The Evolution of Type 1 Diabetes

Type 1 diabetes, which is also referred as juvenile or insulin-dependent diabetes is a condition that is associated with limited or no production of insulin by the pancreas. According to Atkinson et al. (29), insulin is a very significant hormone in the human body as it allows for the entrance of sugar, in the form of glucose into the human cells to produce energy. As a result, lack of insulin production is quite harmful to the body cells, and Eisenbarth (399) associates this to the evolution of type 1 diabetes. Various factors have been considered to lead to type 1 diabetes, and these include both genetic and viral causative agents. Furthermore, type 1 diabetes is symptomatic both in childhood and in adulthood. Although type 1 diabetes affects individuals of all ages in the US, Atkinson et al. (30) assert that there are limited cases of this disease after the age of 40. Additionally, a study done by Eisenbarth (400) found out that 50% of those affected by type 1 diabetes are children aged 20 years and below.

Several risk factors are linked with type 1 diabetes and most significantly, the family history. This implies that a person who has a sibling or parent who had previously had type 1 diabetes is highly susceptible to this disease. Another factor that may lead to type 1 diabetes is the presence or lack of specific genes within the human body cells. Age, geographical locations, race, and gender are also crucial factors associated with the development of this condition.  

Causes of type 1 diabetes

According to Atkinson (10), the exact causes of type 1 diabetes remain unknown. However, various factors have been considered as risk factors associated with this disease. Most significantly, the genes are supposed to play significant roles in the development of this condition. Genetic factors such as type 1 diabetes history in the family are also considered to contribute to the spread of this disorder largely.

Furthermore, certain viruses that make the pancreas to produce limited or no insulin may also result in this condition. Most individuals who have type 1 diabetes have autoantibodies attack due to the high blood sugar levels. For instance, most researchers have linked individuals who are susceptible to type 1 diabetes to possess a particular human leukocyte antigen (HLA) complex (Atkinson 12). 

For viral infection, when a virus enters the body, it adversely interferes with one’s immune system. During this process, the T-cells can turn against the beta cells which are responsible for making insulin in the human body (Eisenbarth 401). This hinders the production of insulin which in turn raises the blood sugar level and thus causing the evolution of type 1 diabetes.

       Geographic or demographic patterns linked to type 1 diabetes

Eisenbarth (401) argues that the incidence of T1D varies equally both in time and space. The variation in T1D from one environmental location to the other is still unclear and whether these variations result from the difference in places or genetic factors. For instance, T1D is highly prevalent in some European descents, and additionally, Haller et al. (1553) assert that the northern and southern regions are more susceptible to this condition. The high prevalence may be as a consequence of the high latitudes and lack of sunlight which causes a deficiency of Vitamin D.

Although geographical location remains an essential factor that is used to define the prevalence and incidence of this disease among various populations, studies done by Chiang et al. (2034) showed that T1D is highly heterogeneous and studies comparing geographical, cultural or ethnic differences should be handled cautiously.

Physiological effects of T1D

Over time, the rise in sugar levels as a result of T1D can pose a lot of health challenges to the affected individuals. Haller et al. (1554) convey that glucose or blood sugar is the most crucial power house that supplies the human body with energy and as a result, lack of these components may affect the organ, cellular and even the tissue systems. Some of the most common effects of T1D on these body systems include:

The circulatory system: Diabetes can cause damages to the large blood vessels, and this may result in macrovascular diseases. The disease may also affect the small blood vessels leading to the development of micro vascular diseases. The most common complications that may arise from macrovascular damages of the circulatory system include heart attack and stroke.

Cardiovascular system: Since T1D is associated with excess blood sugar which has been conveyed by Eisenbarth (420) to reduce the elasticity of the blood vessels, it implies that there is a correlation between this condition and narrowing of the blood vessels which in turn impedes the flow of blood. Furthermore, professional health organizations such as the Center for Disease and Control (CDC) consider T1D to be a significant risk factor for stroke and other coronary diseases just as smoking and high cholesterol.

Nervous system: According to Haller et al. (1554), when an individual has diabetes, he/she is highly susceptible to develop neuropathy or damage to the nerves. CDC reports that one in every two persons diagnosed with T1D usually has a given level of damaged nerves. The damages caused to the nerves result from lack of enough oxygen delivered into the blood vessels. Haller et al. (1560) argue that the nervous system usually occurs 25 years after diagnosis and the most common damage is the peripheral neuropathy which adversely affects the legs, arms, feet, and toes.

The urinary system: The high blood levels in the human body are associated with damaging the blood vessels within the kidneys. As a result of this damage, the kidneys are prevented from filtering the waste products out of the blood. This leads to the development of kidney diseases which adversely affects the urinary system. Furthermore, CDC confirms that 44% of kidney failures result from diabetes as the primary cause (Chiang et al. 2050).

Typical symptoms

 T1D signs and symptoms are usually quite subtle, and the most common and detectable symptoms include increased thirst and hunger, dry mouth, vomiting and nausea, belly pains, urinating frequently, blurred vision, fatigue, weight loss and difficulties in breathing among other symptoms. Although these symptoms may not be specific to the only T1D, doctors and clinical physicians should not only concentrate on the signs to diagnose an individual of T1D but rather, the blood sugar levels should be used to rule in the presence of this condition.

Tests for diagnosis

Chiang et al. (2051) assert that the determination of T1D requires one or more blood tests. A fasting blood glucose test provides a measurement for the blood sugar (glucose) level after 8 hours when an individual begins the fasting process (no drink or food). However, research has shown that this test is not usually reliable and as a result, diabetes diagnosis requires a multiple of tests which are conducted at different times. Additionally, an oral glucose tolerance test is considered to be more reliable than the former test as it involves drinking a particular solution of glucose and what follows is a fasting blood glucose test two hours after consuming the solution (Atkinson et al. 80). Other T1D diagnosis tests include the random blood glucose test which is usually done at unspecified times, A1C test, and the autoantibody test among others. As argued out by Atkinson (35), all these tests are not 100% accurate, and as a result, doctors should consider the sensitivity, specificity and the positive predictive values of these tests before using them to rule in the presence of T1D in an individual.

Treatments and outcomes

After a person has been diagnosed with T1D, it is the responsibility of the doctors and the patient to ensure that effective treatment is administered to the affected person. Before beginning treatments, the doctors should check the A1C levels of the patient. The most common treatment administered to patients who have type 1 diabetes includes the following:

Taking insulin: In the human body, insulin is usually secreted by the beta cells found in the pancreas. Insulin and glucagon hormones must ensure that the blood sugar levels are maintained in a narrow range. As a result, since the pancreas cannot produce any insulin, the affected individuals should take the artificial insulin as prescribed by the healthcare practitioners. Different types of insulin can be used to maintain the blood glucose levels of affected persons, and the most commonly used include short-acting, rapid-acting and long-acting insulin therapies (Atkinson 30).

Consuming healthy and balanced diets: People with T1D have to be quite cautious with the types of food they consume especially taking into consideration the sugar contents. According to Haller et al. (1577), the most significant nutrients that should never miss in their diets include carbohydrates, fats, and proteins as they act as sources of energy. Also, carbohydrates cause a blood sugar level to rise which is an essential requirement for persons suffering from T1D especially due to the glycaemic level and fiber. Additionally, healthy feeding may help in preventing coronary heart diseases among the affected population. For instance, Atkinson et al. (82) found out that taking meals rich in low fat and sugar contents may reduce cardiovascular disorders.

Regular exercises: Generally, physical exercises are quite crucial in enhancing healthy lifestyles, and this is not an exception for T1D patients. However, the doctors and physicians have to design exercise programs for these individuals as Eisenbarth (420) asserts that physical activities lower the blood glucose levels, which is all those susceptible to this disease need. Although these are the most common treatment and management plans for type 1 diabetes, CDC reported that there are future developments which include pancreas and islet cell transplant which may bring a lot of changes in the health industry.

Summary

In the US, type 1 diabetes is one of the most common diseases that affect various populations. Several factors have been identified to contribute to this condition including genetic and viral factors largely. T1D affects the nervous, urinary, circulatory and cardiovascular systems among other tissues and organs. The most common symptoms include dry mouth, increased thirst and hunger, and increased urination. Diagnosis of this condition consists of the use of multiple tests that range from A1C to fasting blood glucose tests among others. The treatments that should be administered to patients suffering from this disease include healthy eating, taking insulin and regular exercises among others.

Works cited

Atkinson, Mark A. "The pathogenesis and natural history of type 1 diabetes." Cold Spring Harbor perspectives in medicine 2.11 (2012): a007641.

Atkinson, Mark A., George S. Eisenbarth, and Aaron W. Michels. "Type 1 diabetes." The Lancet 383.9911 (2014): 69-82.

Chiang, Jane L., et al. "Type 1 diabetes through the life span: a position statement of the American Diabetes Association." Diabetes care 37.7 (2014): 2034-2054.

Eisenbarth, G. S. (2005). Type 1 diabetes mellitus. Joslin’s Diabetes Mellitus, 14th ed. Kahn CR, Weir GC, King GL, et al., Eds. Lippincott Williams & Wilkins, New York, 399-424.

Haller, Michael J., Mark A. Atkinson, and Desmond Schatz. "Type 1 diabetes mellitus: etiology, presentation, and management." Pediatric Clinics

52.6 (2005): 1553-1578.