Theme: iWiki Log in Register

Diff: Type 1 Diabetes

Comparing revision #1 (2023-06-10 00:49:09) with revision #2 (2026-06-22 10:02:19).

Old	New
	'''Type 1 diabetes''' is a lifelong autoimmune condition in which the pancreas makes little or no insulin. Without enough insulin, glucose remains in the blood instead of moving into cells to be used for energy.

Type 1 diabetes, also known as insulin-dependent diabetes or juvenile diabetes, is a chronic autoimmune disorder characterized by the destruction of insulin-producing cells in the pancreas. It is a lifelong condition that requires daily management and the use of insulin to maintain blood glucose levels within a target range. Type 1 diabetes is distinct from type 2 diabetes, which is primarily characterized by insulin resistance.
	Type 1 diabetes is different from [[Type_2_Diabetes\|type 2 diabetes]]. Type 1 diabetes is mainly caused by immune destruction of insulin-producing beta cells, while type 2 diabetes is usually linked to insulin resistance and later loss of insulin production.

== Symptoms ==	== Symptoms ==
The symptoms of type 1 diabetes can develop rapidly and include:
	Symptoms can develop quickly, especially in children and young people. Common features include strong thirst, passing urine more often than usual, tiredness, unexplained weight loss, loss of muscle bulk, blurred vision and persistent infections such as thrush.

* Excessive Thirst (Polydipsia): Increased thirst and frequent urination due to high blood glucose levels.
* Extreme Hunger (Polyphagia): Increased appetite, even after eating, as the body is unable to properly use glucose for energy.
* Unintentional Weight Loss: Sudden and unexplained weight loss despite increased appetite.
* Fatigue and Weakness: Persistent fatigue and weakness due to insufficient glucose utilization.
* Blurred Vision: Blurred vision or changes in eyesight caused by high blood sugar levels.
* Slow Healing: Slow healing of cuts, bruises, or infections.
* Recurrent Infections: Increased susceptibility to infections, particularly yeast and urinary tract infections.
* Irritability and Mood Changes: Sudden mood swings, irritability, or changes in behavior.
	If insulin deficiency becomes severe, the body may break down fat and muscle for energy. This can lead to diabetic ketoacidosis, a dangerous emergency caused by high blood glucose, ketones and dehydration.

== Causes and Risk Factors ==
Type 1 diabetes occurs when the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. The exact cause is unknown, but several factors may contribute to its development:
	== Cause ==
	Type 1 diabetes is an autoimmune disease. The immune system attacks pancreatic beta cells, reducing or stopping insulin production. The exact trigger is not fully understood.

* Genetic Predisposition: Certain genes are associated with an increased risk of developing type 1 diabetes. However, having these genes alone is not sufficient to trigger the disease.
* Autoimmune Factors: Autoimmune reactions, triggered by environmental factors such as viruses or dietary components, may play a role in the destruction of pancreatic cells.
* Family History: Having a family member with type 1 diabetes increases the risk of developing the condition.
* Geographical Factors: Type 1 diabetes is more prevalent in certain regions or populations, suggesting potential environmental influences.
	Risk is affected by genetics and environment. Having a family member with type 1 diabetes increases risk, but many people diagnosed with the condition have no close relative with it.

== Diagnosis ==	== Diagnosis ==
Diagnosing type 1 diabetes involves several tests and assessments, including:
	Diagnosis usually involves blood and urine tests. Blood glucose testing shows whether glucose is raised. Urine testing can show glucose and ketones. HbA1c testing can show average blood glucose over the previous two to three months and is also used for long-term monitoring.

* Blood Tests: Measurement of blood glucose levels to determine if they are above normal range.
* Glycated Hemoglobin (HbA1c) Test: Assessment of average blood glucose levels over the past two to three months.
* Autoantibody Testing: Detection of specific autoantibodies associated with type 1 diabetes, such as glutamic acid decarboxylase (GAD) antibodies.
* C-peptide Test: Measurement of C-peptide levels, which indicates the body's ability to produce insulin.
	Clinicians may use antibody testing and C-peptide testing when the type of diabetes is unclear. Antibody tests can support an autoimmune diagnosis, while C-peptide helps assess how much insulin the body is still producing.

== Treatment ==	== Treatment ==
The management of type 1 diabetes focuses on maintaining blood glucose levels within a target range to prevent complications. Treatment options include:
	The main treatment is insulin. Insulin may be given by injection, pen, pump, or a hybrid closed-loop system that combines a pump, glucose sensor and algorithm. The aim is to keep blood glucose within an agreed target range while avoiding both high and low glucose.

* Insulin Therapy: Regular administration of insulin via injections or insulin pump to regulate blood sugar levels.
* Blood Glucose Monitoring: Regular monitoring of blood glucose levels using a glucose meter to guide insulin dosage adjustments and lifestyle modifications.
* Carbohydrate Counting: Careful monitoring and balancing of carbohydrate intake with insulin administration.
* Healthy Eating: Following a balanced diet rich in whole grains, fruits, vegetables, and lean proteins to manage blood sugar levels.
* Physical Activity: Regular exercise to improve insulin sensitivity and overall health.
* Continuous Glucose Monitoring (CGM): Use of CGM devices to monitor blood glucose levels continuously and detect trends or fluctuations.
* Diabetes Education and Support: Accessing diabetes education programs and support groups to learn self-management skills and receive emotional support.
	Management usually includes:

	* regular insulin
	* blood glucose testing or continuous glucose monitoring
	* carbohydrate counting
	* advice on food, exercise, alcohol, driving and illness
	* regular HbA1c checks and screening for complications
	* education and support from a specialist diabetes team

	People newly diagnosed with type 1 diabetes are usually taught how to adjust insulin, recognise hypoglycaemia and hyperglycaemia, and manage illness using sick-day rules.

== Complications ==	== Complications ==
Poorly controlled type 1 diabetes can lead to various acute and chronic complications, including:
	Short-term complications include [[Hypoglycaemia\|hypoglycaemia]], [[Hyperglycaemia\|hyperglycaemia]] and diabetic ketoacidosis. Long-term high glucose can damage blood vessels and nerves.

* [[Hypoglycemia]]: Low blood sugar levels resulting from excessive insulin or inadequate carbohydrate intake.
* [[Hyperglycemia]]: High blood sugar levels that, if untreated, can lead to diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS).
* Cardiovascular Disease: Increased risk of heart disease, including coronary artery disease, heart attacks, and strokes.
* Kidney Disease (Nephropathy): Kidney damage caused by prolonged high blood sugar levels.
* Nerve Damage (Neuropathy): Nerve damage leading to pain, tingling, or loss of sensation in the feet and hands.
* Eye Complications (Retinopathy): Damage to the blood vessels in the retina, potentially leading to vision problems or blindness.
* Foot Complications: Nerve damage and poor blood circulation in the feet, increasing the risk of infections and ulcers.
	Possible long-term complications include eye disease, kidney disease, nerve damage, foot ulcers, cardiovascular disease and sexual health problems. Good glucose management and regular screening reduce risk and help problems to be found earlier.

== Prognosis ==
Type 1 diabetes is a chronic condition that requires lifelong management. With proper treatment, blood glucose monitoring, and adherence to lifestyle modifications, individuals with type 1 diabetes can lead healthy and fulfilling lives. Regular medical care, including diabetes education and support, is crucial in preventing complications and optimizing long-term outcomes.
	== Living With Type 1 Diabetes ==
	Type 1 diabetes requires daily decisions, but many people live active lives with it. Modern care often combines insulin, glucose sensors, education, structured reviews and mental health support.

	The condition can be demanding because food, exercise, illness, stress, sleep and hormones can all affect glucose levels. Diabetes education is therefore a core part of care rather than an optional extra.

== See Also ==	== See Also ==
	* [[Diabetes_Mellitus]]
	* [[Hypoglycaemia]]
	* [[Hyperglycaemia]]
	* [[Autoimmune_Disorders]]

* [[Type 2 Diabetes]] - Explore a metabolic disorder characterized by insulin resistance and high blood sugar levels.
* [[Autoimmune Disorders]] - Learn about a group of conditions where the immune system mistakenly attacks healthy cells in the body.
	== References ==
	* [https://www.nhs.uk/conditions/type-1-diabetes/ NHS: Type 1 diabetes]
	* [https://www.nhs.uk/conditions/type-1-diabetes/treatment/ NHS: Treatment for type 1 diabetes]
	* [https://www.nhsinform.scot/illnesses-and-conditions/diabetes/type-1-diabetes/ NHS inform: Type 1 diabetes]
	* [https://www.diabetes.org.uk/about-diabetes/type-1-diabetes/treatments Diabetes UK: Type 1 diabetes treatments]

	[[Category:Medicine]]
	[[Category:Diabetes]]
	[[Category:Autoimmune Disorders]]