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Type 1 Diabetes Mellitus is a serious condition that can change rapidly.

Type 1 Diabetes develops most commonly in children, teenagers, and young adults. The cause of this condition is an immune or viral attack on one’s pancreas, specifically upon the insulin-producing centers of the pancreas, which are called the Islets of Langerhans. The Islets of Langerhans are tiny “nests” of specialized cells which “sense” the blood levels of glucose and synthesize and secrete insulin in response. These Islets can be destroyed, however, by viral attack or by immune attack, where one’s own immune system produces antibodies that specifically attach and destroy the Islet cells. The immune attack seriously knocks out insulin production, and the result is persistent elevation in blood glucose concentrations that can be severe.

The change in the pancreas’ ability to detect glucose concentrations and secrete insulin can vary from mild to moderate to severe. It depends upon the severity of the immune attack. If moderate or severe, blood glucose concentrations can rise from the normal range of 70-100 mg/dL to values above 500 mg/dL or even above 1000 mg/dL. These very high concentrations of glucose lead to rapid dehydration, impaired alertness or even coma, and falling blood pressures to the level of true shock. Hence, Type 1 Diabetes Mellitus is termed “brittle,” because it can cause major sickness so rapidly.

Why an individual experiences immune attack or viral attack on the pancreas is not fully understood. A genetic susceptibility may be one reason. Exposure to a particular virus may be another reason, but researchers in the cause of Diabetes are not certain.

Blood testing can reveal antibodies to the Islet Cells of Langerhans. These antibodies are called “Anti Islet Cell Antibodies,” and this blood test can be done in hospital laboratories and national testing centers. Detecting Anti Islet Cell Antibodies is an important assessment for a young person who develops elevated blood glucose concentrations, as this result commands rapid management. Insulin blood concentrations can be measured also and then a plan for insulin prescribing, by injection, can be developed and tailored.

With insufficient insulin production, blood glucose concentrations will rise and swing dramatically, and insulin replacement is the essential prescription for the young person confirmed to have Type 1 Diabetes Mellitus.

Brittle is a very important qualifier for Type 1 Diabetes Mellitus, for once insulin replacement is prescribed for every day injection, a day or two days of forgotten insulin injection will likely bring on rapid deterioration of balance, with rapidly rising glucose concentrations, rapid dehydration, mental change, and deterioration into a diabetes crisis. Severe illness and life threatening ketoacidosis can and will likely evolve. More about this is written in companion articles.

All family members and close friends of a person known to have Type 1 Diabetes Mellitus must be informed, aware, and alert to this brittle nature of Type 1 Diabetes Mellitus. Caring reminders and helpful guidance to the affected person to inject their insulin on schedule, without failure, and to adhere to the diabetic diet with precision will immensely help to control this brittle disease.

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Source by Rex L. Mahnensmith, M.D

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