Type 1 diabetes

Type 1 diabetes
Other namesDiabetes mellitus type 1, insulin-dependent diabetes, juvenile diabetes
A blue circle, the symbol for diabetes
Pronunciation
SpecialtyEndocrinology
SymptomsFrequent urination, increased thirst, weight loss
ComplicationsDiabetic ketoacidosis, severe hypoglycemia, cardiovascular disease, and damage to the eyes, kidneys, and nerves
Usual onsetAt any age; over days to weeks
DurationLifelong
CausesBody does not produce enough insulin
Risk factorsFamily history, celiac disease, autoimmune diseases
Diagnostic methodHigh blood sugar levels, autoantibodies targeting insulin-producing cells
PreventionTeplizumab
TreatmentMonitoring blood sugar, injected insulin, managing diet
Prognosis10-12 years shorter life expectancy[1][2][3]
Frequency11–22 million cases globally[4]

Type 1 diabetes (T1D), formerly known as juvenile diabetes, is an autoimmune disease that occurs when pancreatic (beta cells) are destroyed by the body's immune system.[5] In healthy persons, beta cells produce insulin. Insulin is a hormone required by the body to store and convert blood sugar into energy.[6] T1D results in high blood sugar levels in the body prior to treatment.[7] Common symptoms include frequent urination, increased thirst, increased hunger, weight loss, and other complications.[5][8] Additional symptoms may include blurry vision, tiredness, and slow wound healing (owing to impaired blood flow).[6] While some cases take longer, symptoms usually appear within weeks or a few months.[9][7]

The cause of type 1 diabetes is not completely understood, though there have been recent studies that suggest linkage with HLA-DR3/DR4-DQ8.[10][5] Further, it is believed to involve a combination of genetic and environmental factors.[11][7] The underlying mechanism involves an autoimmune destruction of the insulin-producing beta cells in the pancreas.[6] Diabetes is diagnosed by testing the level of sugar or glycated hemoglobin (HbA1C) in the blood.[12][13]

Type 1 diabetes can typically be distinguished from type 2 by testing for the presence of autoantibodies[12] and/or declining levels/absence of C-peptide.

There is no known way to prevent type 1 diabetes.[5] Treatment with insulin is required for survival.[7] Insulin therapy is usually given by injection just under the skin but can also be delivered by an insulin pump.[14] A diabetic diet, exercise, and lifestyle modifications are considered cornerstones of management.[6] If left untreated, diabetes can cause many complications.[5] Complications of relatively rapid onset include diabetic ketoacidosis and nonketotic hyperosmolar coma.[12] Long-term complications include heart disease, stroke, kidney failure, foot ulcers, and damage to the eyes.[5] Furthermore, since insulin lowers blood sugar levels, complications may arise from low blood sugar if more insulin is taken than necessary.[12]

Type 1 diabetes makes up an estimated 5–10% of all diabetes cases.[15] The number of people affected globally is unknown, although it is estimated that about 80,000 children develop the disease each year.[12] Within the United States the number of people affected is estimated to be one to three million.[12][16] Rates of disease vary widely, with approximately one new case per 100,000 per year in East Asia and Latin America and around 30 new cases per 100,000 per year in Scandinavia and Kuwait.[17][18] It typically begins in children and young adults but can begin at any age.[7][19]

  1. ^ Zheng Y, Permanyer I, Canudas-Romo V, Aburto JM, Nigri A, Plana-Ripoll O (2023). "Lifespan variation among people with a given disease or condition". PLOS ONE. 18 (9): e0290962. Bibcode:2023PLoSO..1890962Z. doi:10.1371/journal.pone.0290962. ISSN 1932-6203. PMC 10473533. PMID 37656703.
  2. ^ Livingstone SJ, Levin D, Looker HC, Lindsay RS, Wild SH, Joss N, et al. (6 January 2015). "Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010". JAMA. 313 (1): 37–44. doi:10.1001/jama.2014.16425. ISSN 1538-3598. PMC 4426486. PMID 25562264.
  3. ^ Arffman M, Hakkarainen P, Keskimäki I, Oksanen T, Sund R (April 2023). "Long-term and recent trends in survival and life expectancy for people with type 1 diabetes in Finland". Diabetes Research and Clinical Practice. 198: 110580. doi:10.1016/j.diabres.2023.110580. ISSN 1872-8227. PMID 36804193.
  4. ^ Cite error: The named reference WHO11 was invoked but never defined (see the help page).
  5. ^ a b c d e f "Diabetes Fact sheet N°312". WHO. November 2016. Archived from the original on 26 August 2013. Retrieved 29 May 2017.
  6. ^ a b c d "Types of Diabetes". NIDDK. February 2014. Archived from the original on 16 August 2016. Retrieved 31 July 2016.
  7. ^ a b c d e "Causes of Diabetes". NIDDK. August 2014. Archived from the original on 10 August 2016. Retrieved 31 July 2016.
  8. ^ Torpy JM, Lynm C, Glass RM (September 2007). "JAMA patient page. Type 1 diabetes". JAMA. 298 (12): 1472. doi:10.1001/jama.298.12.1472. PMID 17895465.
  9. ^ "NIDDK Central Repository - Diabetes Prevention Trial of Type 1 Diabetes (DPT-1)".
  10. ^ TEDDY Study Group (2008). "The Environmental Determinants of Diabetes in the Young (TEDDY) Study". Annals of the New York Academy of Sciences. 1150 (1): 1–13. Bibcode:2008NYASA1150....1.. doi:10.1196/annals.1447.062. PMC 2886800. PMID 19120261.
  11. ^ Erlich H, Valdes AM, Noble J, Carlson JA, Varney M, Concannon P, et al. (2008). "HLA DR-DQ haplotypes and genotypes and type 1 diabetes risk: Analysis of the type 1 diabetes genetics consortium families". Diabetes. 57 (4): 1084–1092. doi:10.2337/db07-1331. PMC 4103420. PMID 18252895.
  12. ^ a b c d e f Chiang JL, Kirkman MS, Laffel LM, Peters AL (July 2014). "Type 1 diabetes through the life span: a position statement of the American Diabetes Association". Diabetes Care. 37 (7): 2034–2054. doi:10.2337/dc14-1140. PMC 5865481. PMID 24935775.
  13. ^ "Diagnosis of Diabetes and Prediabetes". NIDDK. May 2015. Archived from the original on 16 August 2016. Retrieved 31 July 2016.
  14. ^ "Alternative Devices for Taking Insulin". NIDDK. July 2016. Archived from the original on 16 August 2016. Retrieved 31 July 2016.
  15. ^ Daneman D (March 2006). "Type 1 diabetes". Lancet. 367 (9513): 847–858. doi:10.1016/S0140-6736(06)68341-4. PMID 16530579. S2CID 21485081.
  16. ^ "Fast Facts Data and Statistics about Diabetes". American Diabetes Association. Archived from the original on 16 December 2015. Retrieved 25 July 2014.
  17. ^ Global report on diabetes (PDF). World Health Organization. 2016. pp. 26–27. ISBN 978-92-4-156525-7. Archived (PDF) from the original on 7 October 2016. Retrieved 31 July 2016.
  18. ^ Skyler J (2012). Atlas of diabetes (4th ed.). New York: Springer. pp. 67–68. ISBN 978-1-4614-1028-7. Archived from the original on 8 September 2017.
  19. ^ Cite error: The named reference :5 was invoked but never defined (see the help page).