Type I Diabetes: Pathogenesis and Treatment

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Table of Contents

Definition
Pathogenesis of type 1 diabetes
Clinical manifestations
Laboratory diagnosis
Latest treatments
Prevention and prognosis of the disease
Works Cited

Definition

Type1 diabetes occurs when the bodys own immune system destroys the insulin-producing beta cells found in the pancreas (National Institute of Diabetes and Digestive and Kidney Diseases). In such cases, the bodys immune system reverses its action on attacking various cells within the body, instead of fighting against disease causing pathogens. This makes it difficult for the transfer of sugar into the cells of those suffering from type 1 diabetes due to absence of insulin.

Such scenario causes severe build-up of sugar within the blood stream, hence making the body cells deprived of nutrients, which leads to weakening of other bodily functions due to lack of nutrients. However, there is need for through understanding of the immune-detailed process, resulting in type 1 diabetes before application of any kind of therapy. Such processes involve accurate identification of the children suffering from the disease (American Diabetes Association).

Pathogenesis of type 1 diabetes

Causes of type 1 diabetes can be linked to human leukocyte antigen (HLA), capable of contributing to favorable conditions for the disease development within the body. However, genotypes which combine the two susceptibility haplotypes DR4-DQ8 and DR3-DQ2 are identified to be at the greatest risk of contracting type 1 diabetes.

The haplotypes are prevalent among children under the age of 10. At the same time, those who are close to affected children are at high risk of contracting type 1 diabetes based on genetically motivated make-up. Besides such presence of insulin genes in the body, chromosomes can also contribute to the disease. The diseases susceptibility is associated with shorter forms of variable number tandem repeated within the insulin promoter which is contrary to longer forms capable of natural protection (Shulman and Daneman 680).

Issues related to increased expression of mRNA within the thymus of those identified to have longer protective repeats present one of the most potential mechanisms required in type 1 diabetes. Studies have identified over ten loci, related to the disease, in which the genes associated with activation of T-cell have been identified (National Institute of Diabetes and Digestive and Kidney Diseases).

Studies on genetics have defined crucial reasons behind large and well-characterized populations in the process of identifying susceptibility genes for type 1 diabetes. Some genes are known to have less impact on the susceptibility of the disease and used in providing clues for future preventive measures.

Vitamin D and intercellular adhesion molecule gene are utilized for the purposes of providing body protection against the disease. Children diagnosed with rickets at the early stages of life are identified to have high risks of contracting type 1 diabetes at the later stages of their life (National Institute of Diabetes and Digestive and Kidney Diseases).

Type 1 diabetes is the most prevalent disease in young children. This form is considered to appear as a result of environmental changes children are subjected to at early stages of life. The process seems too rapid to be associated with genetic alterations. The cause is further explained by the concomitant widening on the HLA risk profile caused by increased environmental pressures on susceptible genotypes (National Institute of Diabetes and Digestive and Kidney Diseases).

These are caused by disease causing pathogens, specifically identified as rubella. Young children under the attack of congenital rubella are considered to have high chances of contracting type 1 diabetes. Exposing children to dirty environment full of microbes and pathogen leads to innate immune responses containing some allergic reactions to the disease casing organisms (National Institute of Diabetes and Digestive and Kidney Diseases).

Clinical manifestations

Type 1 diabetes takes longer time to manifest due to the fact that the process of destroying insulin-producing beta cells is always long and insidious. This leads to accumulation of insulin production leading to sudden appearance of type 1 diabetes. However, warning signs of type 1 diabetes seem numerous.

These include frequency in urination among children, uncontrolled thirst for sweet things, including cold drinks, dire weakness of the body tissues and muscles also leading to extreme fatigue, blurred vision and frequent cases of irritability and acute symptoms involving nausea and vomiting. In some cases, it is possible to identify some other warning symptom, such as deep and rapid breathing, experiences of dry skin and mouth, frequent stomach pains and flush looking face (National Institute of Diabetes and Digestive and Kidney Diseases).

Laboratory diagnosis

Type 1 diabetes is rarely diagnosed, especially among young adults. According to research, the disease increases its presence from birth to adolescence between age eleven and twelve. The disease is at times linked to heredity though some patients normally have no disease family history.

Patients medical history is a requirement of the diagnosis process alongside clinical features (American Diabetes Association). Such clinical features include examination of urine for glucose levels, checking of blood pressure, thorough examination of certain body parts, especially the feet, etc. Foot sores are at times ignored owing to senselessness within the feet nerves.

Detailed analysis of the blood is required to establish the level of glucose in patients blood. However, glucose tolerance tests which are normally performed involve taking lots of water with 75 grams of glucose, and then blood is tested two hours after the dose has been taken.

In such a case, impaired glucose tolerance is indicated with levels ranging from 140mg/dL to 200mg/dL (American Diabetes Association). Diagnosis is done through laboratory testing by undertaking such processes as suppressing blood glucose level. The performance of random blood glucose level is carried out to detect levels higher than 200 mg/dL and accompanied by increased thirst, fatigue and frequent urination.

Another test used is referred to as oral glucose tolerance test and hemoglobin A1C test. Levels of hemoglobin which are less than 5.7% are normal, while those between 5.7% and 6.4% indicate signs of pre-diabetes where any level higher than 6.4% identifies presence of diabetes (American Diabetes Association).

Latest treatments

Those diagnosed with type 1 diabetes should adopt the habit of taking insulin on a daily basis. This is since insulin has the capability of lowering blood sugar level by making it possible for sugar to leave bloodstream and enter into cells. Insulin is injected under the skin since the doses are not available in pill form.

Health care providers normally give patients the necessary prescriptions on the type of insulin as well as the timing the dose is to be taken. The differences occur depending on speed of action and length of time the injection lasts in the body. However, there are cases when mixture of insulin is used for the purposes of obtaining the best blood glucose control. Injections should be administered from two to four times daily.

Basically, child injections require parental assistance unless the child is over 14 years old (Levitsky and Misra n.pag.). Those suffering from type 1 diabetes are advised to take meals about the same time daily, with the meal comprising almost the same kinds of foods. Undertaking regular exercises assists in controlling blood sugar level and also burning extra calories and fat within the body.

Prevention and prognosis of the disease

There are still no clear prevention measures against type 1 diabetes. However, the ongoing research provides clear perspectives on the direction toward therapeutic interventions required for the solutions. Physicians can apply various preventive measures as prescribed through proven research works, such as initiation of auto-immunity and making some adjustments on beta cell regeneration.

Other possible prevention measures involve identification and elimination of environmental risk factors surrounding children. There is also possibility of re-educating childrens immune system by exposing them to the so-called beta-cell antigens which are taken orally (National Institute of Diabetes and Digestive and Kidney Diseases).

Tolerance can as well be induced through insulin since it provides the required auto-antigen therapy. The immune system can also be regulated by the use of T-cells within the field of beta cell differentiation. As explained, objective regeneration of beta cells may provide other preventive strategy against type 1 diabetes which includes detailed distinction of pancreatic and non-pancreatic components.

The prognosis of type 1 diabetes focuses on the likely outcome of the disease. These comprise duration, complications of type 1 disease and the probable outcome. Proper medical attention ensures appropriate control of the disease. However, the disease may result in some complications, such as kidney disorders, eye infections and problems with the nerve fibers and circulatory system (American Diabetes Association).

Works Cited

American Diabetes Association. Standards of medical care in diabetes.Diabetes Care, 34(2011):S11-S61. Print.

Levitsky, Lynne L and Madhusmita Misra. Management of type 1 diabetes mellitus in children and adolescents. 2011. Web.

National Institute of Diabetes and Digestive and Kidney Disease. Your guide to Diabetes: Type 1and type 2. 2010. Web.

Shulman, RM and D Daneman. Type 1 diabetes mellitus in childhood.Medicine,38 (2010):679-685. Print.

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