Thursday, April 27, 2017

Diabetes Tipe 1 - Symptoms, causes and treats

Understanding Type 1 Diabetes

Diabetes is a chronic (chronic) disease that occurs when the pancreas (the salivary glands) does not produce enough insulin, or when the body does not effectively use insulin. While type 1 diabetes itself is a type of diabetes with low insulin production. Therefore, type 1 diabetes is also called insulin dependency diabetes, otherwise known as diabetes autoimmune disease with a cause that is not known for sure.

Diabetes Tipe 1 - Symptoms, causes and treats

Blood sugar levels are usually controlled by the hormone insulin. If the body is less insulin, blood sugar levels will increase dramatically due to the buildup, this is called hyperglycemia. This is what happens when a person has type 1 diabetes mellitus.
The cause of the lack of insulin production by the pancreas in type 1 diabetics is not known until now so can not be concluded how to prevent it. This type of diabetes can arise at any age, generally affecting patients under age 40, especially children (childhood-onset diabetic). Sometimes known as diabetes 'teenagers'

Diabetes Patients in New York

By 2015, diabetics in Indonesia are estimated to reach 10 million people with an age range of 20-79 years (quoted from the International Diabetes Federation). However, only about half of them are aware of his condition.
Southeast Asia is one of the areas with high prevalence for Type 1 diabetes. In 2010, it is estimated that there are about 113,000 children under 15 who have type 1 diabetes with an estimated 18,000 new cases each year.

General Symptoms and Complications of Type 1 Diabetes Patients

Common symptoms of diabetes in early diseases, also known as classical symptoms in the medical community, are frequent urination (polyuria), often thirsty (polydipsia) and often hungry (polyphagia). These symptoms will develop and worsen with the uncontrolled blood sugar levels (hyperglycemia) that damage tissues and organs, and complicate.
Without insulin, the sugar in the blood can not enter and be used by the cells of the body. Eventually, the body will process fat and muscle into energy causing weight loss. This can lead to an acute condition called diabetic ketoacidosis,condition in which the blood becomes too acidic and the occurrence of harmful dehydration.
High blood glucose levels can also cause damage to blood vessels, nerves, and organs. Therefore, diabetes can lead to a number of complications if not controlled properly. Increased blood sugar levels are not significant and does not trigger any symptoms can cause damage if it occurs in the long term.

Diagnosis and Treatment of Type 1 Diabetes

Insulin dependence or type 1 diabetes includes diseases that can not be cured and can only be controlled. Early diagnosis of diabetes is very important so that treatment can be done so that high blood sugar levels of patients can be controlled. Treatment of diabetes aims to maintain the balance of blood sugar levels and control the symptoms to prevent possible complications.
Pancreatic organs in the body of type 1 diabetics do not produce insulin anymore so they must receive insulin supply from outside the body on a regular basis. They are also required to learn to adjust their doses with the food consumed, blood sugar levels, and activities performed.
The process of adjustment should be done in stages. Some types of insulin that can be used include:
  • Long-acting insulin that can last a day.
  • Short-acting insulin that can last up to eight hours.
  • Fast-acting insulin that does not last long, but reacts quickly.
The way of treatment for diabetics can use a combination of the above types of insulin.
Transplantation of insulin-producing pancreatic cells (islet cells) may also help some people with type 1 diabetes. In this process, islet cells from those taken from deceased donors will be inserted into the pancreas of type 1 diabetics.
Islet transplantation is effective to reduce the risk of severe hypoglycemia attacks. Hypoglycemia is a condition in which blood sugar levels fall too low. This condition is as dangerous as blood sugar levels that are too high. However, despite the countries already implementing islet transplants, many diabetics are reluctant to take care of them because of the high risk.
A healthy and balanced diet and regular exercise can reduce blood sugar levels for diabetics. Quitting smoking can also reduce the risk of heart disease complications.

Symptoms Of Type 1 Diabetes

Early symptoms of type 1 diabetes, also known as the classic symptoms, namely:

  • Frequent urination, especially at night (polyuria).
  • Frequent thirst (polydipsia).
  • Often feel hungry (polyphagia).
It can also be accompanied by other symptoms that arise suddenly, among others:
  • Weight loss.
  • Blurred vision due to changes in shape of the lens in the eye.
  • Fatigue
Symptoms of type 1 diabetes can develop and deteriorate rapidly within a few weeks or even a few days. If patients experience nausea, vomiting, severe deep breath, bad breath, such as fruits, loss of appetite, abdominal pain, or fever high, see your doctor.

Causes Of Type 1 Diabetes

The cause of type 1 diabetes is unknown, but it is suspected that genes may have an effect on the onset of the disease.
Type 1 diabetes was once considered an autoimmune condition. In general, the human immune system serves to resist and destroy anything that is considered foreign or dangerous. In the case of type 1 diabetes, the immune system has mistakenly attacked the cells in the pancreas so that the production of insulin stops. This is because the immune system thinks the pancreas is harmful to the body.
The cause behind the immune system's reaction to these pancreatic cells is not known for certain. However, a combination of several factors is believed to cause this condition.
Hereditary factors are a major predisposing factor for diabetes. A person's risk of developing type 1 diabetes will be slightly higher if there is a nuclear family (mother, father, or sibling) who suffer from the same illness.
The environment is also believed to increase the risk of type 1 diabetes. Examples are as follows:
  • Virus . There is one theory that describes a number that allegedly stimulated an autoimmune response that would attack infected cells and beta cells in the pancreas. For example, enterovirus, Epstein-Barr virus, rubella virus, rotavirus, and mumps virus.
  • Drugs and chemical compounds. There are a number of drugs or chemical compounds that are believed to destroy pancreatic cells, namely pyrinuron and strepzotocin.
  • Gluten . One of the proteins in gluten, gliadin, is thought to potentially affect the development of type 1 diabetes.

Type 1 Diabetes Diagnosis

Early diagnosis of diabetes is very important so that treatment can be done immediately. If you have diabetes symptoms, you should immediately consult a doctor.

Urine test and Glucose Blood Glucose for Determining Content

The regular doctor will ask you for a urine test and blood test. The urine sample will be tested to check the glucose content. Under normal conditions, urine does not contain glucose. However, the substance will accumulate and flow to the kidneys and urine, if you have diabetes. The doctor will also usually check whether there is a ketone content (a compound that indicates type 1 diabetes already complicated) in your urine.
If there is glucose in the urine, you will usually be advised to have a blood test to confirm the diagnosis. Your blood sample is generally taken twice, ie fasting glucose and two hours after meals.
Blood samples for fasting glucose test will be done on the morning after you have fasted for 8 to 12 hours. You will then be given a drink containing the prescribed sugar content.
Exactly two hours later, your blood sample will again be taken for glucose testing to evaluate the activity of insulin in your body.

HbA1c test

The results of this examination will show average blood sugar levels in patients' blood over the last 2 to 3 months. A HbA1c level of 6.5% or greater indicates that the patient has diabetes. This test can also be used as a preliminary examination for people at risk of developing diabetes.

Autoantibody test

This procedure can be used to differentiate type 1 and 2 diabetes before the patient has hyperglycemia.

Type 1 Diabetes Treatment

Diabetes can not be cured. Treatment of diabetes aims to maintain the balance of blood sugar levels and control the symptoms to prevent possible complications.

Step Treatment with Insulin

Pancreatic organs in the body of type 1 diabetics are not able to produce insulin so that patients should receive insulin supply every day. There are several types of insulin that can be used. Among them:
  • Fast-acting insulin whose effect does not last long, but reacts quickly.
  • Short-acting insulin that can last a maximum effect of eight hours.
  • Long-acting insulin that can last a maximum effect a day.
Treatment for diabetics may use a combination of the above insulin types.
Insulin by injection
The most common way of insulin delivery is by injection. This method is chosen because if taken in tablet form, insulin will be digested in the stomach like food and can not get into the blood.
In the early stages of use, doctors will usually help you to inject insulin. Then you will be taught how to inject and store insulin and throw the needle safely.
There are two methods that are usually used to give insulin injections, namely through needles and syringes or pens. Diabetics generally need two to four injections per day.
Insulin Pump
Another alternative to injecting insulin is with an insulin pump. This insulin container is small. A small hose complete with a needle at the end will connect the pump to your body. The needle is generally inserted into the body through the stomach, but there are also put it through the hips, thighs, buttocks, or arms.
This pump will channel insulin into the bloodstream at adjustable doses so you will not have to do any more insulin shots. But you still need to be vigilant and monitor your blood sugar levels thoroughly to ensure you receive the right dose of insulin.
An insulin pump is very practical and can be used by all people with type 1 diabetes, especially those who often have low sugar levels. This tool is also not widely used in Indonesia because of its expensive price.

Blood Sugar Level Monitoring 

Keep your blood sugar level balanced

The main goal of diabetes treatment is to maintain the balance of blood glucose. You can do it with insulin treatment and a healthy diet, but to ensure normal blood sugar levels, you need regular blood sugar checks.
Some of the factors that can affect your blood sugar levels are:
  • Stress.
  • The frequency and intensity of the sport.
  • Other diseases such as runny nose or cough.
  • Taking other drugs.
  • Consumption of alcoholic beverages.
  • Changes in the amount of hormones during menstruation.
Examination of blood sugar itself can be done through a simple blood test with a small prick on the finger. This test is generally recommended for diabetics. You may need to do it four or more times a day. The type of insulin treatment you undergo will affect the required test frequency. The doctor will also explain about the ideal blood sugar levels.
Milligrams/deciliter (mg / dL) is the unit of blood glucose used in general in Indonesia. Therefore, you should be careful, make sure the unit first when buying a blood glucose test and know the value of referrals.
Examination of blood sugar levels regularly
In addition to your own daily monitoring, you are encouraged to take HbA1c test every 2-6 months. This process will show your blood sugar balance as well as the level of effectiveness of the type of treatment you are undergoing.
Methods of Handling Hyperglycemia
High blood sugar levels (hyperglycemia) can occur for several reasons, such as excessive eating, lowered health conditions, or insufficient doses of insulin. Adjustment of diet or dose of insulin will be needed diabetics who have hyperglycemia. Doctors can also help you to find the best adjustments.
Untreated hyperglycemia can cause serious complications. The body will process fat and muscle as an alternative energy source, and increase the level of acid in the blood (diabetic ketoacidosis).
Diabetic ketoacidosis is very dangerous and can result in people experiencing dehydration, vomiting, loss of consciousness, even death. Therefore, people with diabetes who experience hyperglycemia should be treated immediately in the hospital. Patients also usually will be given infusion to increase body fluids, such as saline and potassium.

Handling Method H ipoglikemia

When your blood sugar level is too low, you will experience hypoglycemia. This condition can occur in all diabetics but generally, occurs in people with type 1 diabetes.
Some of the symptoms for mild hypoglycemia are weakness, tremor, and hunger. This condition can be overcome by eating sweet foods or drinks, such as soft drinks (not the type of diet), sugar, or raisins. Pure glucose in tablet or liquid form can also be consumed to treat hypoglycemia rapidly.
Severe hypoglycemia will lead diabetics to feel dazed, drowsy, and even loss of consciousness. Patients with diabetes who experience this condition should be given a glucagon injection (a hormone that can increase blood sugar levels quickly) directly on the muscles or veins.
Loss of consciousness due to hypoglycemia means that hypoglycemia may recur again a few hours later. Therefore, take a break and make sure that someone is with you.
You will need immediate medical help and glucagon injections again if you remain drowsy or unwell for 10 minutes after receiving the first glucagon injection of the muscle.

Handling with Islet Transplant

Islet transplantation may also help some people with type 1 diabetes. In this process, islet cells are obtained from deceased donors and transplanted into the pancreas of type 1 diabetics. Islet cells are a type of pancreatic cells that produce insulin.

Handling with Pancreatic Transplant

Pancreatic transplantation can restore the body's glucose control ability, especially for people with type 1 diabetes with conditions that are fluctuating or have unstable blood sugar levels. However, this procedure is high risk because it requires a more harmful immunosuppression process than insulin replacement therapy so it is only recommended along with or after a kidney transplant.

Other Drugs to Reduce the Risk of Complications

People with type 1 diabetes have a higher risk of developing complications, such as heart disease, stroke, and kidney disease. Therefore doctors may suggest the following medications reduce the risks, such as:
  • Statins to reduce high cholesterol levels.
  • High blood pressure -lowering drugs.
  • ACE inhibitor drugs, such as enalapril, lisinopril, or ramipril, if there are indications of diabetic kidney disease. The development of disease characterized by the presence of albumin protein in the urine can be controlled if treated promptly.
  • Low-dose aspirin to prevent stroke.
In addition to medical treatment, applying a healthy lifestyle can also help in treating type 1 diabetes. For example by low-carbohydrate diet, enough exercise, and avoid stress


High blood sugar levels can cause damage to blood vessels, nerves, and organs. Therefore, diabetes can trigger a number of complications if not controlled properly. Increased blood sugar levels are not significant and not trigger any symptoms can result in long-term impact.

Diabetic Retinopathy

Diabetes can cause damage to blood vessels in the retina (retinopathy). The blood vessels may become blocked, leaked, or grow randomly, blocking the light to reach the retina. This complication can lead to blindness if left unchecked.

Checking your eyes every year will help the early detection of retinopathy so that it can be treated as soon as possible.
Early detectable diabetic retinopathy can be treated with laser surgery. However, this procedure is only to maintain the power of vision and not to heal.

Diabetes Neuropathy (Neural Damage)

Excess blood glucose can damage the fine blood vessels and nerves. This can trigger the sensation of tingling or stinging that usually starts from the fingertips of the hands and feet, then spread to other body parts. Neuropathy that attacks the digestive system can cause nausea, vomiting, diarrhea, or constipation.
Something we usually realize too late, ie damage to the nerves or inhibition of blood flow in the legs can increase the risk of foot health complications. If left unchecked, small cuts and scratches on the feet of diabetics can develop into serious infections.
Patients who have experienced nerve damage should check the condition of his feet every day. If there is a change, consult with your doctor. Foot examination by the doctor is also recommended at least once a year. Complications on the foot that you should be aware of are:
  • Injuries that do not heal.
  • Skin that feels hot to the touch.

Heart Disease and Stroke

Diabetics are five times more likely to develop heart disease or stroke. Blood sugar levels are not balanced and left long enough to increase the risk of atherosclerosis, ie narrowing of blood vessel flow that usually occurs due to accumulation of cholesterol. These complications have the following risks:
Inhibits blood flow to the heart and causes angina attacks (known as sitting wind). Angina attack is indicated by the presence of chest pain that feels pressing.
Causes a heart attack or stroke because it increases the risk of blockage of blood vessels in the heart or brain.

Diabetic Nephropathy (Kidney Damage)

The kidneys have millions of fine blood vessels that filter waste from the blood. If the blood vessels are clogged or leaky, your kidney's performance will decrease.
Severe damage to the kidneys can lead to kidney failure. If you have kidney failure, you will need dialysis (dialysis) or even a kidney transplant.

Sexual Dysfunction

Diabetes can damage both the blood vessels and the nerves. Therefore, male diabetics (especially those who smoke) may experience erectile dysfunction. This disorder can usually be treated with medication.

Meanwhile, women with diabetes also have the potential to experience sexual dysfunction, such as decreased sexual satisfaction, lack of sex drive, failed to reach orgasm, pain during intercourse, and a dry vagina. Handling in diabetic women who have vaginal discharge or feel pain during intercourse can use lubricants or gels.

Miscarriage and Birth Death in the Fetus

This disease can harm the mother and the fetus. The risk of miscarriage and stillbirth will increase if pregnant women's diabetes is not handled thoroughly. Blood sugar levels that are not well maintained during early pregnancy may also heighten the risk of birth defects.
Pregnant women with diabetes are advised to check their diabetes condition regularly to a hospital or clinic. This routine consultation will make it easier for the doctor to monitor the mother's blood sugar level and control the dose of insulin that should be given.

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