Type 1 diabetes is a condition when blood sugar or glucose levels rise above normal limits due to the body not producing enough insulin. This type of diabetes is usually detected in children and adolescents. Glucose levels in the blood are controlled by the insulin hormone produced by the pancreas. When food that enters the body is digested and enters the bloodstream, insulin makes sugar (glucose) in the blood enter cells to be converted into energy. In diabetics, where the amount or performance of the insulin hormone is lacking, the body cannot process glucose into energy.
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| Definition of Type 1 Diabetes, Causes, Diagnosis, Treatment, Prevention, Complications |
Type 1 diabetes is less common than type 2 diabetes. It is known that there are only 9.5% of type 1 diabetes sufferers of all diabetes cases worldwide.
Causes and Symptoms of Type 1 Diabetes
Type 1 diabetes occurs when the body produces little or no insulin at all. As a result, people with type 1 diabetes need additional insulin from outside. This condition is different from type 2 diabetes which occurs as a result of insulin resistance, which is when the body's cells become immune or unresponsive to insulin.
Symptoms of type 1 diabetes usually appear in childhood or adolescence, but can also be experienced in adulthood. sufferers of this condition generally feel frequent urination, often feel thirsty, and get tired easily.
Treatment and Prevention of Type 1 Diabetes
Treatment for people with type 1 diabetes aims to maintain blood sugar levels in normal conditions and prevent complications. The method of treatment can be a change in lifestyle to the use of drugs.
Although there is no sure way to prevent type 1 diabetes, the development of this condition can be avoided by living a healthy lifestyle, such as exercising regularly and maintaining an ideal body weight.
Type 1 diabetes is an autoimmune disease, which is a condition when the body's immune system turns against healthy body cells. In people with type 1 diabetes, the body's immune system attacks and destroys the beta cells in the pancreas, which produce insulin.
Insulin functions to bind glucose in the blood and bring it into cells to be converted into energy. When the beta cells are destroyed and are no longer able to produce insulin, sugar cannot enter the cells. As a result, sugar builds up in the blood and causes high blood sugar (hyperglycemia).
It is not yet known what causes the immune system to attack the beta cells in the pancreas. However, there are a number of factors thought to be associated with this condition, namely:
genetics
People who have a nuclear family (parents or siblings) with type 1 diabetes are more at risk of suffering from the same disease. This is thought to be related to mutations in the HLA gene, which is a gene that produces proteins for the immune system.
Age
Although it can attack any age, type 1 diabetes is more prone to occur in children, especially children aged 4-14 years.
Virus infection
There are several types of viruses that are thought to trigger type 1 diabetes, such as the Coxsackie or Epstein-Barr virus (EBV).
Symptoms of Type 1 Diabetes
Symptoms of type 1 diabetes can appear suddenly and get worse quickly within a matter of weeks. In general, the symptoms of this condition develop during childhood and adolescence, but it can also occur in adulthood.
Symptoms of type 1 diabetes include:
- Frequent urination (polyuria), especially at night
- Frequent thirst (polydipsia)
- Often feel hungry so eat a lot (polyphagia), but decreased body weight
- Nausea and vomiting
- Dry mouth
- Wounds on the body that are difficult to heal
- Blurred vision
- The body gets tired easily and feels weak
- Easy to get angry
- Frequent infections of the skin, vagina, or urinary tract
When to See a Doctor
Check with your doctor if you have symptoms of type 1 diabetes as mentioned above, especially if accompanied by:
- The sugar level is higher than prescribed by the doctor
- Blood sugar level below 70 mg/dL
- Numbness, tingling, or pain in the feet or legs
- Impaired vision
- Sores on the feet that are difficult to heal
- Often feel depressed or anxious
Seek medical help immediately if symptoms include:
- Stomach ache
- Hard to breathe
- Fruity breath
- Shiver
- dazed
- Loss of consciousness
Diagnosis of Type 1 Diabetes
To diagnose diabetes in patients, doctors will run a hemoglobin A1c (HbA1c) test. The HbA1c test is performed to measure the patient's average blood sugar level in the last 2–3 months. If the HbA1c test results show a number of 6.5% or higher, it is a sign that the patient has diabetes.
If the patient has a condition that can affect the results of the HbA1C test, for example being pregnant, the doctor will run a blood sugar test, such as:
- Fasting blood sugar test
The doctor will ask the patient to fast for 8 hours, before a blood sample is taken and examined in the laboratory. The patient's sugar level is considered normal if it is less than 100 mg/dL. Meanwhile, sugar levels of 100–125 mg/dL indicate prediabetes. Patients are newly diagnosed with diabetes when blood sugar levels reach 126 mg/dL or more.
- Current blood sugar test
The patient's blood sample will be taken at any time, without the need to fast. If the blood test results show 200 mg/dL or more, the patient will be diagnosed with diabetes. The doctor may repeat the test to confirm the results.
In patients diagnosed with diabetes, doctors can run antibody tests to determine the type of diabetes they have. In addition to antibody tests, urine tests can also help determine the type of diabetes. Doctors can suspect that a patient has type 1 diabetes if ketones are detected in the urine.
Treatment of Type 1 Diabetes
Type 1 diabetes treatment aims to return blood sugar levels to normal and prevent complications. The patient's blood sugar level will be maintained in the range of 80–130 mg/dL before eating, and below 180 mg/dL 2 hours after eating.
Treatment methods that can be done include:
1. Insulin
The doctor will inject insulin several times a day. Administration is done by injection, because insulin will be digested by the stomach and cannot enter the bloodstream when given in pill form.
The doctor will teach how to inject insulin, so that the patient can do it independently at home. Patients will also be told how to store insulin and how to properly dispose of needles.
Insulin can also be administered using an insulin pump. The insulin pump is about the size of a cell phone, and comes with a tube connected to a catheter. Catheters can be inserted into the patient's abdomen, arm, hip, thigh or buttocks. Meanwhile, the pump can be pinned to a belt or put in a trouser pocket.
The insulin pump is programmed to deliver insulin into the body continuously, little by little. This is to maintain blood sugar levels are always normal. At mealtime, the patient can increase insulin levels, depending on the levels of carbohydrates consumed.
Treatment with insulin must be accompanied by checking blood sugar levels regularly, to ensure that blood sugar is always within normal limits. This is because blood sugar levels can be affected by various things, such as exercise, drugs, hormonal changes and general health conditions.
2. Artificial pancreatic system
The artificial pancreas system is a series of devices designed to mimic the function of the pancreas in regulating blood sugar levels. This device consists of an insulin pump, continuous glucose monitoring (CGM), and a pump and CGM interface, as a control and dose regulator.
The artificial pancreas system can measure glucose levels regularly and adjust the insulin levels injected, just like a real pancreas.
3. Drugs
In addition to giving insulin, doctors can prescribe the following types of drugs:
- Aspirin, to maintain the patient's heart health
- Angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor blockers (ARB), to maintain patient kidney health
- Cholesterol-lowering drugs, to reduce the risk of developing heart disease
4. Healthy diet
To help the healing process, patients can eat foods high in fiber and low in fat, such as wheat, vegetables and fruits. Patients will also be advised to reduce their intake of carbohydrates and animal food products. This diet pattern is also recommended for people who do not suffer from diabetes.
It is important for patients to know the amount of carbohydrate intake in the food consumed, so that the insulin dose injected is in the right amount. If necessary, consult with a nutritionist regarding diet and types of food that suit your needs.
5. Sports
Patients are advised to do sports, for example by walking or swimming. Do at least 30 minutes every day with light-moderate intensity. In children, exercise can be done 1 hour every day.
Apart from doing regular exercise, it is advisable to check blood sugar more frequently. This is so that nutritional intake and insulin doses are given according to what the body needs, and to avoid hypoglycemia when exercising.
Type 1 Diabetes Complications
Type 1 diabetes can cause a number of dangerous complications, including:
1. Hypoglycemia
Hypoglycemia is a condition where blood sugar levels are too low. This complication is triggered by injecting too much insulin. Hypoglycemia can also occur due to a lack of carbohydrate intake or excessive physical activity.
2. Hyperglycemia
Hyperglycemia is a condition where sugar levels are too high. In diabetics, this condition can occur due to eating too many portions or not enough insulin doses. Untreated hyperglycemia can lead to diabetic ketoacidosis.
3. Diseases of the heart and blood vessels
Untreated diabetes can increase the risk of coronary heart disease, heart attack, high blood pressure, high cholesterol, high triglycerides, stroke and heart failure.
4. Nerve damage (neuropathy)
Diabetes can damage the walls of the small blood vessels (capillaries) that provide nutrition to the nerves, especially the nerves in the feet. This condition will trigger pain, a burning sensation, or numbness in the toes. Numbness in the feet can cause diabetics to not be aware that there is a wound on their feet.
Nerve damage can also occur in the digestive tract and cause sufferers to experience nausea, vomiting, diarrhea or constipation.
5. Diabetic ulcers
Diabetic ulcers occur due to uncontrolled blood sugar resulting in wounds that are difficult to heal. These sores often occur in the big toe or sole of the foot.
6. Kidney damage (nephropathy)
High sugar levels can damage the filtering system in the kidneys. If the damage is severe enough, the patient may experience kidney failure, requiring dialysis or a kidney transplant.
7. Eye damage
Diabetes can increase the risk of cataracts and glaucoma. In addition, diabetes can also cause damage to the blood vessels of the retina (diabetic retinopathy) which is at risk of causing blindness.
8. Skin and mouth infections
Diabetes can increase the risk of infection in the eyes and mouth. The infection can be a bacterial infection or a fungal infection. Gingivitis and dry mouth may also occur more frequently.
9. Pregnancy complications
High blood sugar increases the risk of dangerous complications in pregnant women, such as diabetic ketoacidosis, diabetic retinopathy and preeclampsia. The unborn fetus is also at risk of miscarriage or abnormalities at birth.
10. Sexual dysfunction
In men, especially those who smoke, damage to nerves and blood vessels due to diabetes can trigger erectile dysfunction. Whereas in women, sexual dysfunction that occurs can be in the form of vaginal dryness, difficulty having an orgasm, or pain during sexual intercourse.
Prevention of Type 1 Diabetes
Until now, there is no way to prevent type 1 diabetes. However, the development of this condition can be avoided by living a healthy lifestyle, such as:
- Eat healthy, nutritionally complete and balanced foods
- Increase your intake of foods high in fiber, and low in fat and calories, such as fruits, vegetables and whole grains
- Do regular exercise for 30 minutes a day or 150 minutes a week
- Lose weight if you are obese or overweight, by changing your diet and exercising
- Adequate sleep and rest
- For pregnant women, it is advisable to consult a doctor first before losing weight.
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