Type 1 Diabetes is a chronic non-communicable illness in which there is a deficiency in insulin resulting from an autoimmune destruction of insulin producing cells (beta cells) in the pancreas. In the absence of insulin cells do not utilize glucose (sugar) which results in a build up of glucose in blood and subsequently major metabolic derangements. Type 1 Diabetes used to be called Juvenile onset because of its onset in childhood, however it is not uncommon to be diagnosed with this form of Diabetes in adulthood.
Symptoms
Type 1 Diabetes can present in several different ways:
Weight loss
Polyuria (passing a lot urine) – this happens because of high sugar being excreted by the kidneys accompanied by loads of water.
Polydipsia (drinking a lot of water) – also due to water loss from the kidneys leading to dehydration and increased thirst.
Diabetic Ketoacidosis – high levels of sugar with acid build up, mainly due to built up of ketones (as an alternative source of energy) in the absence of insulin, which normally prevents ketone formation.
Incidental discovery of high blood sugar on blood work (with no symptoms).
Diagnosis Of Type 1 Diabetes Mellitus
Using the American Diabetes Association (ADA) diagnostic criteria, one of the following has to be met and, in the absence of unequivocal hyperglycemia, repeated to confirm the results:
Fasting plasma glucose of 126mg/dL (7.0mMol/L) or higher, or
A 2-hr plasma glucose of 200mg/dL (11.1mMol/L) or higher after a 75-mg oral glucose tolerance test (OGTT), or
A random plasma glucose of 200mg/dL (11.1mMol/L) or higher with classic symptoms of hyperglycemia or hyperglycemic crisis, or
Hemoglobin A1c of 6.5% or higher performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay.
Criteria for Pre-diabetes (at risk of Diabetes) include:
A1c of 5.7-6.4%
Fasting plasma glucose of 100 to 125mg/dL (5.6 to 6.9mMol/L) – impaired Fasting plasma glucose (IFG)
A 2-hr plasma glucose of 140-199mg/dL (7.8 to 11.0mMol/L) – impaired glucose tolerance (IGT)
Treatment
Treatment of Type 1 Diabetes is insulin, either with long and short acting insulin or an insulin pump, which has received a wide use over the last decade. Success in managing type 1 diabetes is accomplished by the following measures:
Proper administration of insulin (both long and short acting insulin)
Dietary modification and planning
Monitoring blood sugar daily (usually 3-4 times a day)
Lifestyle modification – exercise to maintain ideal body weight
