What are the clinical symptoms and immune factors of type 1 diabetes?

Diabetes is a type of diabetes that has become more common among children and adolescents in recent years. This type of diabetes is very harmful to patients. It can even be said that the impact of type diabetes on patients will be lifelong. For those patients with type diabetes, if it is not treated in time, it may endanger their normal life and health. Many patients with type 2 diabetes will have problems such as drinking too much water, getting hungry easily, and having no energy.

Type 1 diabetes has a great impact on the physical and mental growth of young children. At the same time, this type of diabetes is also an acute disease. Usually, type 1 diabetes is directly related to respiratory and digestive tract infections. The following is an introduction to type 1 diabetes patients, which I hope will attract the attention of parents.

Type 2 diabetes - clinical symptoms

Common symptoms

The onset of the disease is relatively acute, and about 1/3 of type 1 diabetes patients have a history of fever and upper respiratory tract, digestive tract, urinary tract or skin infection before the onset of the disease.

Drinking and urinating frequently, eating frequently and feeling hungry easily, but also losing weight, becoming noticeably emaciated, feeling tired, listless, and having blurred vision. Children with type 1 diabetes may experience enuresis after they have regained control of their urination, which is often an early symptom of diabetes.

complication

Patients with type 1 diabetes are susceptible to various infections, especially respiratory and skin infections. Female infants may also suffer from fungal vulvitis with perineal infection as the most obvious symptom.

Children with type 1 diabetes who have unsatisfactory long-term blood sugar control may develop cataracts within 1 to 2 years. Patients with advanced type 1 diabetes suffer from retinopathy and renal impairment due to microvascular disease.

Type 1 diabetes - etiology and pathology

Autoimmune system defects: Because a variety of autoimmune antibodies can be detected in the blood of patients with type 1 diabetes, such as glutamic acid decarboxylase antibodies (GAD antibodies), islet cell antibodies (ICA antibodies), etc. These abnormal autoantibodies can damage the insulin-secreting beta cells of the human pancreas, making it unable to secrete insulin normally. Therefore, the medical community has high expectations.

Genetic factors

Studies have shown that genetic defects are the basis for the onset of type 1 diabetes, and this genetic defect is manifested in abnormal HLA antigens on the sixth pair of human chromosomes. Scientists' research suggests that type 1 diabetes has a familial history - if your parents have diabetes, you are more likely to develop the disease than people without this family history.

Immune factors

Type 1 diabetes is an autoimmune disease mediated by T lymphocytes and characterized by immune insulitis and selective pancreatic β-cell damage. Approximately 67% to 88% of the pancreases of newly diagnosed children with type 1 diabetes are confirmed by histological examination to have insulitis and significant infiltration of T and B lymphocytes. Through follow-up testing of autoantibodies in offspring of type 1 diabetes, islet cell autoantibodies (ICA) were discovered first, followed by glutamic acid decarboxylase antibodies (65KD GADA), tyrosine protein phosphorylase antibodies (IA2A), and insulin autoantibodies (IAA).

Viral infection factors

It may surprise you, but many scientists suspect that viruses can also cause type 1 diabetes. This is because patients with type 1 diabetes often suffer from viral infections in the period before developing the disease, and the "epidemic" of type 1 diabetes often occurs after a viral epidemic. Viruses, such as those that cause mumps and rubella, and the coxsackievirus family that can cause polio, can play a role in type 1 diabetes.

Environmental factors

Environmental factors include viral infection, milk feeding during infancy, vaccination, climate, geography, toxins, and stress, all of which can contribute to the onset of type 1 diabetes. In these settings, there has been much research into viral-induced type 1 diabetes. Studies have found that for patients with newly diagnosed type 1 diabetes, specific IgM antibodies to some viruses can be detected in the serum of many cases, such as coxsackie virus, rubella virus, cytomegalovirus, mumps virus, etc., and enterovirus plays a more important role in the onset of type 1 diabetes.

Type 1 diabetes - pathogenesis

It is currently believed that type 1 diabetes is caused by the destruction of pancreatic islet cells by viruses or toxins, which leads to an autoimmune response based on genetic predisposition. It is generally believed that there are two mechanisms for B cell destruction. One is that viruses or poisons may directly damage cells. The other is that in most cases these external factors cause certain changes in pancreatic B cells, inducing an autoimmune response and causing the cells to slowly die.

Type 1 diabetes - Clinical diagnosis

Various pathogenic factors lead to insufficient insulin sources. When the fasting insulin level drops below 5μIU/ml (international unit), it is type 1 diabetes. If GAD or ICA is positive, the diagnosis can be confirmed by combining clinical diagnosis.

Diagnosis

A fasting insulin level lower than 5 μIU/ml (international unit) and a fasting blood glucose level higher than 6.8 mmol/L (millimolar) is diagnosed as type 1 diabetes.

Laboratory tests

Fasting blood sugar>6.6mmol/L, 2h postprandial blood sugar>11.1mmol/L.

For blood sugar testing, the urine collected before each meal and before going to bed is called "intra-urine" (4 intra-urine times a day), and the urine collected between two intra-urine times is called "segmental urine" (4 segmental urine times a day). In untreated patients, urine sugar is often positive, with 24-hour urine sugar >5g.

Glycated hemoglobin reflects the comprehensive average level of blood sugar within 2 months and is a reliable indicator for judging the long-term blood sugar control of children. >8.5%～10% is considered mildly elevated. The number of those who have not received treatment or those who are not satisfied with the control after treatment is more than 14%.

β-cell function is determined by measuring insulin and C-peptide levels at different time phases while measuring blood sugar during the glucose tolerance test. In children with type 1 diabetes, the peak blood glucose level increases significantly during glucose load and fails to return to baseline levels within 2 hours, while the insulin and C-peptide responses are low.

Blood lipids in untreated type 1 diabetic patients are significantly elevated.

Patients with type 1 diabetes are also prone to various symptoms. Therefore, parents who have type 1 diabetes patients at home must do a good job of daily care for the patients. When any problems are found, seeking medical attention in time is the best way to avoid tragedy.