Diabetes mellitus Type 1


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Diabetes mellitus Type 1

  1. 1.    Diabetes is a chronic (lifelong) disease marked by high levels of sugar in the blood. sugar disease. The defect in this condition is that either the pancreas does not produce enough insulin or it produces sufficient insulin, but the cells of the body are unable to use the insulin properly.
  2. 2. The Pancreas Beta Cells: secrete insulin. Alpha Cells: secrete glucagon Autoimmunity occurs in islet of Langerhans against the beta cells...
  3. 3.  -Peptide Hormone, regulates blood sugar.  -Causes body cells to take up glucose from the blood. -Insulin receptors found on:  Liver cells  Skeletal muscles  Adipose tissue 
  4. 4.  Without insulin, too much glucose stays in your blood.  Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth.
  5. 5. 4 major types: 1) Type 1 Diabetes 2) Type 2 Diabetes 3) Gestational Diabetes 4) Pre-diabetes
  6. 6.      Diabetes is becoming a world pandemic. Incidence prevalence are increasing dramatically, with an estimated 171 million diabetics in 2000 and a projected increase to 366 million by 2030 Type 1 diabetes causes an estimated 5–10% of all diabetes
  7. 7.     Also called ―Insulin dependent diabetes‖ or ―Juvenile diabetes‖. Autoimmune destruction of insulin-producing (beta cells) of the pancreas Results in total insulin deficiency. Age of onset: usually childhood, young adulthood
  8. 8.  Age below 30 years polyuria -Excessive urination Polyphagia-Excessive hunger polydipsia- Excessive thirst  sometimes asymptomatic.    EATS A LOT BUT DOES NOT GROW     Bed wetting in children weight loss Dehydration Coma
  9. 9. Triggers:  -Poorly understood, plenty of theories.  -Molecular mimicry…  -Injury to islets…  -Random failure of tolerance…   Cell mediated response: -Type 1 diabetes is caused by a T cell–mediated autoimmune destruction of the pancreatic beta cells.
  10. 10.  Molecular mimicry: similar epitopes between pathogen and host. hGAD65:Autoantigen Coxsackie & hCMV: Viral peptides Viruses can produce proteins similar to those of the host. Immune cells present viral protein homologous to self protein. Failure of tolerance and autoimmunity
  11. 11. The exact cause of type 1 diabetes is unknown.  In most people with type 1 diabetes, the body's own immune system — which normally fights harmful bacteria and viruses — mistakenly destroys the insulinproducing (islet) cells in the pancreas.  Genetics  Environmental  Viruses  Diet 
  12. 12. Several alleles of HLA-DQB1 are associated with an increased risk of developing type 1 diabetes.  The locus also has the genetic name IDDM1 as it is the highest genetic risk for type 1 diabetes.  The strongest gene, IDDM1, is located in the HLA Class II region on chromosome 6, at staining region 6p21.  Certain variants of this gene increase the risk for decreased histocompatibility characteristic of type 1.  Such variants include DRB1 0401, DRB1 0402 etc.  Race. White people have a greater risk for developing type 1 diabetes than black, Asian, or Hispanic people.
  13. 13. Diabetes 1 60% 50% 40% 30% 20% 10% 0% Diabetes 1
  14. 14. Twin Study:  For identical twins, when one twin had type 1 diabetes, the other twin only had it 30%–50% of the time.  Despite having exactly the same genome, one twin had the disease, where the other did not; this suggests environmental factors, in addition to genetic factors, can influence disease prevalence.
  15. 15.  o o o Exposure to: Epstein-Barr virus coxsackievirus mumps virus or cytomegalovirus may trigger the autoimmune destruction of the islet cells, or the virus may directly infect the islet cells.
  16. 16.  Research suggests that vitamin D may be protective against type 1 diabetes.  However, early drinking of cow's milk — a common source of vitamin D — may increase infants' risk of the disease
  17. 17. Complications in Type 1 Diabetes  Hypoglycemia  Hyperglycemia  Ketoacidosis
  18. 18.  A condition arising due to low blood glucose.  It can be caused by eating less than usual, more exercise than normal or too much insulin administered.  Sometimes referred to as an ―insulin reaction‖  Must be treated before immediately before symptoms worsen
  19. 19.        Shakiness Dizziness Sweating Hunger Headache Pale skin color Sudden moodiness or behavior changes, such as crying for no apparent reason     Clumsy or jerky movements Seizure Difficulty paying attention or confusion Tingling sensations around the mouth
  20. 20.  If you pass out from hypoglycemia, people should: ◦ NOT inject insulin ◦ Inject glucagon ◦ Call for emergency help
  21. 21.  A technical term for high blood glucose.  It can be caused by a clog in insulin pump tubing, missing an insulin dose, eating more than usual, stress or less exercise than normal.  Can be a serious problem if you don’t treat it
  22. 22.      Ketones are acids that build up in the blood. They appear in the urine when the body doesn’t have enough insulin. They can poison the body. They are also an indicator that your diabetes is getting out of control or that you are getting sick. They are present in high amounts in a condition known as: Ketoacidosis.
  23. 23. Ketoacidosis      Results from a failure to treat hyperglycemia Mostly occur in individuals with type 1 diabetes It is a serious condition that can lead to diabetic coma or even death. Treatment for this condition usually takes place in the hospital. You can prevent this by learning the warning signs and by checking blood and urine regularly.
  24. 24.     Increase with duration of diabetes 50% retinopathy in 20 years of Type 1 diabetes Retinal changes related to diabetes ◦ Hemorrhage, swelling, decreased vision Leading cause of blindness
  25. 25.  Glomerular changes in kidneys of diabetics leading to impaired renal function  First indicator: microalbuminuria  In type 1 diabetics, 10 – 15 years
  26. 26.  Increased risk for Type 1 and 2 diabetics  Development of arterial occlusion and thrombosis resulting in gangrene
  27. 27.  Increased susceptibility to infection  Normal inflammatory response is diminished  Slower than normal healing.  Foot ulcers and infections
  28. 28.    Latent Autoimmune Diabetes in Adults (LADA) It is a form of (type 1 diabetes) which is diagnosed in individuals who are older than the usual age of onset of type 1 diabetes. ― Late-onset Autoimmune Diabetes of Adulthood, "Slow Onset Type 1" diabetes, and sometimes also "Type 1.5
  29. 29. ◦ Patient is symptomatic plus  Casual plasma glucose (non-fasting) is 200 mg/dl OR  Fasting plasma glucose of 126 mg/dl or higher OR  Two hour plasma glucose level of 200 mg/dl or greater during an oral glucose tolerance test
  30. 30. Key Pieces Of Diabetes Self-Management Monitoring blood glucose Following a meal plan Getting regular exercise Taking medication 34
  31. 31.     Eating too much sugar causes diabetes Diabetes is a nuisance, but not serious You can catch diabetes from someone else Herbs and natural supplements can help prevent or treat diabetes
  32. 32.  Diabetes can be kept under check by proper care and treatment  Once diabetes is established it cannot be cured, so stop running after magical cures!!.
  33. 33.  Take insulin through daily shots or an insulin pump.  Eat a healthy diet that spreads carbohydrate throughout the day.  Check blood sugar levels several times a day.  Get regular exercise.  When a small child has diabetes, the parents have the responsibility for blood sugar control.  Treatment may change based on the results of daily home blood sugar tests and other tests or exams.
  34. 34. I-port {$100} 75 injections & 72 hours
  35. 35.    Insulin cannot be taken in pill form. If it were to be consumed orally, it would break down during digestion just like normal proteins in your food. Insulin must be injected into the fat under your skin in order for it to get into your bloodstream.
  36. 36. Treatment Type 1 diabetes is fatal if not treated with external insulin. Insulin: -fast acting and slow acting Delivery: -subcutaneous injection -insulin pump
  37. 37.  During this procedure, islets (clusters of cells from the pancreas that help make insulin) are taken from the pancreas of a deceased organ donor. Then, the islets are purified, processed, and transferred to someone else. These then begin to make and release insulin individually. This could possibly be the biggest step in helping patients with type 1 diabetes live without insulin injections.
  38. 38.             Prevention all starts with a better lifestyle eating healthier being active taking medicine as directed taking care of your body check feet to make sure there is no nerve damage or interruption of blood flow take care of teeth control blood pressure and high no smoking! check in with your doctor at least once a month have your blood sugar checked along with weight, blood pressure, and feelings Check blood sugar levels daily by using home monitoring device