Abhishek Jha

Diabetes mellitus type

1

Also known as T1DM and formerly insulin dependent diabetes or juvenile diabetes (usually appears in childhood or in teens)

It results from the autoimmune destruction of the insulin-producing beta cells in the pancreas.

Subsequent lack of insulin leads to increased blood and urine glucose.

Affects 1 in 300 children and more adults

Definition

  Severe derangement of carbohydrates, lipids and protein metabolism.

Untreated T1DM cause hyperglycemia, hypertriglyceridemia(chylomicrons and VLDL), polyuria (frequent urination), polydipsia (increased thirst), polyphagia (increased hunger), weight loss and ketoacidosis.

It is short term and long term ,  In the short term, untreated type 1 diabetes can lead to diabetic ketoacidosis, and in the long term it can lead to eye damage, organ damage, etc.

In contrast to type 2, there is complete absence of insulin productions, so insulin/glucagon ratio cannot be increase.

Liver is always gluconeogenic and ketogenesis and cannot buffer properly blood glucose levels.

Hepatic gluconeogenesis is continues, liver contribute to hyperglycemia in well fed state and in muscle and adipose tissue GLUT4 remain sequestered within cells.

Hyperglycemia result from the inability of insulin dependent tissue to take up glucose.

Uncontrolled proteolysis in skeletal muscle, maintain hyperglycemia in starved state.

Uncontrolled lipolysis in adipose tissue increase plasma fatty acid levels and ketone body productions in liver.

Ketoacidosis result due to accumulations of ketone bodies and hydrogen ions, and accelerated fatty acid oxidations.

Hypertriacylglycerolemia occur because VLDL and chylomicrons cannot be removed from blood by lipoprotein lipase which is insulin dependent enzyme.

Type 1 DM is fatal , if not treated with external insulin.

Insulin are 2 type: fast acting and slow actingDelivery : subcutaneous injections and insulin pump.

Pancreas and islets cells transplantations can be done.

Cyclosporine A, an immunosuppressive agent, has apparently halted destruction of beta cells.

Research on stem cell are being carried out.

Treatment