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Type 1 Diabetes Mellitus (T1D or Insulin-Dependent Diabetes)



Definition

The term type 1 diabetes mellitus (T1D or insulin-dependent diabetes) is used to denote a chronic disease directly associated with the inability of a human body to produce the hormone insulin. In other words, this type of diabetes is caused by autoimmune destruction of beta cells in the pancreas that are responsible for the production of insulin. The given paper aims to shed light on the pathophysiology of T1D. In addition, much attention will be paid to the diagnosis and treatment of the disease.

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Type 1 Diabetes Mellitus

In general, diabetes mellitus is included in the list of incurable disorders that deal with the failure of insulin secretion and action. In simple words, diabetes mellitus may be characterized as the imbalanced production of insulin, need in this hormone, and finally, the ability of a human body to use available amounts of insulin (Thent, Das, & Henry, 2013). The causes of the development of diabetes mellitus remain unknown even in the 21st century. Nevertheless, the majority of the researchers believes that genetics and the exposure to threatening viruses are the main factors that may influence the development and progression of the disease. In other words, genetic, acquired, and environmental components may cause both types of diabetes mellitus (Thent et al., 2013).

Taking into account the pathophysiology of T1D, it is important to note that the disease results in the autoimmune destruction of ?-cells in the pancreas (Ozougwu, Obimba, Belonwu, & Unakalamba, 2013). Consequently, the destruction of ?-cells may lead to severe metabolic derangements directly associated with insulin-dependent diabetes mellitus. The early stages of destruction of beta cells are connected with decreases or loss of pulsatile insulin secretion. In addition, the level of blood glucose rises, hence spilling into the urine and resulting in osmotic diuresis. Rapid weight loss among patients with T1D is caused by the breakdown of fat and structural proteins. Moreover, these changes in a human organism cause many other manifestations of uncontrolled diabetes, especially polyuria and thirst.

The researchers in the sphere of healthcare claim that the absence of insulin on a cellular level influences overproduction of acidic ketone bodies. Consequently, it results in serious complication of diabetes that is usually referred to as diabetes ketoacidosis (Ozougwu et al., 2013). Deficiency of insulin negatively affects insulin administration. Insufficient amounts of hormone insulin cause uncontrolled lipolysis and increasingly elevated amounts of free fatty acids in blood plasma. The latter stops glucose metabolism in numerous peripheral tissues, especially in skeletal muscle. In general, the researchers concluded that insulin deficiency negatively impacts glucose metabolism, lipid metabolism, and, finally, protein (Ozougwu et al., 2013).

Concerning the patho of clinical manifestations, which encompasses common signs and symptoms of T1D, it is important to note that increased thirst, polyuria, xerostomia, lack of energy, drowsiness, fatigue, increased irritability, confusion, and unexplained loss of weight are the most common signs of this disease (American Diabetes Association, 2015). In the majority of cases, signs and symptoms are similar in both types of diabetes mellitus. However, experimental data prove that inT1D, symptoms become apparent more rapid (American Diabetes Association, 2015). It is important to note that the most common symptoms of T1D are often classified as 4Ts. They are four most noticeable and widespread symptoms, including polydipsia, unnaturally high levels of urination, continuous feeling of exhaustion, and finally, unexplained weight loss. Because patients with T1D suffer from excessive amounts of fluid produced by the kidneys, their bodies become dehydrated, weak, exhausted, and confused (American Diabetes Association, 2015).

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Investigations and scientific experiments of sequelae of the disease process prove that T1D can result in numerous life-threatening complications. For example, diabetic ketoacidosis is one of the most dangerous complications of T1D, which occurs when a human body starts to produce extremely high levels of ketones that may be compared to blood acids (American Diabetes Association, 2015). The most common symptoms and signs of ketoacidosis are excessive tiredness, vomiting, lethargy, and nausea. Diabetic ketoacidosis is a life-threatening complication of T1D because it may lead to coma and death in the case of ineffective and untimely treatment. Moreover, hypoglycemia is another high-risk complication of T1D, which is usually referred to as low blood sugar or glucose.

This complication is dangerous because it attacks the central nervous system and may lead to difficulty speaking, continuous headaches, abnormal breathing, blurred vision, and even stupor or coma. Many research studies provide convincing evidence that T1D may lead to a number of dangerous consequences and complications. They may include damages of nerves, retinopathy, sexual dysfunction, foot problems, hypertension, nephropathy, and numerous heart diseases, including strokes (American Diabetes Association, 2015). T1D impedes normal blood circulation, which is the reason gangrenes and amputations are common among patients diagnosed with this health disorder (American Diabetes Association, 2015).

Despite the fact that the diagnosis of T1D can be easily identified based on classical symptoms, especially excessive thirst, weight loss, and increased urine volumes, diagnostic tests are usually required to prove the diagnosis. Doctors insist on undergoing the glycated hemoglobin test, blood sugar test, and simple blood test to diagnose this type of diabetes (American Diabetes Association, 2010). The glucose tolerance test is sometimes vital for detecting T1D because it shows resistance and response of a human body to sugar. Finally, a full history of patients and complete examinations together with several laboratory tests will diagnose diabetes, identify its classification, and decide on effective treatment (American Diabetes Association, 2010).

The correct differential between type 1 and type 2 diabetes mellitus is challenging because of similar signs and symptoms. Nevertheless, the clinical presentation is considered the most reliable indicator of diabetes type. It should be stressed that T1D compared to T2D is usually diagnosed in the early childhood. Finally, routine screening is an effective method for the diagnosis of T2D (American Diabetes Association, 2010). Other differentials for T1D may include monogenic diabetes mellitus, endocrine disorders, chronic pancreatic, alcohol abuse, vitamin B-12 deficiency, and nondiabetic glycosuria.

The researchers have concluded that T1D is incurable and not currently preventable disease because it can only be prevented before it starts damaging beta cells. In general, insulin replacement therapy is considered the mainstay of treatment. According to the research results, insulin has given the chance to medical professionals to save approximately 5 million people diagnosed with T1D during the year 2010 (Schneider, Kretowicz, & von Herrath, 2013). In addition, scientists always improve the quality of production, formulation, and delivery of insulin doses and preparations. The primary purpose of insulin is to prolong the life of patients with T1D and decrease the risks of possible complications (Schneider et al., 2013). Therefore, insulin aims at slowing the progression of chronic complications that are typical to both types of diabetes.

However, available data prove that people with T1D treated with insulin suffer from poor glycemic control in comparison to patients treated with alternative therapies. Immunosuppressive drugs are comparatively ineffective for treatment of T1D because health-threatening side effects make them harmful for long-term use (Schneider et al., 2013). Pancreas and islet cell transplantation is sometimes the best option for patients with T1D because they may restore proper regulation of glucose. Despite the success rate of transplantation is not high, it is the best choice for patients who cannot control their body systems with the help of insulin intake (Schneider et al., 2013).

Summary

Finally, client self-care and education are tremendously important because every person with T1D should have enough knowledge and skills to follow therapeutic targets and control weight and blood pressure. Effective dietary therapy, herbal treatment, and moderate physical activities positively impact the quality of life of patients with diabetes mellitus (Thent et al., 2013).

As a result, having identified the nature of T1D, analyzed pathophysiology of the disease, established diagnosis and effective methods of treatment, it is possible to sum up that diabetes mellitus is a dangerous incurable disease that results in unbearable human suffering and the huge economic costs. In general, genetics, environmental factors, and viruses usually cause this type of disease. In addition, T1D leads to severe infections and dysfunctions, starting from continuous headaches and ending with diabetic ketoacidosis or amputations. However, insulin treatment, herbs, healthy lifestyle, avoidance of negative habits, and a balanced diet are the most effective methods for people with T1D to prolong their lives and make them more qualitative.

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