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Type 1 diabetes is an autoimmune disease that affects approximately one of every 250 Americans.¹ Japan has one of the lowest incidence rates of Type 1 diabetes in the world, averaging 2.37 cases per 100,000 persons in children aged 0-14.²

Usually insulin is secreted by the pancreas in small amounts. However, after a meal, glucose from the food stimulates the pancreas to release insulin in an amount based on the size of the meal. Once insulin has transported the glucose to the body’s cells and the amount of glucose in the blood has decreased, the beta cells in the pancreas reduce the amount of insulin secreted to avoid hypoglycemia (low blood glucose levels). In Type 1 diabetes, the body’s immune system destroys the beta cells (which are responsible for producing insulin) in the pancreas. This results in a complete lack of insulin. Without insulin, the body cannot move nutrients, especially glucose, into the body’s cells where the nutrients are used as a source of energy to function, and the entire process breaks down.

Researchers are not sure what causes Type 1 diabetes. There is a genetic component that makes certain people susceptible, but scientists also believe that an environmental trigger plays a role in causing the disease. It appears that something in the environment, perhaps a toxin or a virus, tricks the immune system into mistakenly destroying the beta cells. Autoantibodies, markers of the destruction, can be seen in 85 to 90 percent of people with Type 1 diabetes when their blood glucose levels are high.³

The symptoms of Type 1 diabetes include polydipsia (thirst), polyuria (excessive urination), increased hunger, dry mouth, nausea, unexplained weight loss and fatigue. Currently it is not possible to prevent diabetes, and there is no cure. People with Type 1 diabetes inject insulin to maintain their blood glucose levels within the normal range. Exubera (insulin human [rDNA origin]), the first inhaled insulin, was approved by the U.S. Food and Drug Administration in 2006. It is a short-acting insulin designed to be taken just before meals, and is usually used in combination with longer-acting injected insulins. Other forms of insulin, such as mouth sprays and topical applications (e.g., patches), are also in development.

When blood glucose levels are not well controlled, retinopathy, nephropathy (kidney damage) and neuropathy (damage to nerves) can result. However, with effective meal planning, exercise and intensive insulin therapy, many people with Type 1 diabetes live long and healthy lives.

Discussion questions

1. Please summarize the article. What is the main point of the article?
2. What is the prevalence of Type 1 diabetes?
3. What is Type 1 diabetes?
4. What causes Type 1 diabetes?
5. How is Type 1 diabetes treated?
6. What are the potential long-term effects of Type 1 diabetes?
7. How can the potential long-term effects of Type 1 diabetes be avoided?

References:

1. WebMD.com. (Accessed February 26, 2007)
2. Kawasaki E, Matsuura N, Eguchi K. Type 1 diabetes in Japan. Diabetologia. 2006 May; 49(5):828-36. Epub 2006 Mar 28. (Accessed February 26, 2007)
3. WebMD.com. (Accessed February 26, 2007)