Diabetes mellitus type 1 is a form of diabetes mellitus. The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Diseases Database is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... For the disease characterized by excretion of large amounts of severely diluted urine, see diabetes insipidus. ...

Type 1 diabetes (formerly known as "childhood" or "juvenile" diabetes or "insulin dependent" diabetes) is most commonly diagnosed in children and adolescents. The adult incidence of Type 1 is similar to that for children [1], which is one of the reason for changing the preferred term. Many adults diagnosed with Type 1 have been misdiagnosed as Type 2 diabetics, which has partly accounted for the misconception of Type 1 as a disease of children. See diabetes mellitus for further general information on diabetes. ...

The most important forms of diabetes are characterized by decreases in, or the complete absence of, the production of insulin (Type 1 diabetes), or decreased sensitivity of body tissues to insulin (type 2 diabetes). The most useful laboratory test to distinguish Type 1 from Type 2 diabetes is the C-peptide assay, which is a measure of endogenous insulin production since external insulin to date has included no C-peptide. Lack of insulin resistance, determined by a glucose tolerance test, would also be suggestive of Type 1. Many Type 2 diabetics still produce some insulin internally, and all have some degree of insulin resistance. It has been suggested that Oral insulin be merged into this article or section. ... In medicine, insulin resistance is a decompensation of glucose homeostasis where tissues appear to be less responsive to insulin. ... It has been suggested that Oral insulin be merged into this article or section. ... See diabetes mellitus for further general information on diabetes. ... C-peptide is a peptide which is made when proinsulin is split into insulin and C-peptide. ... In medicine, insulin resistance is a decompensation of glucose homeostasis where tissues appear to be less responsive to insulin. ... A glucose tolerance test in medical practice is the administration of glucose to determine how quickly it is cleared from the blood. ...

Fructosamine, also known as Glycated Serum Protein (GSP) or Glycated Albumin, is used primarily to identify the plasma glucose concentration over time and so assess diabetic control . ... A glucose tolerance test in medical practice is the administration of glucose to determine how quickly it is cleared from the blood. ... Glycosylated (or glycated) hemoglobin (hemoglobin A1c, Hb1c , HbA1c or HgA1c) is a form of hemoglobin used primarily to identify the plasma glucose concentration over time. ...

Pathophysiology

Type I diabetes is usually an autoimmune disorder, in which the body's own immune system attacks the beta cells in the Islets of Langerhans of the pancreas, destroying them or damaging them sufficiently to reduce or eliminate insulin production. The autoimmune attack may be triggered by reaction to an infection, for example by one of the viruses of the Coxsackie virus family. The endocrine (i. ... The pancreas is an organ in the digestive system that serves two major functions: exocrine - producing pancreatic juice containing digestive enzymes. ... It has been suggested that Oral insulin be merged into this article or section. ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Coxsackie A virus is a cytolytic virus of the Picornaviridae family, a enterovirus (a group containing the polioviruses, coxsackieviruses, and echoviruses). ...

Some researchers believe that the autoimmune response is influenced by antibodies against cow's milk proteins. A large retrospective controlled study published in 2006 strongly suggests that infants who were never breast fed had twice the risk for developing Type 1 diabetes as infants who were breast fed for at least 3 months. The mechanism, if any, is not understood. [2] Research has not been able to establish a connection between autoantibodies, antibodies to cow's milk proteins, and Type 1 diabetes. [3] [4] [5] Wikipedia does not yet have an article with this exact name. ... A glass of cows milk Milk most often means the nutrient fluid produced by the mammary glands of female mammals. ... An autoantibody is a protein manufactured by the immune system that is directed against one or more of the hosts own proteins. ...

A subtype of type 1 (identifiable by the presence of antibodies against beta cells) typically develops slowly and so is often confused with Type 2. In addition, a small proportion of Type 1 cases have the hereditary condition maturity onset diabetes of the young (MODY) which can also be confused with Type 2. Maturity onset diabetes of the young (MODY) refers to any of several rare hereditary forms of diabetes mellitus due to dominantly inherited defects of insulin secretion. ...

Vitamin D in doses of 2000 IU per day given during the first year of a child's life has been connected in one study in Northern Finland (where intrinsic production of Vitamin D is low due to low natural light levels) with a reduction in the risk of getting type I diabetes later in life (by 80%) [6]. Some suggest that vitamin D3 may be an important pathogenic factor in type 1 diabetes independent of geographical latitude [7]. Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ...

Some chemicals and drugs specifically destroy pancreatic cells. Vacor (N-3-pyridylmethyl-N'-p-nitrophenyl urea), a rodenticide introduced in the United States in 1975, selectively destroys pancreatic beta cells, resulting in Type 1 diabetes after accidental or intentional ingestion. [8] Vacor was withdrawn from the U.S. market in 1979. Zanosar is the trade name for streptozotocin, an antibiotic and antineoplastic agent used in chemotherapy for pancreatic cancer, that kills beta cells, resulting in loss of insulin production. [9] Streptozotocin (STZ, Zanosar) is a drug used in treating cancer of the pancreas. ... An antibiotic is a drug that kills or slows the growth of bacteria. ... herbs that have the specific action of inhibiting and combating the development of tumors. ... Pancreatic cancer (also called cancer of the pancreas) is a malignant tumour within the pancreatic gland. ...

Other pancreatic problems, including trauma, pancreatitis, or tumors (either malignant or benign), can also lead to loss of insulin production. Pancreatitis is inflammation of the pancreas. ...

Treatment

Main article: Diabetes Management

Currently, type 1 is treated with insulin replacement therapy, carbohydrate counting and careful monitoring of blood glucose levels using Glucose meters. Insulin delivery is also possilbe via an insulin pump, which allows steady infusion of insulin for prolonged periods at preset levels, and the capability to program 'push doses' (ie, boluses) of insulin as needed at meal times. To meet Wikipedias quality standards, this article or section may require cleanup. ... In medicine, blood sugar is glucose in the blood. ... Four generations of blood glucose meter, c. ... An insulin pump is a device used for administering insulin in the treatment of diabetes mellitus. ... Look up bolus in Wiktionary, the free dictionary. ...

Insulin treatment must be continued indefinitely. Continuous glucose monitors are also available to alert the presence of dangerously high or low blood sugar levels. Experimental replacement of beta cells (by transplant) is being investigated in several research programs and may become clinically available in the future. Thus far, beta cell replacement has only been performed on persons over the age of 18.

Prevalence

About 5-10% of North American diabetics have type 1. The fraction of type 1 in other parts of the world differs; this is likely due to both differences in the rate of type 1 and differences in the rate of other types, most prominently type 2. Most of this difference is not currently understood. Variable criteria for categorizing diabetes types may play a part.

Curing Type 1 Diabetes

Although type 1 diabetes is not currently curable, there are several approaches being researched:

• Pancreas transplantation
  • Pancreas transplants are not generally recommended because introducing a new, functioning pancreas to a patient with diabetes can have negative effects on the patient's normally functioning kidney. For patients with kidney failure, however, a pancreas transplant is a viable option.
• Islet cell transplantation
  • Less invasive than a pancreas transplant, Islet cell transplantation is considered a very promising approach to curing type 1 diabetes. In one variant of this procedure, Islet cells are injected into the patient's liver, where they take up residence and begin to produce insulin. The liver is expected to be the most reasonable choice because it is more accessible than the pancreas and the Islet cells seem to produce insulin well in that environment. The patient's body, however, will treat the new cells just as it would any other introduction of foreign tissue: the immune system will attack the cells as it would a viral infection. Thus, the patient also needs to undergo treatment involving immunosuppressants, which reduce immune system activity. Recent studies have shown that Islet cell transplants have progressed to the point that 58% of the patients in one study were insulin independent one year after the operation.^[10]
• Artificial pancreas development
• Genetic engineering (fat or muscle cells that don't normally make insulin might possibly have a human insulin gene inserted — then these "pseudo" islet cells are transplanted into people with type 1 diabetes)
• Immune modification
  • Shutting down the autoreactive T cells that attack beta islet cells, allowing the islet cells to regenerate. Denise Faustman is investigating this hypothesis at Mass General Hospital, in Boston.
• Stem cells
  • Research is being done at several locations in which islet cells are grown from stem cells. As of now they have been transplanted into mice and rats with some success.

Human kidneys viewed from behind with spine removed The kidneys are bean-shaped excretory organs in vertebrates. ... A porcine islet of Langerhans. ... Microscopic image of an islet of Langerhans (lighter area) surrounded by exocrine pancreas tissue (darker staining) Islet transplantation is the transplantation of islets from a donor pancreas and into another person. ... The liver is the largest internal organ of the human body. ... The immune system is composed of a complex constellation of cells, organs and tissues, arranged in an elaborate and dynamic communications network and equipped to optimize the response against invasion by pathogenic organisms. ... Immunosuppressive drugs or immunosuppressants are drugs that are used in immunosuppressive therapy to inhibit or prevent activity of the immune system. ... It has been suggested that this article or section be merged with Insulin pump. ... An iconic image of genetic engineering; this autoluminograph from 1986 of a glowing transgenic tobacco plant bearing the luciferase gene of the firefly, illustrating the possibilities of genetic engineering. ... Autoimmunity is the failure of an organism to recognise its own constituent parts (down to the sub-molecular levels) as Self, which results in an immune response against its own cells and tissues. ... Dr. Denise Faustman Denise Faustman, is a U.S. physician and medical researcher. ... Mouse embryonic stem cells. ...

Further reading

• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) - Diabetes in America Textbook (PDFs)

Notes

1. ↑  Mayo Clinic: "Islet cell transplant: Emerging treatment for type 1 diabetes," 2005.

External Links

• Children with Diabetes
• Type 1 Diabetes at the American Diabetes Association
• The Juvenile Diabetes Forum sponsored by the Juvenile Diabetes Research Foundation