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What does Type 1 diabetes mean? How different is it from Type 2 diabetes? What are the implications and treatments available? Here is all you need to know about Type 1 diabetes

What is Type 1 diabetes?

Type 1 diabetes is a form of the autoimmune disease caused due to an absolute deficiency of insulin in the body. In layman’s terms, it is a condition caused due to damage to the insulin-secreting beta cells in the pancreas by our immune system, resulting in a complete stoppage of insulin secretion in the body. It is causing extremely high sugar levels, and needing urgent medical care.

Whom Does it Affect?

Although T1DM can occur at any age, it most commonly occurs between the age group of 6 – 8 years or 12-14 years.

What is The Cause?

Although the exact cause is unclear, it is hypothesised that a specific kind of gene leads to that condition. Children with their parents having Type 1 DM, have 5-6% chances of getting T1DM. The chances go up to 30% if both parents are T1DM.It is also possible that it could be the result of a viral infection to the mother during pregnancy., or the child itself.

What Are The Symptoms?

           The onset is usually abrupt, with the child becoming more and more listless in a matter of a week. S/He would need to urinate very frequently, several times in the night. Bedwetting is a typical symptom. In a matter of days, the child loses several kilos of weight and becomes extremely thirsty. If left unchecked, the child may end up with a life-threatening coma called diabetic ketoacidosis or DKA.

How Is It Diagnosed?

Diagnosis is made with blood tests, like the Hba1c, which confirms the diagnosis. Another important test called the c peptide test is done. This determines the insulin supplied in the body. An absence of c peptide is indicative of Type 1 DM.

What are the Treatment Options for Type 1 Diabetic?

Unfortunately, there is no other treatment except insulin therapy. Most patients require multiple small shots of insulin per day. Usually, insulin is given as a shot using a syringe or a pen-like device. A novel insulin pump or continuous subcutaneous insulin infusion device(CSII) has been around for two decades. It is a pager-like device worn on the body, delivers insulin continuously and is regulated by a mobile phone-like device. One press of a button delivers the dose. The advantage is preventing multiple jabs, and CSII gives extremely good control of sugars. A novel wireless device called omnipod which can be attached to the body, is available in some countries and probably would be available in India very soon.

INSULIN PENS

INSULIN PUMP(CSII)

OMNIPOD

How is Carb Counting Done?

First, let’s understand what carbohydrate counting is? It is a method by which the amount of carbohydrate (CHO) in a given food is determined or counted so that the insulin dose required to cover that particular meal is calculated and insulin is adjusted appropriately.

This is how it is done.

First, the total daily dose (TDD) of insulin required by the patient is calculated. Generally, 0.55 units of insulin are needed per kg body weight. If we have someone who is 40 kg, the TDD roughly comes to 20-24 units.

Then the Insulin Sensitivity Index (ISI) is calculated. Generally, a standard number,500, is divided by TDD. In our example, this means

ISI= 500/20 = 25 gm.

This means 1 unit of insulin covers 25 gms of carbohydrates.

So, if a patient takes 1 cup of rice, which has 50 gms of CHO, then as per our calculation, we need 50/25= 2 units. So the patient needs 2 units of insulin to cover this rice cup. This is how T1DM patients can calculate the insulin they need to take to cover a meal. The carb content of most foods are available on google.

In this manner, A T1DM can self-manage his insulin doses.