Type 1 Diabetes
Diabetes, also known as diabetes mellitus, is the name of a disorder in which the body has a problem properly regulating blood sugar levels also known as blood glucose levels. There are two major types of diabetes. The first type is type I, also known as juvenile onset diabetes. The second type, is type II diabetes or non-insulin dependent diabetes. The first type of diabetes is a disorder of the immune system where one's own immune system attacks the cells in the pancreas that produce insulin. Insulin is a hormone that allows sugar to be transported from the blood into the cells of the body so that it can be used for energy.
Type I diabetes occurs most often when a person's immune system gets confused and starts to destroy the cells in the pancreas to produce insulin. The pancreas, which is an organ about the size of your hand and is located near the stomach, has two groups of cells that produce insulin. These cells are called beta cells. The two small regions in the pancreas are referred to as Islets of Langerhan. As I said before, beta cells normally produce insulin and insulin allows us to absorb sugar and use it as an energy source. When we do not produce enough insulin, our cells are unable to get glucose (sugar) inside to use as energy. When this happens, the cells resort to using fat as an energy source. For those who have not been diagnosed with type I diabetes and yet still have the disease, a number of symptoms will present themselves. These symptoms can include urinating frequently, extreme thirst, a fruity breath odor, fatigue, irritability, etc.,
Common Symptoms For Undiagnosed Diabetics
When ever these type of symptoms are present in a person, it is very important that diabetes be considered as a possible diagnosis. Failure to properly diagnose this condition is a life-threatening matter and must be addressed quickly and properly.
When people have their ability to produce insulin impaired, they must take insulin in order to stay alive. Early on in this disease, some people find that their need for insulin will increase and decrease quite a bit. Some patients even found that if they go on a low carbohydrate diet they can stop taking insulin for some time. However, this is not the most typical response. In fact, even those who are able to change their diet to deal with the reduced production of insulin, eventually have to take insulin for the rest of their life. The only reason the patients are able to go without insulin early on in their condition is because the beta cells that produce insulin are usually destroyed over a period time. When this period time is fairly long, the patient can temporarily compensated by way of dietary changes.
Type I diabetes is generally found in children, teenagers, and young adults. We do not yet know exactly why the immune system attacks the beta cells, but a combination of autoimmune, genetic and other environmental factors are typically involved.
A more common type of diabetes which is not the subject of this website, is the type II diabetes. Type II diabetics produce sufficient amounts of insulin, but their cells do not have enough receptor sites on the outside of their cells. These receptor sites recognize insulin and when it contacts the outside of the cell, the cell opens a pathway for the glucose molecule to enter inside. Several patients have lots of insulin but not enough receptor sites on their cells and up with a very similar type of disease. Whereas type I diabetics tend to be thin and young, type II diabetics tend to be obese and older. In fact, type II diabetics can usually resolve their condition is they lose weight and exercise along with eating a diet that is rich in vegetables and protein and less in sugars and some fruits.
One of the treatments for both types of diabetics is the use of a modified diet. As I mentioned before, insulin is needed to take sugar from the bloodstream into the cells and type I diabetics must take insulin usually injected by syringe or by a mechanical insulin pump. By eating a diet rich in protein and vegetables, and reducing foods that have high levels of sugar, they will have better control of their blood sugar levels. This is very important because very high sugar levels and very low sugar levels in the blood are dangerous. In fact, low blood sugar levels can result in a life-threatening emergency and high blood sugar levels will slowly destroy organ systems in the body like the nerves, eyes, cardiovascular system, etc.
Complications
A person with type I diabetes mellitus can have many major organs in their body affected, including their heart, nerves, eyes, kidneys, and blood vessels. It is important to keep the blood sugar levels close to normal or at least as close to normal as possible in order to reduce the risk of serious complications.
There are a number of long-term complications from having type I diabetes that will gradually developed over the years if the disease is not treated with extreme care. Also the earlier you develop diabetes and if you don't control it properly and allow your blood sugar levels to go too high too often, eventually severe publications will present themselves. Below is a list of the common chronic complications of diabetes mellitustype I.
Heart and Blood Vessel Damage/Atherosclerosis
This condition dramatically increases the risk of a number of heart and vascular problems, including artery disease in your heart (angina), myocardial infarction (heart attack), stroke (blood clot to the brain), narrowing of the arterial walls (atherosclerosis), and hypertension (high blood pressure). The fact is about 65% of people who have diabetes actually die from the heart and blood vessel diseases that typically goes along with diabetes.
Nerve damage (peripheral neuropathy)
When your body has too much sugar in the blood the walls of the small blood vessels(capillaries) that nourish and feed the nerves in your body, become damaged and are unable to provide proper nutrition to your nervous system. When this happens you can feel numbness, tingling, burning or pain that usually starts at the tip your toes or the tips of your fingers and gradually comes towards the center of your body. Blood sugar that was poorly controlled could eventually cause you to lose all sensation in your hands and feet. It could also cause you to suffer problems with your digestive system by damaging the nerves that control your intestines and stomach. This can cause nausea, vomiting, constipation, and or diarrhea. For men, erectile dysfunction can also become an issue as the ability for the blood vessels to provide sufficient blood to the penis is restricted by the blood vessel disease or the nerves that control sexual function.
Kidney damage (nephropathy)
Excess blood sugar can injure the millions of blood vessel clusters that are used to filter waste from your blood. Diabetes can damage this filtering system and can lead to kidney failure. Kidney failure otherwise known as irreversible end-stage kidney disease, requires the use of dialysis to filter the blood and the patient needs to have a kidney transplant.
Eye Damage
The blood vessels in the eyes can also be damaged by diabetes causing what is known as diabetic retinopathy. This condition can potentially lead to blindness. Diabetes can also lead to other serious visual conditions such as cataracts and glaucoma.
Skin and Mouth Conditions
For the patient who has elevated sugar levels, the skin is more susceptible to infections by both bacteria and fungus. Mouth infections are often common, specially for people with poor dental hygiene.
Foot Damage
The feet can be damaged by poor blood flow and nerve damage. When there is not enough blood flow to the feet, if they become injured they are unable to heal and often become infected. These infections lead to death of the tissues of the foot and eventually the foot must be amputated to save a patient's life. When the nerves are damaged, patients can cut or injure their feet without being aware of it. Since the nerves do not work well and the feet are always numb, the patient does not feel any pain or soreness when the feet are injured. These injuries lead to the same damage and amputation as mentioned above.
Osteoporosis
Diabetic patients can end up with reduced bone mineralization and therefore increased risk of osteoporosis. When a patient has weak bones, they are prone to fracture. These fractures commonly occur when people fall on hard surfaces (hip fracture) or when lifting heavy objects (back bone fracture).
Hearing problems
Because of both the problem with nerve damage and the problem with blood supply, hearing impairment is a common occurrence with diabetics. Like the other conditions this can be reduced by maintaining a excellent diet and keeping blood glucose levels within their normal ranges.
Pregnancy Issues
Diabetes is often dangerous for both the mother and the baby unless the condition is very carefully controlled. The risk of having a stillbirth or miscarriage or having a baby with birth defects is greatly increased when diabetes is not properly controlled. For the mother, there is an increased risk of having diabetic ketoacidosis, which is the process we mentioned before of the body burning fat more than sugar, which can lead to an unhealthy metabolic state. The mother can have either problems and even high blood pressure issues when a diabetic becomes pregnant. Having said this, if a diabetic woman is very careful with both her diet and her insulin use, theoretically there would be no additional risk to either her or the baby.
As we stated earlier in this website type I diabetics must treat their condition with insulin administration and dietary changes. This involves injecting the proper amount of insulin into the body by way of a small needle into the fat underneath the skin. It is injected into the fat so that it is slowly absorbed; thereby slowing its absorption by the body and helping to reduce the chance of a sudden drop in blood sugar levels. Common injection sites for insulin is in the abdomen (underneath the belly button), the sides of the hips (love handles), or any other area that has subcutaneous fat. The reason that insulin cannot just be taken as a pill is because it is a complex protein, otherwise known as a hormone, and would be destroyed by the acid in the stomach and would not be absorbed by the intestines in a way that would allow it to perform its job (bringing glucose into the cells for energy usage). There are scientists trying to find a better way to administer insulin to diabetics. Currently, diabetic patients can inject fast acting insulin or slow acting insulin or combination of both two control blood sugar levels. Other patients use an insulin pump to inject fast acting insulin in very small amounts throughout the day as needed. The insulin pump is a computerized device that can be instructed to administer a large bolus of insulin during a meal. For example, if a diabetic were to have an apple, a grilled cheese sandwich and a Diet Coke for lunch, they could tell the insulin pump what they are eating and it would provide a recommendation for how much insulin should be used during that meal. If the patient is happy with the pump's suggested dosage (there is a little computer in there) all they need do is press the accept button and the proper insulin amount will be administered.
Type 1 Diabetes and Celiac Disease
Since diabetes is a autoimmune disorder, the immune system of diabetics does not function normally. A common and often underdiagnosed condition that can commonly go along with type I diabetes is celiac disease. Today in America, about one in 10 people with type I diabetes are affected by celiac disease. This is compared with about 1 in 100 who have celiac disease in the general population. Among children, celiac disease has led healthcare professionals and parents to consider other reasons for their diabetic child's symptoms. Since both diseases are related to a malfunctioning immune system (to be discussed later), it is not surprising that there is a greater incidence of this disease among type I diabetics.
What is celiac disease?
Just like type I juvenile onset diabetes, celiac disease is an autoimmune disease. In this disease, the immune system reacts in an inappropriate way to proteins found in wheat and other grain products like rye and barley. This inappropriate reaction triggers an inflammatory response in the small intestine resulting in damage to the small hair like villi (hair like structures absorb nutrients). This condition can lead to serious health consequences including neurological disorders, vitamin deficiencies, bone weaknesses (osteoporosis), malnutrition, and an increase in the incidence of cancer.
Why the symptoms may not be noticed
As diabetics know that their immune system does not function properly, they and their doctors will often ignore or dismiss the symptoms of celiac disease as being somehow related to their diabetes. When this happens the patients try to improve their diets and how they administer insulin to better regulate their blood sugar levels; in the hopes that this will address the strange symptoms. These symptoms can include fatigue, joint pain, muscle cramps, anemia, weight loss, and weakness. And these symptoms could be considered the result of diabetes. It is important that all diabetics are tested for celiac disease when there is any question about its presence. Some of the less serious but quite troubling symptoms are depression and irritability and chronic stomachaches. One of the problems with celiac disease is that about 50% of those diagnosed with the condition have no symptoms at all. My daughter, Cassie, lived with the disease for more than five years until we stumbled on the condition. She was lactose intolent and we believed that that was not being managed properly. Later she was diagnosed as a diabetic-type 1, and we thought it was related to this. However, now that she has removed gluten from her diet, many of her serious symptoms have resolved. To Peter Green, M.D., professor of clinical medicine at Columbia University Medical Center states, "the majority of the people with the disease remain undiagnosed, because celiac masquarades as many different medical problems, or presents without overt symptoms."
My daughter, Cassie, is a type 1 diabetic and graciously made several videos for me to add to this website. You can view some of her others throughout
the website, however, I wanted to add these as well.
