• The person has excessive thirst, as the person urinates more frequently.
• As the disease develops, the person may become progressively hungry, as the body burns its own fat for energy.
Some common symptoms of diabetes to watch for.
• Even though the person may be hungry and eat more, there may also be sudden weight loss, as the body continues to burn its own fat.
• Although they are not as much of a sign as the others mentioned above, nausea and vomiting can accompany the disease in some people.
Is type 1 diabetes more harmful to women than to men?
According to a recent study in The Lancet Diabetes & Endocrinology, it appears that type 1 diabetes is truly more harmful to women than to men.
The researchers looked at 26 studies that included more than 200,000 participants and found that women with type 1 diabetes had more than twice the risk of men of dying from heart disease, a 37 percent higher risk of dying from stroke, and a 44 percent greater risk of dying from kidney disease.
Some scientists believe that the fluctuating hormone levels in women may affect their sensitivity to insulin.
Furthermore, women’s blood vessels may experience more damage than men’s vessels when blood glucose levels are higher.
Overall, the researchers recommend close monitoring of blood glucose levels in women with type 1 diabetes, and paying more attention to the risk factors (such as high blood pressure) that can raise women’s chances of cardiovascular events.
What is LADA?
LADA is a form of type 1 diabetes mellitus.
It is referred to by many names, including latent autoimmune diabetes in adults (LADA), late-onset autoimmune diabetes of adult hood or aging, slow-onset type 1 diabetes, or type 1.5 diabetes.
In this disease, the type 1 diabetes diagnosis is made when the person is an adult.
It comes on more slowly in adults, with the person not usually being overweight (as in type 2 diabetes) and having low or no insulin resistance.
Overall, for a person who develops type 1.5 diabetes, insulin may not be needed for months or, in some cases, years (one report stated that insulin is, on the average, required five to ten years after diagnosis).
No one knows how many adults truly have LADA because many health care professionals use the term LADA only for super-slow-to-develop cases, not all type 1 adult cases.
What is polydipsia?
P olydipsia is the medical term for abnormal thirst. It is also considered an early symptom of diabetes, especially type 1. This thirst occurs because the body, as it suffers from elevated blood glucose (sugar) levels, responds by eliminating the excess glucose through urination. And as the person urinates more, the body demands more water, which is why a person with diabetes often experiences excessive, abnormal thirst.
Why do some adults develop LADA?
As in young children who develop type 1 diabetes, LADA diabetes apparently occurs in adults because of autoantibodies, or the antibodies that attack the insulin-producing cells in the pancreas. LADA can also form because of a person’s genetics or if someone in the person’s family (most likely a parent and/or sibling) has diabetes. (For more information about autoantibodies, see this chapter.)
POSSIBLE REASONS FOR TYPE 1 DIABETES
What causes most cases of type 1 diabetes?
It is thought that there are several reasons for the development of type 1 diabetes, but most of them are debated or still need to be studied. The most commonly mentioned one involves the body’s own immune system attacking beta cells in the pancreas, causing the organ to stop producing insulin. The development of the disease is thought to be part genetic, but scientists (to date) agree that no one characteristic seems to bring about type 1 diabetes.
How long does it take for type 1 diabetes to develop?
There is no real set “schedule” for a person to eventually develop type 1 diabetes. According to research and statistics, the body’s autoimmune system can attack a person’s beta cells over months or even years, eventually resulting in type 1 diabetes.
What are some of the definitions of “type 1.5 diabetes”?
T he term “type 1.5 diabetes” has been used to describe several different types of conditions. In some research, it is also called LADA, or latent autoimmune diabetes in adults. Type 1.5 diabetes has also been used to describe the condition of a person who has both type 1 and 2 diabetic features. In particular, the body not only fails to make its own insulin but also resists injected insulin (it has also been called “double diabetes”).
Do only young children develop type 1 diabetes?
No, it is a misconception that only children develop type 1 diabetes. Although the majority of type 1 diabetics are children, which is why so many people erroneously believe any adult-onset diabetes must be type 2, an adult can develop a slow-onset form of type 1 diabetes called latent autoimmune diabetes in adults (or LADA; for more about LADA, see above).
Can exposure to chemicals or drugs cause type 1 diabetes?
A few studies suggest that there may be a connection between type 1 diabetes and exposure to chemicals or drugs. But it is unlikely that such an environmental factor (such as exposure to a chemical or drug) alone can cause diabetes. It may be that if a person with a genetic susceptibility (inheriting a particular set of genes) is exposed to a certain chemical or environmental “triggering” factor, he or she may develop type 1 diabetes. But overall, this concept is highly debated.
What are the chances of developing type 1 diabetes because someone in the person’s family has the disease?
According to several studies, including one from the Joslin Diabetes Center, if a father has type 1 diabetes, the child has a 7 percent chance of developing the disease; if the mother has type 1 diabetes, the child has a 2 percent chance of developing type 1 diabetes. Other research suggests that the risk for developing type 1 diabetes is between 1 and 10 percent for people with a parent or sibling with the disease. Overall, the average chance of a child’s developing type 1 diabetes is 0.3 to 0.4 percent.
Why does heredity play a part in type 1 diabetes?
Although the genetic component of type 1 diabetes is not as strong as for type 2 diabetes, there is a reason for the higher risk of the disease being passed from generation to generation. Research has shown that DNA, or deoxyribonucleic acid, the set of instructions that tells the cells in the body how to grow, live, and function, mutates, increasing the risk for the disease.
Scientists have found that certain genes seem to be associated with type 1, type 2, and intermediary diabetes.
What are antibodies and autoantibodies?
Certain white blood cells of a person’s immune system are mainly responsible for protecting the body from germs and foreign invaders, including T cells (they attack foreign cells directly) and B cells (they produce antibodies, or special proteins that can recognize the surface shapes of molecules that attack the body).
Autoantibodies, usually found in people with autoimmune disorders, are B cells that sometimes make their own antibodies and recognize a person’s own cells. In the case of type 1 diabetes, it is thought that the autoantibodies identify the insulin-producing cells of the pancreas (beta cells) as cells to be attacked, and from there, the T cells destroy the beta cells.
What autoantibodies are common in people with type 1 diabetes?
There appear to be three autoantibodies that are common in people with type 1 diabetes.
In the pancreas, these autoantibodies recognize and attack the islet cells (of which beta cells are one type), insulin, and glutamic acid decarboxylase (a protein made by the beta cells in the pancreas, also called GAD or the 64 K protein).
The autoantibodies seem to be markers in the body and contribute to the destruction of the pancreas’ beta cells by identifying which cells should be attacked by the immune system.
Ultimately, this causes the immune system’s T cells to destroy the insulin-producing cells of the pancreas.
Overall, of the people who are newly diagnosed with type 1 diabetes, 70 to 80 percent have autoantibodies to islet cells, 30 to 50 percent have autoantibodies to insulin, and 80 to 95 percent have autoantibodies to GAD. These autoantibodies often appear before the symptoms of type 1 diabetes show up. Thus, some researchers suggest that people who are at higher risk of developing type 1 diabetes be screened for these autoantibodies.
Can a virus cause type 1 diabetes?
Through the many years of research on type 1 diabetes, several reports have suggested that the disease may be caused by a virus. To date, no such virus, or even indirect evidence of such a virus, exists. Here are several of the viral-diabetes connection suggestions:
• One suggestion is that people who develop type 1 diabetes, according to some reports, often have had a recent viral infection before they are diagnosed. It has also been reported that many diagnoses of type 1 diabetes occur after a major viral outbreak.
• Another suggestion comes from research suggesting that viruses that cause mumps and German measles, along with the Coxsackie family of viruses (related to the virus that causes polio), may play a role in the development of type 1 diabetes. The researchers note that a certain autoantibody (see above) is almost identical to a region of a protein found in the virus Coxsackie B4. And because both are similar, the immune system’s T cells may not be able to tell the difference, thus destroying the “invading” cell, but in reality destroying the body’s own beta cells.
• Still another virus suggestion is that type 1 diabetes is a relatively new disease caused by a slow-acting virus, causing the immune system to attack proteins in the pancreas. To date, no such virus has been found.
INSULIN AND TYPE 1 DIABETES
Why does a person with type 1 diabetes need to take insulin?
A person with type 1 diabetes will need to take insulin for the rest of his or her life. In this case, the person’s immune system mistakenly has attacked and destroyed the pancreas’ beta cells that are responsible for producing insulin. Without insulin to aid blood glucose to be used by the body’s cells, the person’s blood glucose levels rise. There must be some type of replacement, thus, a person with type 1 diabetes must take insulin (usually by injection) every day.
What is insulin shock?
Insulin shock occurs if a person’s blood glucose levels are extremely low, causing him or her to lose consciousness. Such a severe low blood glucose level is considered a medical emergency.
Do people with type 2 diabetes ever have to take insulin injections?
Yes, some people with type 2 diabetes may eventually have to take injections of insulin to stabilize their blood glucose levels, especially if they take oral medications (like metformin) for a long time. (For more about type 2 diabetes and insulin, see the chapter “Prediabetes and Type 2 Diabetes.”)
In type 1 diabetes the pancreas doesn’t produce insulin, and therefore, glucose builds up in the body.
What are the various types of insulin a person with type 1 diabetes (and sometimes eventually a person with type 2 diabetes) takes?
There are several types of insulin you can take, each serving a different purpose for a person with type 1 diabetes (and sometimes eventually a person with type 2 diabetes). Some are used one at a time, while others can be taken in combination. They include rapid-acting, regular or short-acting, intermediate-acting, long-acting, or pre-mixed. (For more about the various types of insulin, see the chapter “Taking Charge of Diabetes.”)