Diabetes mellitus of the first type develops as a result of damage to the insulin apparatus of the pancreas. The disease is considered hereditary, based on the autoimmune damage of its own tissues. The pancreas is exposed to an autoimmune attack, namely its beta cells responsible for the production of the hormone insulin.
Type 1 diabetes mellitus is more often detected in children and people of young age (up to 30 years), therefore it has another name – “juvenile diabetes”. In recent years, there has been a tendency to increase age limits – people over 30 and 40 years of age are falling ill.
Changes in the pancreas in type 1 diabetes
Today, doctors adhere to a genetic theory of the onset of diabetes mellitus of the first type. The disease manifests in genetically predisposed people under the influence of provoking factors — antibodies are being produced that are aimed at damaging the beta cells of the pancreas. These cells produce insulin, which is necessary for the processing of glucose. Due to the death of beta cells, insulin production ceases. In this type of diabetes, insulin deficiency is absolute, whereas in type 2 diabetes, it is relative.
The process of formation and manifestation of diabetes goes through several stages:
In the first stage, there is only a genetic predisposition, which is expressed in the defect of genes associated with type 1 diabetes.
In the second stage, there is a “launch” of the autoimmune process against beta cells by one of the initiating factors:
- heavy metals;
- some foods (soy, gluten-containing products, coffee, cow’s milk).
At this stage, damage to the cells of the insulin apparatus of the pancreas is asymptomatic. Only a blood test for autoantibodies can indicate this process. They can be detected long before the clinical manifestations of the disease (for 10-15 years), as well as at the initial stage of type 1 diabetes.The titer of autoantibodies can be judged on the degree of damage to beta cells.
In the third stage, the total number of beta cells decreases. When conducting a glucose tolerance test, tolerance is observed.
In the fourth stage, there is a violation of tolerance and an increase in the level of “sugar” in the blood on an empty stomach, but diabetes is not clinically manifested.
When a large number of beta cells die and insulin deficiency develops, diabetes begins to manifest itself with clinical symptoms. This is the fifth stage. It is believed that this moment comes when the pancreas loses about 80-90% of beta cells.
Symptoms of type 1 diabetes
The disease usually begins suddenly and has characteristic clinical diabetes symptoms Type 1:
- Frequent visits to the toilet “in a small way” (polyuria), which is facilitated by an increase in the osmotic pressure of urine due to the presence of glucose in the urine, which normally should not be there. Diabetes in children occurs with bedwetting.
- There is a strong thirst (polydipsia), due to the loss of a large amount of fluid in the urine, and with increased appetite there is a rapid weight loss;
- The patient is worried about dry mouth, pruritus, fatigue;
- Non-specific signs are frequent pustular skin diseases (boils, carbuncles).
But even these bright signs of diabetes are not always considered by the patient as a disease. The underestimation of the situation often occurs in children. Then the visit to the doctor is carried out already with the development of complications that are not long in coming. After a few weeks, ketoacidosis can develop – an increase in ketone bodies and glucose in the blood. Patient smells like acetone. The condition requires immediate hospitalization. If untreated, the condition may turn into a diabetic coma.
Diabetic coma is a consequence of hyperglycemia and the accumulation of ketone bodies, resulting in a lack of insulin, fasting of tissues, because glucose in the absence of it is not absorbed by many organs.
To fill the missing insulin, patients with type 1 diabetes have to get it from the outside. Insulin is administered in a dosage that is determined by the doctor for each patient individually. In the body, insulin is injected. With type 1 diabetes, insulin therapy is lifelong.
It is also necessary to follow a diet that excludes fast “carbohydrates”, it is useful to exercise.
Future forecast for diabetes in children and adults
Diabetes is dangerous development of complications. The most common cause of death in type 1 diabetes is vascular complications. This disease is characterized by damage to small-caliber vessels. First of all, it affects the kidneys – glomerulitis develops (inflammation of the renal glomeruli), which are later replaced by connective tissue. Formed chronic renal failure, which leads to death.
Damage to the vessels of the limbs and small vessels feeding the nerves leads to the development of a “diabetic foot”. The dying off of soft tissues in the area of the toes, the feet, followed by the addition of a secondary infection can cause dangerous purulent complications, such as gangrene, sepsis.
Diabetes in young children (up to 4 years) can be complicated by the rapid development of ketoacidosis and diabetic coma. This happens due to late diagnosis of the disease, neglect of therapy. Such complications can end sadly.
Life expectancy for diabetes in children and adults is determined by the timeliness of diagnosis, the correct selection of treatment, as well as self-control by the patient or parents of the patient (if it is a child). If the disease is diagnosed at an early stage, adequate therapy is selected, and the patient follows a diet, uses insulin according to a regimen and regularly monitors glucose levels, then the remissions can be very long. In this case, a person can lead a normal life, be employed.
Life expectancy is significantly reduced in persons who abuse alcohol and do not maintain control of “blood sugar”.
With the use of modern forms of insulin and the diversity of its uses, life expectancy has increased, and its quality has improved. Even 50 years ago, patients with diabetes mellitus type 1 lived 15 years less than today.