Monday, September 1, 2008

Type 1 Diabetes

Type 1 diabetes is a disease where the level of the blood glucose is above normal. This type usually occurs in children and young adults and was also referred to as Juvenile Diabetes until its official name was changed in 1997. Next to asthma, it is the second most common chronic disease affecting children. Every year, about 13,000 cases in America alone are being settled.

Causes

Carbohydrates in the food are being broken down to glucose (sugar). It enters the bloodstream up to the cells throughout the body. These cells need the pancreas to produce for them insulin, a hormone that helps in utilizing and converting blood glucose to energy. People diagnosed with Type 1 diabetes have bodies that are not able to convert glucose to energy.


Their pancreas barely produces insulin and/or that the cells in their liver, muscles and fat do not respond correctly to the hormone. When this happens, the glucose will not be able to enter the cells. Sensing that these cells are glucose-deficient, the brain signals the body to secrete more glucose from its other sources like fat, protein and glycogen. The brain and the nervous system use only glucose while other cells can use fat. Sometimes, the body also produces counterregulatory hormones such as glucagon, epinephrine, growth hormone, and cortisol in an attempt to feed the cells. Still, all of the glucose produced only remain and accumulate in the blood because there is still no presence of insulin. The energy-starved cells eventually die. When glucose reaches the kidneys for filtering, and the level exceeds the tolerance of the kidneys, it is flushed out in the urine. Thus, the patient flushes out excessive amounts of urine.

Symptoms

During this stage, the glucose level may also add up to the blood’s osmotic pull. This triggers the water in the tissue cells to leave and move to the bloodstream. Cells become dehydrated afterwards. The patient, not only eats and urinates every so often, he then also develops unquenchable thirst. As glucose becomes useless, other symptoms in the patients may also surface. These include tiredness, weight loss, itchiness especially around the genital area caused by overgrowth of yeast, and other skin infections.

When the brain cells lack glucose for quite some time, the patient will suffers from confusion, unconsciousness, coma and eventually death.

Treatment

Patients diagnosed with type 1 diabetes are required to be regularly injected with insulin to survive. Depending on the insulin type, doses may be done several times a day. Insulin inhalers are also available but the accuracy of its effectiveness is not the same as the injection.

A change in lifestyle and eating habits to maintain one’s weight is a must. Having an appropriate diet and exercise as well as monitoring blood sugar at home are crucial too in managing this disease.

Even if the patient gets treated with exogenous or externally-derived insulin, the disease may sometimes develop and generate complications that are long-term. These may be grouped as microvascular, macrovascular and neuropathic complications. Microvascular problems consist of retinopathy, which leads to blindness and nephropathy, which leads to kidney failure. Macrovascular problems consist of coronary artery disease, cerebrovascular disease and peripheral vascular disease. Neuropathic problems consist of impotence and numbness in the arms and legs. Among these, kidney failure and cardiovascular disease rank as the most common causes of death.

Pancreas transplant is a known cure for this disease nowadays. This is rarely done as surgeries like these are very expensive. Strong and effective drugs will be permanently taken by people who went through pancreas and kidney transplants. This is critical so that immune reactions by rejection of the organs will be suppressed. However, these drugs show side-effects that can be more dangerous than the disease itself. Every year, 10 - 20% of those who undergo the surgery do not survive and 50% of them have had their bodies reject the new pancreas. If this happens, the disease comes back.

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