Overview

What is diabetes?

Diabetes is a disease in which blood glucose levels are above normal. People with diabetes have problems using food for energy. After a meal, carbohydrates in food are broken down into a sugar called glucose, which is carried by the blood to cells throughout the body. Cells require insulin, a hormone made in the pancreas, to help use blood glucose for energy.

People develop diabetes because the pancreas does not make enough insulin or because the cells in the muscles, liver, and fat do not respond to insulin properly, or both. As a result, the amount of glucose in the blood increases while the cells are starved of energy.

Juvenile/Type 1 diabetes

Prior to 1997, the type of diabetes typically diagnosed in young people was called juvenile diabetes or type 1. Diabetes emerging in adults was called adult-onset diabetes or type 2. Then in 1997, the official names of the types were changed to type 1 and type 2.

Type 1 diabetes is the second most common chronic disease in children (after asthma). About 13,000 new cases are diagnosed in the U.S. each year. Patients with type 1 diabetes make up about 5 percent to 10 percent of all cases of diabetes. It most commonly appears in girls and boys when they are about 14 years old. Usually, type 1 diabetes is first diagnosed in children, teenagers, or young adults but it can occur at any age.

Type 1 diabetes is an autoimmune disease in which the immune system attacks the beta cells in the pancreas that make insulin. As a result, the pancreas does not make insulin, a hormone which helps use blood sugar (glucose) for energy. The cells become starved of energy and there is an excess of glucose in the blood. People with Type 1 diabetes must have daily injections of insulin to live. Proper diet, exercise and home blood sugar monitoring are essential to manage the disease.

Food and exercise must also be balanced because of the risk of hypoglycemia, low blood sugar, and hyperglycemia, high blood sugar.

Both are life-threatening concerns. When hypoglycemia develops, cells are not getting enough glucose. Confusion, loss of consciousness, coma and death results when the brain is deprived of glucose for too long.

Hyperglycemia and prolonged absence of insulin may lead to ketoacidosis, the accumulation of ketones in the blood when the body uses fat for energy instead of glucose. Ketones make the blood acidic and slow down all body functions. Like hypoglycemia, hyperglycemia can also lead to coma and death.

Prognosis

The only cure available today for type 1 diabetes is a pancreas transplant, which is rarely done. Because both pancreas transplants and kidney transplants require lifelong use of powerful drugs to suppress immune reactions that can reject the organs, pancreatic transplants are usually done in those with type 1 diabetes who also need a kidney transplant. The side effects of immune-suppressive drugs can be severe and even worse than the disease. One or two people out of every 10 who get the surgery die within a year. Also the new pancreas is rejected by half of the people who get this operation. If the transplant fails, diabetes returns. Recently, experimental treatments with stem cells have shown some promise. For most people, type 1 diabetes is a life-long disease that can be effectively managed with insulin.

More on Diabetes Type 1

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This article was reviewed and updated June 2007.