By Athena Philis-Tsimikas, M.D., Scripps Health
With Type 2 diabetes reaching epidemic proportions in America, Type 1 diabetes has received little media attention. However, in recent years Type 1 diabetes—the chronic, lifelong form of diabetes that occurs when the pancreas does not produce enough insulin to properly control blood sugar levels—has been on the rise. Formerly known as “juvenile diabetes” because it is most often diagnosed in children, adolescents and young adults, Type 1 diabetes is now affecting a growing number of adults as well. Up to three million Americans have been diagnosed with Type 1, and adults represent nearly half of the 30,000 new cases diagnosed each year.
People with diabetes either cannot produce enough insulin to correctly regulate blood sugar levels or cannot properly process the insulin they do produce (a condition known as insulin resistance). As a result, their blood sugar levels are higher than normal, which can lead to serious and often life-threatening complications such as kidney failure, heart disease, nerve damage, blindness and more.
Unlike Type 2 diabetes, which is often linked to being overweight and can be managed with medication and lifestyle changes, Type 1 diabetes cannot currently be prevented or cured. In people with Type 1, the body’s immune system attacks its own insulin-producing cells in the pancreas, thereby preventing the body from producing enough insulin to regulate blood sugar. Early symptoms of Type 1 diabetes include increased thirst or hunger, unexplained weight loss and frequent urination. Because these symptoms tend to come on so quickly, some people may have no idea they have diabetes until they find themselves receiving emergency treatment for a critical insulin deficiency. Within five to ten years, the insulin-producing cells of the pancreas are completely destroyed and the body can no longer produce any insulin at all. As a result, most people with Type 1 diabetes require daily insulin injections.
The exact cause of Type 1 diabetes remains a mystery, but researchers believe both heredity and environmental factors such as viruses may play a role. There are about 50 genes linked to the disease, and a person’s risk of developing Type 1 diabetes increases with the number of genes he or she shares with other family members who have been diagnosed. If an immediate relative (parent, sibling or child) has Type 1 diabetes, the risk of developing the disease is 10 to 20 times greater than the risk of the general population. If one child in a family has Type 1 diabetes, siblings have about a 1 in 10 risk of developing it by age 50.
The earlier Type 1 diabetes is detected and treated, the better. A simple blood test can help detect it up to 10 years before symptoms appear, enabling physicians to begin treatment and, ideally, minimize or even prevent insulin deficiency emergencies and long-term health complications. A free nationwide screening, Type 1 Diabetes TrialNet, offers testing to family members of people with Type 1 diabetes. The blood is tested for certain antibodies that indicate an increased risk for Type 1 diabetes; those who have the antibodies are invited to participate in a study that monitors the likelihood of developing the disease. To date, more than 100,000 people have been screened nationwide, and about 5 percent have tested positive for the antibodies.
Screenings are available to anyone age 45 or younger whose sibling, parent or child has been diagnosed with the disease. Screenings also are recommended for people 20 years old or younger with a cousin, aunt, uncle, niece, nephew, half-sibling or grandparent with Type 1. In San Diego County, screenings are available at the Scripps Whittier Diabetes Institute in La Jolla; for more information, call 858-626-5695. For information on screening locations across the country, go to www.diabetestrialnet.org.
Athena Philis-Tsimikas, M.D., is corporate vice president for the Scripps Whittier Diabetes Institute. “To Your Health” is brought to you by the physicians and staff of Scripps. For a physician referral or more information, please call 1-800-SCRIPPS.