Type 1 diabetes (insulin-dependent) is defined by the absence of insulin production. What is the difference with type 2? At what age ? What symptoms? What cause? What treatment?
There are two types of diabetes: type 1 diabetes and type 2 diabetes. Type 1 diabetes, formerly called insulin-dependent diabetes (or IDD)is an autoimmune disease that corresponds to a disorder of the assimilation, use and storage of sugars provided by food. According to the Federation of Diabetics, type 1 diabetes which affects approximately 6% of diabetics and type 2 diabetes which affects 92%. Normally, this diabetes is discovered in young people: children, adolescents or young adults.
What is type 1 diabetes?
Diabetes is a disease characterized by abnormal rise in blood sugar, i.e. the level of sugar in the blood. In type 1 diabetes, which affects between 8 and 10% of diabeticsthis increase is due to an autoimmune disease. “It’s about the immune system that will, for some unknown reason, attack and destroy cells in the pancreas which secrete insulin, explains Professor Fabrice Bonnet, diabetologist and endocrinologist in Paris. “This leads to a very significant insulin deficiency, which contributes to strong hyperglycemia, sometimes of more than three grams”, he says. This type of diabetes therefore often develops rapidly, “THE more often between 13 and 20 years old, but sometimes even in 6-month-old patients. But in some rare cases, type 1 diabetes can also occur in a 50-year-old person,” adds the specialist. This disease can quickly cause damage to different organs, mainly the kidneys, eyes, nerves, or blood vessels.
What are the symptoms of type 1 diabetes?
“Symptoms of type 1 diabetes usually come on quickly, unlike type 2 diabetes which can go silent for a long time,” explains Professor Fabrice Bonnet. It starts with:
- Of the frequent urination
- A greater thirst than usual
- A rapid weight loss
- A fatigue
- A feeling of intense hunger
- A ketoacidosis: a serious complication that happens more quickly in children, and can lead to dehydration, vomiting, abdominal pain, or even malaise.
At what age do you discover type 1 diabetes?
Unlike type 2 diabetes, which generally appears in people over the age of 40, type 1 diabetes is generally discovered during childhood, adolescence or early adulthood.
What are the causes of type 1 diabetes?
Type 1 diabetes has an autoimmune origin: this means that the body will turn against its own cells. Indeed, certain white blood cells, called T lymphocytes, will attack the cells of the endocrine pancreas producing insulin, called the islets of Langherans. When the islets of Langerhans are destroyed by T cells, which misidentify them as a threat, this results in a very significant decrease in insulin secretion. However, the role of the latter is to maintain blood sugar levels at normal values by causing glucose to penetrate into the body’s tissues, such as fat or muscle. When there is no more insulin, the glucose will stay in the blood, thereby increasing blood sugar levels. When this exceeds 1.2g/l, it is considered hyperglycemia.
Is type 1 diabetes hereditary?
“We tend to think that type 1 diabetes is hereditary, but in reality, having parents with this condition only leads to a low predisposition, explains the diabetologist. Rather, type 2 diabetes is hereditary.” In type 1 diabetes, the risk is between 4 and 8%, more precisely 8% if the father is diabetic, 4% if it is the mother (but 30% if both parents are)can we read on the website of the Federation of Diabetics.
What is the life expectancy in type 1 diabetes?
According to INSERM, patients who benefit from insulin therapy thus have a life expectancy equivalent to the rest of the population.
What test to diagnose type 1 diabetes?
At the first symptoms suggestive of diabetes, particularly in children, it is essential to consult quickly, to avoid the first complications. The attending physician can make the diagnosis by a blood test showing hyperglycaemia over 1.20g/l. This should be observed at at least 2 times for diabetes to be confirmed.
What are the possible complications of type 1 diabetes?
Undiagnosed type 1 diabetes or poorly controlled by treatment can quickly lead to acute complications. The most common is diabetic ketoacidosis. This occurs when the body cannot use enough glucose to produce energy, and will therefore draw it from fatty acids. But this use leaves a waste of acidic substances, which then cause various more or less serious symptoms: characteristic breath, a dehydration, nausea, vomiting, stomach aches, difficulty in breathing, which can then go as far as confusion and coma. Diabetic ketoacidosis requires emergency hospitalization : in fact, ketoacidotic coma is the most frequent cause of death related to type 1 diabetes. This is why it is necessary, in the case of type 1 diabetes, to quickly put in place a treatment adapted to the person and follow it to the letter.
What diet in case of type 1 diabetes?
We tend to associate diabetes with deprivation. “But in the case of type 1 diabetes, the right diet to adopt is simply a balanced dietto avoid excessive weight gain “, explains the doctor. This diet is not so different from the ones we should all follow. The only additional point is that it must also contribute to the control of diversified glycaemia and adapted to the physical activity of the patient. ” Must therefore avoid fast sugars as much as possiblebut also limit slow sugars and spread them throughout the day “, explains the diabetologist. As the diet must be adapted to the particularities of each patient, it is advisable to consult a dietician or diabetologist. He can set up a dosage and a rhythm of taking insulin according to diet, physical activity, weight and habits.
What are the treatments for type 1 diabetes?
Since type 1 diabetes is insulin-dependent, it can only be treated by insulin injections. This number of injections must be adapted throughout the disease, so that the patient always has enough insulin to maintain normal blood sugar and glycated hemoglobin below 7%. If this is no longer the case, complications can appear quite quickly. Additionally, type 1 diabetes cannot be cured. “So it is a lifelong treatment that awaits patients. But more and more research is being carried out on diabetes, since it is a disease that is exploding in the world, and innovations have been made. Today, the Insulin “shots” have been replaced by pens with a single dose adapted, which facilitates the treatment, and for the youngest, there are insulin pumps which diffuse continuously for three days, explains the doctor. the lives of the youngest, who can already be very disturbed by the disease”
Current treatments consist of bringing insulin to the body:
- either in the form of injections (injection of insulin with a syringe or a pen),
- either with an insulin pump (pump therapy), a portable or implantable device intended to continuously administer insulin.
- “We are talking about future innovations such as an artificial pancreas which will avoid insulin injections, or improved insulin pump.”
Type 1 diabetes and pregnancy
If being type 1 diabetic does not prevent you from getting pregnant, it remains a high risk pregnancy which should be closely monitored. In reality, monitoring begins even before becoming pregnant: in the three months preceding the baby tests, it is advisable to maintain a perfectly stable blood sugar level. Indeed, a good glycemic balance from conception and a specific adapted follow-up maximizes the chances of having a pregnancy without complications. In addition, the diet must be adapted to pregnancy to facilitate glycemic control and reduce the risk of ketoacidosis, which becomes stronger in the last months. Delivery can be vaginal, but is likely to be induced if the baby is at risk of being overweight at term. This can indeed lead to risks for the mother or even fetal distress. If the baby’s weight is more than 4.350 kg, it can be decided to have recourse to a caesarean section.
Thanks to Professor Fabrice Bonnet, diabetologist and endocrinologist in Paris.