There are two major types of diabetes, called type 1 and
type 2. Type 1 diabetes was also formerly called insulin dependent diabetes mellitus
(IDDM), or juvenile onset diabetes mellitus. In type 1 diabetes, the pancreas
undergoes an autoimmune attack by the body itself, and is rendered incapable of
making insulin. Abnormal antibodies have been found in the majority of patients
with type 1 diabetes. Antibodies are proteins in the blood that are part of the
body's immune system. The patient with type 1 diabetes must rely on insulin
medication for survival.
Type 1 diabetes
In autoimmune diseases, such as type 1 diabetes, the
immune system mistakenly manufactures antibodies and inflammatory cells that are
directed against and cause damage to patients' own body tissues. In persons with
type 1 diabetes, the beta cells of the pancreas, which are responsible for
insulin production, are attacked by the misdirected immune system. It is
believed that the tendency to develop abnormal antibodies in type 1 diabetes is,
in part, genetically inherited, though the details are not fully understood.
Exposure to certain viral infections (mumps and
Coxsackie viruses)
or other
environmental toxins may serve to trigger abnormal antibody responses
that cause damage to the pancreas
cells where insulin is made. Some of the antibodies seen in type 1
diabetes include anti-islet cell antibodies, anti-insulin antibodies and
anti-glutamic decarboxylase antibodies. These antibodies can be
detected in the majority of
patients, and may help determine which individuals are at risk for
developing
type 1 diabetes.
At present, the American Diabetes Association does not recommend
general screening of the population for type 1 diabetes, though
screening of high risk individuals, such as those with a first degree
relative (sibling or parent) with type 1 diabetes should be encouraged.
Type 1 diabetes tends to occur in young, lean individuals, usually
before 30 years of age, however, older patients do present with this
form of diabetes on occasion. This subgroup is referred to as latent
autoimmune diabetes in adults (LADA). LADA is a slow, progressive form
of type 1 diabetes. Of all the people with diabetes, only approximately
10% have type 1 diabetes and the remaining 90% have type 2 diabetes.
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