If 80% of the insulin-producing cells of the pancreas are destroyed, the available insulin is not sufficient to break down the sugar.
Typical symptoms of type 1 diabetes then appear within days and weeks:
- Unquenchable thirst
- Heavy urine production
- Weight loss
- States of exhaustion
- Frequent infections
Increasing metabolic derailment can lead to coma. The smell of acetone in the breath can also indicate type I diabetes.
To date, many possible causes have been discussed for the development of the disease (genetic, environmental and nutritional factors). However, there are no clear findings to date.
How does insulin deficiency lead to increased blood glucose levels in the blood?
Insulin is a messenger substance that the beta cells in the pancreas produce and release into the bloodstream. Insulin plays a key role in the regulation of blood sugar. It is the only hormone in the body that lowers blood sugar levels.
Insulin controls carbohydrate metabolism and ensures that the liver or muscles absorb, utilize or store blood sugar. Insulin therefore inhibits sugar production in the liver.
When energy requirements are high (stress, sport, fever), the body can ensure that the organs are supplied with sugar as fuel.
If this fine interplay of hormones gets out of balance, the blood sugar level rises. In this case, we speak of diabetes mellitus - diabetes.
Specialists in the treatment of diabetes are specialists in the field of diabetology. To diagnose whether diabetes mellitus is present, doctors carry out a blood glucose test.
The fasting blood glucose level (when measured repeatedly) and the HbA1c value are meaningful. The HbA1c value expresses the long-term sugar level in the blood. Doctors also use a sugar load test (oral glucose tolerance test) for the diagnosis. Here the doctor measures the course of the blood sugar level in the blood after the patient has drunk a sugar solution.
Due to the relatively rapid manifestation of the disease, type 1 diabetics are usually conspicuous by their severely elevated blood glucose levels. Patients often already have pronounced symptoms that indicate the disease. In addition to elevated blood glucose levels, type 1 diabetics often have specific autoimmune markers in their blood. This allows this disease to be differentiated from other forms of diabetes, which is important for treatment.
The short-term treatment goal for type 1 diabetes is to prevent metabolic imbalances and alleviate the associated symptoms. This means avoiding sharp increases in blood sugar levels or hypoglycemia.
As there is an insulin deficiency in type 1 diabetes, the patient receives insulin for treatment. This is usually given by injection or via an insulin pump. In addition, doctors also use procedures such as natural islet cell transplantation in individual cases.
Researchers are also working on experimental therapy methods ("artificial islet cell organ"). The long-term goal of insulin therapy is to prevent secondary diseases.
Possible secondary diseases include damage to the
- eyes
- feet
- kidneys
- blood vessels
- nerves
Diet plays a major role in patients with type 1 diabetes. How much and when they inject insulin is linked to their meals. A correct and conscious diet is therefore a lifelong component of diabetes therapy.
The islet cell transplant
Islet transplantation is a form of therapy that transfers insulin-producing cells ("islets") from a donor organ.
Who is eligible?
Patients (predominantly type 1 diabetics) for whom insulin doses or insulin pumps are not sufficient and who continue to suffer from severe derailments (hypoglycaemia).
How does islet isolation and transplantation work?
Experts isolate the islets from a donor organ using a complex digestion process. The islets are tested according to strict criteria such as purity, sterility and function. The islets are then flushed into the patient's liver via the hepatic vein. There they settle and start producing insulin.
What happens after the transplant?
The recipient's immune system recognizes the transplanted cells as "foreign". This would normally result in rejection of the transplant. To prevent this, islet recipients must take immunosuppressive medication.
The most important therapeutic goal of islet cell transplantation is to restore the body's own insulin production and stabilize glucose metabolism. In some cases, insulin independence is even possible for several years.
