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Diabetes type 1 - Bri Stidham, Treatments - Coggle Diagram
Diabetes type 1 - Bri Stidham
Pathogenesis
Type 1 Diabetes is due to pancreatic islet destruction predominantly by an autoimmune process. T1D is caused by a T cell mediated autoimmune destruction of the pancreatic beta cells. The natural process of the body using insulin occurs when blood glucose concentration declines, then homeostasis is restored. After homeostasis occurs, it is disturbed, like after eating something with lots of sugar, causing the beta cells to release insulin.
The release of insulin causes an increased rate of glucose transporting into the cell, ATP generation, increased conversion of glucose to glycogen, increased protein synthesis, and increased fat synthesis. This cycle repeats over and over in a healthy individual. In those with T1D, the beta cells produce less and less insulin after an autoimmune event, preventing the cycle to continue.
The loss of beta-cells will eventually lead to insulin insufficiency and hyperglycemia. The genetic region of T1D is the human leukocyte antigen locus. The cause of beta-cell death is still being researched, but it is known that after antigen presenting cells present beta-cells to the immune system, an immune response occurs due to inefficient regulation of immune reactions. Beta-cell death then induces the release of antigens and initiates an immune response against other healthy beta-cells. Auto-reactive T cell's are activated by the dendritic cells, stimulating auto-reactive cytotoxic T and B cells. The overall process of beta-cell destruction includes cooperation of dendritic cells, macrophages, T, B, and natural killer cells.
sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6004986/
Incidence/Prevalence
It seems to be an equal risk in males vs. females
About 1.45 Americans have Type 1 Diabetes.
200,000 people under 20 years old have T1D.
It is estimated that around 64,000 people each year are diagnosed with T1D
By 2050, 600,000 people under 20 years old are expected to have T1D.
Between 2011-2012, 17,900 individuals under the age of 20 were diagnosed with T1D.
T1D is growing 2.1% each year, compared to the population growth of 0.8.
Less than 1/3 of people with T1D achieve consistent target blood-glucose numbers.
There is $16 billion in T1D associated healthcare expenses and lost income each year.
Sources:
https://beyondtype1.org/type-1-diabetes-statistics/
Risk Factors
Type 1 Diabetes is assumed to be caused by an immune reaction, so the exact cause or prevention is unknown at this time. Some factors that may play into getting diagnosed with
T1D includes:
Family history: having a parent or sibling with T1D
Age: Any individual can get diagnosed with T1D, but it typically develops in children, teens, or young adults.
sources:
https://www.cdc.gov/diabetes/basics/risk-factors.html
Diagnostics
Glycated hemoglobin (A1C) test: A blood test that shows an average blood sugar from the last 2-3 months. This test measures the amount of blood sugar attached to hemoglobin. If there is an elevated amount of sugar attached to hemoglobin, the higher the blood sugar levels. An A1C of 6.5% or higher on two separate tests indicates diabetes.
Random blood sugar test: Taking a random blood sugar test
after eating/ at any time to see the levels. If the blood sugar is above 200 mg/dL, this suggests Diabetes.
Fasting blood sugar test: A blood sugar test would occur after fasting overnight, or for an extended period of time. A sugar of 100 mg/dL is healthy, 100-125 mg/dL is pre-diabetic, and 126 mg/dL or higher on two tests is considered diabetic.
Clinical Manifestations
Some symptoms of T1D includes:
-increased thirst, frequent urination, bed wetting in children who do not frequently wet the bed, increased hunger, weight loss, irritable and mood changes, tired and weak, blurry vision.
sources:
https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011
Take insulin
Count carbohydrates, fats, and proteins
Monitor blood sugar frequently
Clean diet
Exercise regularly and keep healthy weight
Types of insulin:
Short acting- Also known as regular insulin. This insulin works about 30 minutes after injection. Its peak is 90-120 minutes and lasts 4-6 hours. Some examples are Humulin R and Afrezza.
Rapid-acting insulin- This insulin works within 15 minutes. Peak is reached around 60 minutes and lasts 4 hours.
Intermediate acting- NPH insulin, starts working about 1-3 hours. Peak is reached about 6-8 hours and lasts 12-24 hours.
Long-acting insulin- Provides coverage from about 14-40 hours. Examples are glargine, detemir, and degludec.
Insulin delivery options:
Injections or an insulin pump: a small device worn outside the body programmed to deliver certain amounts of insulin throughout the day while you eat.
Other medications prescribed for T1D:
High blood pressure medications: ACE inhibitors or ARBs can be prescribed to keep kidneys healthy.
Aspirin: To protect your heart and due to increased cardiovascular events.
Cholesterol-lowering drugs: T1D people are on stricter cholesterol restrictions due to higher risk for cardiovascular disease.
Treatments
