Type 1 Diabetes Mellitus

What Is Diabetes?

The term diabetes refers to metabolic diseases associated with an elevated blood glucose level, primarily the result of insulin resistance (type 2 diabetes) or insulin deficiency (type 1diabetes). These metabolic disorders are associated with a significantly increased risk of concomitant and secondary diseases. The preliminary stage of diabetes mellitus is called prediabetes.

Type 1 Diabetes Mellitus: Causes and Development

An absolute insulin deficiency primarily causes type 1 diabetes. Insulin is a hormone that ensures that the sugar ingested with food, which enters the blood after digestion, can be absorbed by the liver, fat cells, and muscles.

The liver, fat, and muscles are the storages for sugar. If insulin is lacking, it remains in the blood and cannot be absorbed. The insulin deficiency in type 1 diabetes is caused by the body's immune system destroying the cells that produce insulin (pancreatic ß-cells).

Type 1 diabetes is thus one of the autoimmune diseases. These are caused by a parental inheritance of defective genes or their mutation. The peak incidence of type 1 diabetes is between the ages of 5 and 25, which means that it mainly affects young people.

A unique form of type 1 diabetes is "latent autoimmune diabetes with onset in adults" (LADA), a late manifestation of type 1 diabetes between the ages of 30 and 60, which is often diagnosed as type 2 diabetes at the beginning.

What Are the Symptoms of Type 1 Diabetes?

While symptoms rapidly accompany type 1 diabetes, type 2 diabetes has a slow onset, usually without symptoms in the early stages. The main symptoms of diabetes include fatigue, poor performance, increased urination (polyuria), and a strong feeling of thirst (polydipsia). In addition, weight loss, vision problems, itching, and susceptibility to infections can be symptoms of diabetes.

How Is Type 1 Diabetes Mellitus Diagnosed?

Diabetes diagnostics is primarily carried out by detecting elevated sugar levels in the blood. In this context, a glucose value above 125 mg/dl when fasting indicates diabetes mellitus. In addition, the sugar content in the urine can be an indication of diabetes. To diagnose type 1 diabetes mellitus, specific antibodies must be detected in the blood. These are components of the blood that the body produces to destroy cells that produce insulin mistakenly.

In the treatment of diabetes mellitus type 1, regular checkup examinations must take place to assess the adjustment to the medication and the development of possible secondary diseases.

Diabetes Treatment

The therapy goals are to enable a standard quality of life and reduce the risk of secondary diseases. In addition, acute complications should be avoided. Therefore, the first step is to achieve harmless target blood glucose levels. Fasting blood glucose and blood glucose before meals must not exceed 120 mg/dl.

Intensive Insulin Therapy for Type 1 Diabetes

Type 1 diabetes mellitus is treated with intensive insulin therapy. Here, the insulin supply is adjusted to the food intake (basic bolus principle). Long-term insulin is administered in the morning to maintain a constant insulin concentration. At mealtime, additional insulin is then taken or injected according to the subsequently measured blood glucose levels. Insulin therapy may also be administered via an insulin pump.

Diabetes Complications: Diabetic Coma & Hypoglycemia

Acute symptoms or complications of diabetes are diabetic coma and low blood glucose if the diabetes is not treated correctly. When blood sugar levels are too low, falls and dizziness can occur because the brain does not get enough sugar. Diabetic coma results from too high a blood sugar level. The sugar in the blood then pulls the water from other organs, which regarding the brain can lead to loss of consciousness and even coma

Diabetes Late Effects and Secondary Diseases

Late effects of diabetes include diabetic angiopathy (sugar molecules deposit on and clog blood vessels), diffuse macroangiopathy (myocardial infarction), peripheral arterial occlusion disease (blockage of leg arteries), and ischemic cerebral infarction (stroke due to sugar molecules in the arteries of the brain).

Diabetic Angiopathy

Diabetic microangiopathy refers to the occlusion of small vessels by the sugar molecules. This includes diabetic nephropathy, in which the sugar molecules destroy the kidney and its vessels. Furthermore, diabetic retinopathy (destruction of the retina of the eye) and diabetic maculopathy (macula: point of sharpest vision of the retina) can be accompanied by swelling of the macula. In the process, these diseases can lead to significant visual impairment or blindness.

In other words, these diseases occur due to the clogging of the arteries by the increased circulating sugar molecules in the blood. As a result, the affected areas are no longer adequately supplied with oxygen-rich blood and are thus damaged.

Another group of symptoms is caused by diabetic polyneuropathy; this means damage to the body's nerve fibers caused by the increased sugar molecules. In this process, the sugar molecules settle on the nerves and lead to various pathological changes. These include symmetric peripheral sensorimotor polyneuropathy, in which unpleasant to painful body sensations (tingling, numbness, pain) occur in both legs. In addition, the feeling of pain or temperature in the legs may be reduced. There may also be pain and weakness in the thigh and pelvic muscles.

Nerves in the brain (oculomotor nerve, facial nerve) may also be damaged, resulting in facial and eye muscle deficits. Rarely, the nerves of other areas of the body may also be affected (gastrointestinal tract, bladder, esophagus). Diabetic foot syndrome results from reduced blood flow and damage to the foot (take a look at the article "diabetic foot syndrome").

Which Doctor is the Right Contact for Diabetes Mellitus?

The right contact person for diabetes is a specialist in internal medicine, specializing in endocrinology (metabolic diseases) and/or diabetology. After consulting such a doctor, you can get nutritional counseling or advice from the treating physician.

We will help you find an expert for your condition. All listed physicians and clinics have been reviewed by us for their outstanding specialization in type 1 diabetes mellitus and are awaiting your inquiry or request for treatment.