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What Is It?
Type 1 diabetes is a disease in which the body does not make enough insulin to control blood sugar
levels. Type 1 diabetes was previously called insulin-dependent diabetes or juvenile diabetes.
During digestion, food is broken down into basic components. Carbohydrates are broken down into
simple sugars, primarily glucose. Glucose is a critically important source of energy for the body's
cells. To provide energy to the cells, glucose needs to leave the blood and get inside the cells.
Insulin traveling in the blood signals the cells to take up glucose. Insulin is a hormone produced by
the pancreas. When levels of glucose in the blood rise, like following a meal, the pancreas normally
produces more insulin.
Type 1 diabetes occurs when some or all of the insulin-producing cells in the pancreas are destroyed.
This leaves the patient with little or no insulin. Without insulin, sugar accumulates in the
bloodstream rather than entering the cells. As a result, the body cannot use this glucose for energy.
In addition, the high levels of glucose that remain in the blood cause excessive urination and
dehydration, and damage tissues of the body.
Type 1 diabetes is an autoimmune disease. This means it begins when the body's immune system
attacks cells in the body. In type 1 diabetes, the immune system destroys insulin-producing cells
(beta cells) in the pancreas.
Why the immune system attacks the beta cells remains a mystery. Some people are genetically
predisposed to the disease. That does not mean they will necessarily get the disease. It just means
that they are more likely to do so. Something in the environment, such as particular viral infections
or something about the diet, may trigger this autoimmune disease in people with a genetic
predisposition.
Type 1 diabetes is not caused by the amount of sugar in a person's diet before the disease develops.
Type 1 diabetes is a chronic disease. It is diagnosed most commonly between ages 10 and 16. Type 1
diabetes equally affects males and females.
Symptoms
Initial Symptoms
Symptoms usually come on suddenly and strongly. Typically the most prominent symptoms are
excessive urination and extreme thirst. This is because the increased glucose in the blood causes the
kidneys to create more urine than usual. Losing more fluid in the urine makes a person dehydrated.
And dehydration leads to great thirst. Children may start to wet the bed again.
Weight loss, with no loss of appetite, also is common. The weight loss is due in part to dehydration.
Water has weight. Imagine holding a gallon jug of water: it weighs about eight pounds. People with
new, uncontrolled type 1 diabetes can lose a gallon of water from dehydration.
Other common symptoms are weakness, fatigue, confusion, nausea and vomiting. These symptoms
can be caused both by dehydration and by a condition called ketoacidosis.
Ketoacidosis occurs because cells can't use the glucose they need for energy. So the cells have to use
something else. In response to low insulin levels, the liver produces an alternative fuel called
ketones. Ketones are a kind of acid. When they build up in the blood, it's called ketoacidosis.
Ketoacidosis can cause heart problems and affect the nervous system. Within hours, it may put a
person at risk of coma or death.
Chronic Symptoms
Even after it is diagnosed and treatment is begun, type 1 diabetes can affect all body systems. It is
less likely to damage the body, and cause symptoms, if the blood sugar levels are well controlled by
treatment.
The serious and potentially life-threatening complications that can occur with type 1 diabetes
include:
Eye damage (retinopathy) — Tiny blood vessels of the retina (the back of the eye, the part that
senses light) are damaged by high blood sugar. Damage to the vessels can stop the flow of blood to a
part of the retina, or cause bleeding into the retina. Both events damage the ability of the retina to
sense light. Diabetes also can cause a proliferation of new blood vessels that don't effectively feed
blood to the retina, but that do leak and bleed. Caught early, retinopathy can be stopped by tightly
controlling blood sugar and laser therapy. If blood sugar remains high, retinopathy eventually causes
blindness.
Nerve damage (neuropathy) — High blood sugar can damage nerves, leading to pain or numbness of
the affected body part. Damage to nerves in the feet, legs and hands (peripheral neuropathy) is most
common. Nerves that control body functions, such as digestion and urination, also can be damaged.
Foot problems — Sores and blisters commonly occur on the feet of people with diabetes. If
peripheral neuropathy causes numbness, a sore may not be noticed. If it is not noticed, it can more
easily become infected. Blood circulation can be poor, leading to slow healing. Left untreated, a
simple sore can lead to gangrene. Amputation may be necessary.
Diabetes tipe 1 terjadi ketika beberapa atau semua sel penghasil insulin di
pankreas dihancurkan. Ini meninggalkan pasien dengan sedikit atau tanpa
insulin. Tanpa insulin, gula terakumulasi dalam aliran darah daripada
memasuki sel. Akibatnya, tubuh tidak dapat menggunakan glukosa ini
untuk energi. Selain itu, tingginya kadar glukosa yang tersisa dalam darah
menyebabkan buang air kecil dan dehidrasi yang berlebihan, dan merusak
jaringan tubuh.
Gejala awal
Gejala biasanya muncul tiba-tiba dan sangat kuat. Biasanya gejala yang
paling menonjol adalah buang air kecil berlebihan dan haus yang ekstrem.
Ini karena peningkatan glukosa dalam darah menyebabkan ginjal membuat
lebih banyak urin daripada biasanya. Kehilangan lebih banyak cairan
dalam urin membuat seseorang mengalami dehidrasi. Dan dehidrasi
menyebabkan kehausan. Anak-anak mungkin mulai membasahi tempat
tidur lagi.
Penurunan berat badan, tanpa kehilangan nafsu makan, juga biasa terjadi.
Penurunan berat badan sebagian disebabkan oleh dehidrasi. Air memiliki
berat. Bayangkan memegang kendi air galon: beratnya sekitar delapan
pound. Orang dengan diabetes tipe 1 yang baru dan tidak terkontrol dapat
kehilangan satu galon air karena dehidrasi.
Gejala umum lainnya adalah kelemahan, kelelahan, kebingungan, mual
dan muntah. Gejala-gejala ini dapat disebabkan oleh dehidrasi dan oleh
kondisi yang disebut ketoasidosis.
Ketoasidosis terjadi karena sel tidak dapat menggunakan glukosa yang
mereka butuhkan untuk energi. Jadi sel harus menggunakan sesuatu yang
lain.