Type1 Diabetes Mellitus

Type1 Diabetes Mellitus Type1 Diabetes Mellitus

What is type1 diabetes? How common is it?

Type1 diabetes is a form of diabetes where there is total loss of beta cell functions. Beta cells are nothing but cells in our pancreas which produce insulin. In type1 diabetes our immune system mistakenly damages the pancreatic beta-cell in our own body. Scientists call this phenomenon autoimmunity. There are other conditions similar to type1 diabetes where other endocrine organs are damaged, the commonest organ that we know is the thyroid. Thyroid autoimmunity is extremely common and affects close to  5 to 10% of the population. Type1 diabetes is very similar to this disease but it is much less common than hypothyroidism fortunately. 

Type1 diabetes affects a varying proportion depending upon the geographic area. In some countries like Finland, the incidence of type1 diabetes is very high. In India the incidence of type1 diabetes is less than 4 per one lakh population, whereas in countries like Finland, this incidence can be as high as 40 per one lakh population.This means for a population of 100000 citizens there will be 4 people who will get this disease every year. So in a city like Bengaluru with 10 million citizens, we can expect 400 people to get this disease every year.

How do we recognise whether you have type1 diabetes or type2 diabetes?

Type1 diabetes is a form of diabetes that involves very rapidly and like type2 diabetes. A person who is absolutely healthy can develop type1 diabetes in a matter of a week to a month. On the other hand, in type 2 diabetes, the evolution of diabetes is very slow and you can recognise that people are going to get diabetes in the future by looking at their blood glucose. In general people with type 2 diabetes will have a family history since type 2 diabetes is due to abnormal genes. Onset of diabetes at a younger age between the ages of 10 and 20 will go strongly in favor of type1 diabetes. 

Type1 diabetes patients will often present with very high blood glucose values and will be very symptomatic. They may pass excessive urine, feel thirsty often and lose a lot of weight all within a span of a few weeks or a month. Blood glucose values can be very high in type1 diabetes. Some patients with type1 diabetes have a serious condition called Diabetic ketoacidosis at the time of diagnosis. Apart from the presence of diabetic ketoacidosis which can be obvious in the history of urine routine examination, looking for ketones can be an easy method to distinguish between type1 diabetes and type2 diabetes. The most accurate method to differentiate between type1 diabetes and type2 diabetes is to evaluate patients. Diabetic ketoacidosis is a serious condition where an acid called beta hydroxybutyrate or acetoacetate can build up in the blood of patients with type1 diabetes. This condition can be life-threatening and the mortality rate or the number of people with this condition who do not survive post hospitalization is close to 5% which is a very high number, considering that many people who have this condition are quite young.

What can be the symptoms of diabetic ketoacidosis?

Patients with diabetic ketoacidosis will have a combination of symptoms like excessive vomiting, abdominal pain, fast breathing and after having and getting diabetic ketoacidosis treated  for many hours or days, they might become unconscious as well.

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