Diabetes Type 1 Support Group

Type 1 diabetes (formerly known as "childhood" or "juvenile" diabetes or "insulin dependent" diabetes) is most commonly diagnosed in children and adolescents. The adult incidence of Type 1 is the same as for children, leading to the name change from juvenile diabetes. Many adults diagnosed with Type 1 are misdiagnosed as Type 2 diabetics, leading to the misconception of Type 1 as a disease of children.

The most important forms of diabetes are due to decreases in or the complete absence of the production of insulin (type 1 diabetes), or decreased sensitivity of body tissues to insulin (type 2 diabetes). The most valid laboratory test to distinguish Type 1 from Type 2 diabetes is the C-peptide test, which detects the amount of insulin being produced in the body. Lack of insulin resistance, determined by a glucose tolerance test, would also be suggestive of Type 1.

Type I diabetes is an autoimmune disorder, in which the body's own immune system attacks the beta cells in the Islets of Langerhans of the pancreas, destroying them or damaging them sufficiently to reduce or eliminate insulin production. The autoimmune attack may be triggered by reaction to an infection, for example by one of the viruses of the Coxsackie virus family.

Some researchers believe that the autoimmune response is influenced by antibodies against cow's milk proteins. A large restrospective case controlled study published in 2006 found that infants who were never breast fed had twice the risk for developing Type 1 diabetes as infants who were breast fed for at least 3 months. The mechanism, if any, is not understood. [2] Research has not been able to establish a connection between autoantibodies, antibodies to cow's milk proteins, and Type 1 diabetes.

A subtype of type 1 (identifiable by the presence of antibodies against beta cells) develops slowly and so is often confused with Type 2. In addition, a small proportion of type 1 cases have the hereditary condition maturity onset diabetes of the young (MODY) which can also be confused with Type 1.

Vitamin D in doses of 2000 IU per day given during the first year of child's life has been connected in one study in Northern Finland (where the intrinsic production of Vitamin D is low) with a reduction in the risk of getting type I diabetes later in life (by 80%). Vitamin D3 may be an important pathogenic factor in type 1 diabetes independent of geographical latitude.

Some chemicals and drugs specifically target the pancreas. Vacor (N-3-pyridylmethyl-N'-p-nitrophenyl urea), a rodenticide introduced in the United States in 1975, selectively destroys panacreatic beta cells, resulting in Type 1 diabetes after accidental or intentional ingestion. Vacor was withdrawn from the U.S. market in 1979. Zanosar is the trade name for streptozotocin, an antibiotic and antineoplastic agent used in chemotherapy for pancreatic cancer, that kills beta cells, resulting in loss of insulin production.

Other pancreatic problems including trauma, pancreatitis or tumors (either malignant or benign) can also lead to loss of insulin production.

Currently, type 1 is treated with insulin injections, inhalable insulin, lifestyle adjustments, and careful monitoring of blood glucose levels using blood test kits. Insulin delivery is also available by an insulin pump, which allows the infusion of insulin 24 hours a day at preset levels, and the ability to program push doses (bolus) of insulin as needed at meal times. The treatment must be continued indefinitely. Experimental replacement of beta cells (by transplant) is being investigated in several research programs and may become clinically available in the future.

Regular blood testing, especially in type 1 diabetics, is essential to keep adequate control of glucose levels and to reduce the chance of long term sideffects of the disease. There are many (at least 20+) different types of blood monitoring devices available on the market today; not every meter suits all patients and it is a specific matter of choice for the patient, in consultation with a physician or other experienced professional, to find a meter that they personally find comfortable to use. The principle of the devices is virtually the same: a small blood sample is collected and measured. In one type of meter, the electrochemical, a small blood sample is produced by the patient using a lancet (a sterile pointed needle). The blood droplet is usually collected at the bottom of a test strip, while the other end is inserted in the glucose meter. This test strip contains various chemicals so that when the blood is applied, a small electrical charge is created between two contacts. This charge will vary depending on the glucose levels within the blood. In older glucose meters, the drop of blood is placed on top of a strip. A chemical reaction occurs and the strip changes color. The meter then measures the color of the strip optically.

Prolonged and elevated levels of glucose in the blood, which is left unchecked and untreated, will, over time, result in serious diabetic complications and sometimes even death. It is therefore highly important that a diabetic patient checks their blood levels either daily or every few days to see what levels they are achieving over a given period of time. There is also computer software for the PC which is available from blood testing manufacturers which can display results and trends over time. Type 1 patients will have to check on a more regular daily basis due to insulin therapy, which is a fine art to master. The US Food and Drug Administration has also approved a non-invasive blood glucose monitoring device. This allows checking blood glucose levels, while puncturing the skin as little as twice a day. Once calibrated with a blood sample, it pulls body fluids from the skin using small electrical currents, taking six readings an hour for as long as thirteen hours. It has not proven to be reliable enough, or convenient enough to be used in lieu of conventional blood monitoring. Other non-invasive methods like radio waves, ultrasound and energy waves are also being tested.