Type 1 Diabetes

Type 1 diabetes is a chronic condition that is life threatening if untreated. Although not as common as Type 2 diabetes and other non-communicable diseases it often leads to long standing complications which can be costly or even fatal. Its burden is passed on to families and communities as many populations are forced to see trends of Type 1 diabetes emerging.

According to the World Health Organization, the prevalence of Type 1 diabetes cases rises each year and is expected to more than double in the next two decades. The numbers are expected to be higher because of changing lifestyles. The other challenge is that many people with diabetes are undiagnosed.

Globally, the CDC estimates that less than 10 per cent of the world population has Type 1 diabetes. According to Diabetes UK, countries with the highest prevalence of Type 1 diabetes include Finland with 57.6 per 100,000 closely followed by Sweden and Saudi Arabia with 43.1 and 31.4 per 100,000 respectively. UK has the world’s fifth highest rate of Type 1 diabetes in children at 24.5 per 100,000 incidents.

African countries like Kenya are affected too. According to the Kenya National Diabetes Strategy report, Type 1 diabetes accounts for 10 to 15 percent of the population living with diabetes. The figures may seem far much less when compared to those of Type 2 diabetes which accounts to at least 80 percent. 

However, with the increasing burden of type diabetes in Kenya, Type 1 diabetes needs to be taken into consideration. If managed well, through early testing, management and awareness programs, it can prevent death in those affected. It all starts by understanding what Type 1 diabetes is, its symptoms and how to manage it.

What is Type 1 Diabetes?

Type 1 diabetes was formerly known as autoimmune diabetes or juvenile diabetes, but since it can also affect adults, it is referred to as insulin-dependent diabetes. Type 1 diabetes condition is as result of the pancreas’ failure to produce insulin. In this autoimmune disease, insulin-producing beta cells in the pancreas are gradually destroyed.

In order to understand Type 1 diabetes in detail, let us first set our eyes on the main organ affected known as the pancreas. It the human body, this organ is located in the abdomen, marginally below the liver. The pancreas aids in digestion and at the same time it regulates blood sugar. Its essential role is to convert the food we eat into energy for the body’s cells which in turn helps us carry on with day to day activities. The pancreas contains insulin-producing cells known as beta cells. These cells in particular make insulin, which is a hormone that controls the sugar levels in the blood.

Therefore, in Type 1 diabetes, the body’s immune system misbehaves by destroying these beta cells. This prevents the body from having the ability to produce enough insulin to regulate blood glucose levels. When blood glucose levels increase or decrease, or if insulin injections are missed, short-term complications such as hypoglycemia (low blood sugar) or ketoacidosis whereby blood sugar spikes and ketones build up to dangerous levels, occur.

Long-term complications of Type 1 diabetes can lead to conditions like stroke, retinopathy (blindness), heart disease, kidney disease, neuropathy to mention a few cases. So, Type 1 diabetes treatment would require regular insulin intake either through an injection or an insulin pump due to the loss of insulin production in the pancreas.

What are the causes of Type 1 Diabetes?

In the conventional field of medicine, root causes of Type 1 diabetes in which the immune system mistakenly attacks the beta cells are generally unknown. However, a few studies suggest that some of the root causes of diabetes have been identified. One such theory claims that certain viruses can lead to inflammation of the pancreas of which in turn activates the immune system to respond by turn attacking the pancreatic beta cells.

According to the National Center for Biotechnology Information centre, the prime viruses identified are known as the enteroviruses. These viruses include the Coxsackie B virus (CVB). Other viruses include the rotavirus, mumps virus and the cytomegalovirus.

In families, these viruses tend to be more common in young siblings developing Type 1 diabetes in comparison to non-diabetic siblings. Also, these viruses which can infect mothers during pregnancy. While infected, viruses can be multiplied in turn transmitted to their unborn children who later develop type 1 diabetes. So, expectant mothers are at a risk.

As soon as infection of the viruses occur, the immune system responds and begins attacking the beta cells leading to inflammation. This in turn leads to the induction of autoimmunity. Thus, when pancreatic beta cells are killed, Insulin becomes deficient and, the body cannot control blood glucose levels and symptoms start appearing. Type 1 diabetes occurs as a result.

What are the symptoms of Type 1 Diabetes?

Type I diabetes is more common in children than in adults. It tends to progress more slowly in adults than it does in children. In some cases, Type I diabetes in adults may be misdiagnosed as type II diabetes.

At early stages, some Type 1 diabetes symptoms can mimic symptoms of other diseases. The subtle symptoms can go on for months or years before diagnosis. One of the symptoms of diabetes is nerve pain. Diabetic nerve pain also known as neuropathic pain comes as a result of complications such as diabetic or peripheral neuropathy.

If symptoms are not treated it can be fatal. So, it is important to schedule frequent tests with a doctor especially if some of these symptoms occur: 

• Day time fatigue
• Feeling the need to urinate regularly
• Unexplained weight loss
• Extreme thirst
• Itching of the genitals

How is Type 1 Diabetes diagnosed?

To diagnose type I diabetes, doctors use a blood or urine tests. To confirm that a patient has type 1 diabetes, the following tests are done:

• GAD (Glutamic Acid Decarboxylase) – This is an auto-antibodies test used to test whether a person has either Type 1 or Latent Autoimmune Diabetes of Adulthood (LADA). In this test, the presence of GAD autoantibodies indicates an immune system attack, which points to Type 1 diabetes. A normal result of this test should be less than 5 units/ml. Anything above indicates Type 1 diabetes.
• C-peptide tests – This is a test whereby C-peptide, a by-product of insulin, helps indicates how much blood insulin is being produced.
• Ketone test – This is a test whereby ketone test strips check for the presence of one type of ketone called acetoacetic acid.

Treatment of Type 1 Diabetes

For Type 1 diabetes conventional treatment, Insulin is administered by an injection with insulin pens. Insulin is also delivered by wearing insulin pumps. Physical activity is also encouraged and a healthy meal plan of very little starch, higher protein, and healthy fats and a lot of vegetables is recommended to patients with type I diabetes so as to maintain a healthy blood sugar control.

Other ways of managing Type 1 diabetes include intermittent fasting, adopting the low carb/ketogenic diet. A doctor would have to be consulted before a patient opts to venture into these dietary interventions. For further details, contact us at Afyacode and get in touch with our doctors.