent rejection of the donor cells, and the probability that the transplanted cells may only function for a few years.About 20,000 children are diagnosed with type 1 diabetes each year and is a life-changing situation. it affects the whole family. Parents must help children monitor blood sugar and plan meals. Insulin dosages must be monitored and blood sugar levels need to be checked often. Diabetes in children is a 24-hour-a-day problem, when a child is attending school and participating in extracurricular activities. Parents and their children need to make arrangements to follow through with insulin treatments even while the child is at school.
Symptoms
Unusual thirst
Weight loss and an increase in appetite as the body metabolizes fat for energy. Disrupted glucose metabolism causes lack of energy and drowsiness for extended periods.
Higher risk for bacterial infections and fungal infections. Common fungal infections include athlete’s foot, vaginal yeast infection in women, jock itch, ringworm, and diaper rashes in babies.
Dangerous signs and symptoms such as blurry vision, numbness or tingling in the extremities (especially the feet), loss of consciousness, fatigue, fruity breath, dry mouth, and diabetic coma.
Ketoacidosis . The body cells start burning fat for energy, which causes ketones to build up in the blood. These acids can change the person’s blood pH level and can trigger a life-threatening coma. This is termed diabetic ketoacidosis and is a medical emergency.
(The author is a former Director Sri Jayadeva Institute of Cardiology, former VC Bangalore University and former Chairman Karnataka State Health Commission)