Diabetes mellitus type 1, formerly known as insulin-dependent diabetes mellitus, occurs mostly in children and adolescents, and can also occur at various ages. The onset is relatively rapid, and the insulin in the body is absolutely insufficient, which is prone to ketoacidosis. Insulin treatment must be used to obtain satisfactory curative effect, otherwise it will endanger life. The visiting department is the endocrinology department, and the multiple groups are children and adolescents.
The principle of treatment for type 1 diabetes: the treatment of type 1 diabetes should control high blood sugar and avoid hypoglycemia.
1，Autoimmune system defect
A variety of autoantibodies, such as glutamic acid decarboxylase antibody (GAD) and islet cell antibody (ICA), can be found in the blood of patients with type 1 diabetes. These abnormal autoantibodies can damage the insulin secreting B cells of human islets and make them unable to secrete insulin normally.
The present study indicates that genetic defects are the basis of type 1 diabetes, and this genetic defect is found on the abnormal HLA antigen of human sixth pairs of chromosomes. Research suggests that type 1 diabetes is familial onset – if your parents have diabetes, you are more susceptible to this disease than those without family history.
3，Virus infection may be the cause
Many scientists suspect that viruses can also cause type 1 diabetes. This is because patients with type 1 diabetes often have a history of viral infection before onset, and type 1 diabetes often occurs after viral infection. For example, those viruses that cause mumps and rubella, and the family of coxsackievirus, which can cause poliomyelitis, can play a role in type 1 diabetes.
Such as milk, oxygen free radicals, some rodenticide, whether these factors can cause diabetes, scientists are studying.
This disease often occurs in children or adolescents, which is the first characteristic. In addition to children, in fact, type 1 diabetes can occur in all ages of life, especially in menopause. The second characteristics of type 1 diabetes are generally rapid onset, thirsty, polydipsia, polyuria, polydipsia and weakness, weight loss and other symptoms. Some patients have ketoacidosis at the first stage. The third characteristic of type 1 diabetes is that it will eventually be treated with insulin without exception, so type 1 diabetes is also known as insulin-dependent diabetes mellitus.
Antibody tests, namely insulin autoantibodies (IAA), islet cell antibodies (ICA) and glutamic acid decarboxylase antibodies (GAD-Ab), may be positive in type 1 diabetic patients. The insulin and C-peptide levels of Peugeot islet function are very low.
According to the comprehensive judgment of age and clinical manifestations, the diagnosis can also be made by insulin determination.
The difference between type 1 diabetes and type 2 diabetes.
The incidence of type 1 diabetes is related to HLA antigen, while type 2 diabetes has nothing to do with it. Type 1 diabetes can be detected in GAD and other specific antibodies, type 2 diabetes antibody negative; Type 1 diabetes is absolutely deficient in insulin, so it is necessary to use external insulin for life. Type 2 diabetes does not need insulin to maintain life. Type 1 diabetes is often more acute and prone to ketoacidosis, while type 2 diabetes is not.
The goal of insulin therapy for type 1 diabetes is to ensure that patients have good quality of life (that is, to avoid severe hypoglycemia as far as possible) and to control the metabolic level satisfactorily (that is, actively prevent diabetic complications). Metformin and glucosidase inhibitors can also be added to older patients.
Compared with traditional insulin, insulin analogues have pharmacokinetic advantages. For example, lispro or aspart insulin has ultrashort activity, and glargine or detemir insulin can simulate the characteristics of basic insulin. No matter what insulin treatment plan is adopted, patients should first receive special education, learn to monitor blood glucose regularly, adjust the treatment plan in time, and promote blood glucose to meet the standard.