Type 1 diabetes mellitus (T1DM)

Description of the Disease

This metabolic syndrome features chronic hyperglycemia (elevated glucose concentration in the blood) and disrupts carbohydrate, fat, and protein metabolism due to impaired insulin secretion or action in the pancreas. Type 1 diabetes (T1DM) develops due to absolute insulin deficiency. It can originate idiopathically (when the cause is unknown) or result from the destruction of pancreatic beta cells caused by an autoimmune process (these cells produce insulin). Type 1 DM typically occurs at a young age, usually up to 20-25 years old, but can also appear as late as 40.

Symptoms

The onset of the disease is sudden, with frequent and abundant urination (children may wet the bed), thirst, itching, and tingling around the genital area. Other symptoms include weight loss, increased fatigue and weakness, increased appetite, and a smell of acetone from the mouth due to ketoacidosis. Ketoacidosis occurs when the body cannot break down glucose and produce energy due to the lack of insulin. To compensate for the lack of energy, the body rapidly breaks down fats, producing substances called ketone bodies. The body then releases these ketone bodies into the blood and excretes them in the urine. When their concentration reaches a critical level, a diabetic coma, which is life-threatening, can occur.

Diagnosis

Laboratory blood and urine tests determine elevated levels of glucose, ketones, increased glycated hemoglobin (HbA1c), and C-peptide. An ophthalmologist consultation is also required.

Treatment

Patients receive lifelong insulin prescriptions. They receive training on how to use insulin and acquire knowledge about diet, physical activity, and monitoring sugar levels.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology