“Will my daughter have type 1 diabetes for the rest of her life?”
My daughter was diagnosed with type 1 diabetes 3 years ago, and it feels like we just had gotten the hang of managing the disease. Will she have diabetes for the rest of her life, or will it go away?
3 Answers
Type 1 diabetes is insulin dependent diabetes or also known as juvenile diabetes. It is classified in to two groups. About 90% of type 1 diabetes (type A) is due to autoimmune disease process while the 10% type 1 diabetes (type B) is not related to autoimmune process. But both require insulin not only to control diabetes but also for survival.
Type 1 diabetes is therefore an autoimmune destruction of the insulin producing cells called Islet cell, located mainly at the head of the pancreas. About 90% of type 1 diabetes is therefore due to a destructive inflammatory process of the islet cell called insulitis. This inflammatory process destroys about 85% of islet cells before full blown diabetes will emerge. The remaining 15-20 % of islet cells can not make enough insulin to support the metabolic demand of the body.
The purpose of insulin is to transport glucose from the blood to the tissues (cells) to be utilized for energy and for other purposes. In the absence of insulin the blood sugar increase and spills through the kidneys to the urine. Eventually dehydration and acidosis will prevail making survival impossible. Type 1 diabetes is therefore insulin dependent and needs insulin not only to control blood sugars but also for survival.
Type 1 diabetes is a destruction of insulin producing cell called islet. Three things are required for type 1 diabetes to happen.
1) Genetic susceptibly
2) Environmental trigger
3) An Autoimmune cascade.
For an individual to develop type 1 diabetes, he/she has to have genetic susceptibity (susceptible alleles) interacting with environmental factors leading to chronic autoimmune inflammation of the islet cell leading to the destruction of at list 80% of the cells that make insulin.
Genetic susceptibilities are conferred by specific genes or alleles involved in cell surface recognition molecules. Environmental factors (triggers) could be viruses, food products and other environmental or cellular agents that interact with the susceptible host immune system. An autoimmune process is a dysregulation of the immune system that fails to tolerate self antigens. It takes place when auto reactive cell fail to tolerate self antigens and initiate chronic inflammation of specific tissue targeted it for destruction (islet cells).
Once the majority of islet cells are destroyed the clinical symptoms of diabetes emerge. Though type 1 diabetes takes 2-5 years to emerge the symptoms of type 1 diabetes are dramatic (come suddenly). These symptoms are;
1) Thirst
2) un usual hunger
3) Fatigue
4) Excessive urination
5) Blurry vision
6) weight loss
7) bed wetting
8) Dehydration and Acidosis.
Type 1 diabetes is only treated with insulin. With out insulin survival is difficult. So far there is no cure for type 1 diabetes. It is also true that type 1 diabetes is not reversible because the body can not or does not make enough insulin since the majority of islet cells are destroyed by the chronic autoimmune inflammation. Good diet and exercise would help but does not treat type 1 diabetes. Islet cells (insulin producing cells) have a remarkable ability of regeneration. However the rate of distraction of the islet cells by the immune system is much greater than the ability of the islet cells to regenerate.
There are adult centers for islet cell transplant who harvest islet cells from 3-4 human cadavers for a single person transplant into human liver. But the use of immunosuppressant medications in this case is not safe in most adults and will not be considered for children. These islet cell transplants using human cadaver with immune suppressing medication will only last for few years as the transplanted islet cells also get lost with time. Various immune modulating agents were used in the past with little success.
There is ongoing research aimed at islet cell regeneration. When stem cell technology, islet cell regeneration technics and islet cell engineering advances, there may be a cure for type 1 diabetes in the future. That time will be one of the greatest accomplishment in medicine as the discovery of insulin in 1921 was one of the most glorious events in medical history.
With proper treatment, type 1 diabetic can live a healthy happy normal life, like any person. Their longevity may be closer to that of the average person when diabetes is treated well. The life expectancy was about 10 years shorter than average person, but, with the advent of sophisticated insulin pumps, blood glucose monitors, and sensors an excellent glycemic control is feasible (HbA1c<7.5%). If good glycemic or diabetes control is achieved there is no reason why a diabetic patient would not have a life expectancy much closer to the average person ( currently 78 years for men and 81 years for women).
Going back to you daughter: Your daughter has type 1 diabetes for the last three years. You seem to manage her diabetes well. And I hope you continue to do so. At this time there is no cure for type 1 diabetes. And type 1 diabetes typically is not reversible. So far most established autoimmune diseases are not reversible, though some do but typically type 1 diabetes is not one of them. Until there is a cure, which we hope will come in the future, you need to focus on managing her diabetes well, as you seem to be doing now. Use the best available diabetes gadgets we have. Perform frequent blood glucose testing and administer proper amount of insulin and promote healthy diet and weight as to maintain reasonable blood sugars. And limit day to day blood sugar variations. Do not stress your self and don't stress your daughter as well. Only do your best and things will be fine. Get help when you need them and work with your doctor closely.
Good luck
Type 1 diabetes is therefore an autoimmune destruction of the insulin producing cells called Islet cell, located mainly at the head of the pancreas. About 90% of type 1 diabetes is therefore due to a destructive inflammatory process of the islet cell called insulitis. This inflammatory process destroys about 85% of islet cells before full blown diabetes will emerge. The remaining 15-20 % of islet cells can not make enough insulin to support the metabolic demand of the body.
The purpose of insulin is to transport glucose from the blood to the tissues (cells) to be utilized for energy and for other purposes. In the absence of insulin the blood sugar increase and spills through the kidneys to the urine. Eventually dehydration and acidosis will prevail making survival impossible. Type 1 diabetes is therefore insulin dependent and needs insulin not only to control blood sugars but also for survival.
Type 1 diabetes is a destruction of insulin producing cell called islet. Three things are required for type 1 diabetes to happen.
1) Genetic susceptibly
2) Environmental trigger
3) An Autoimmune cascade.
For an individual to develop type 1 diabetes, he/she has to have genetic susceptibity (susceptible alleles) interacting with environmental factors leading to chronic autoimmune inflammation of the islet cell leading to the destruction of at list 80% of the cells that make insulin.
Genetic susceptibilities are conferred by specific genes or alleles involved in cell surface recognition molecules. Environmental factors (triggers) could be viruses, food products and other environmental or cellular agents that interact with the susceptible host immune system. An autoimmune process is a dysregulation of the immune system that fails to tolerate self antigens. It takes place when auto reactive cell fail to tolerate self antigens and initiate chronic inflammation of specific tissue targeted it for destruction (islet cells).
Once the majority of islet cells are destroyed the clinical symptoms of diabetes emerge. Though type 1 diabetes takes 2-5 years to emerge the symptoms of type 1 diabetes are dramatic (come suddenly). These symptoms are;
1) Thirst
2) un usual hunger
3) Fatigue
4) Excessive urination
5) Blurry vision
6) weight loss
7) bed wetting
8) Dehydration and Acidosis.
Type 1 diabetes is only treated with insulin. With out insulin survival is difficult. So far there is no cure for type 1 diabetes. It is also true that type 1 diabetes is not reversible because the body can not or does not make enough insulin since the majority of islet cells are destroyed by the chronic autoimmune inflammation. Good diet and exercise would help but does not treat type 1 diabetes. Islet cells (insulin producing cells) have a remarkable ability of regeneration. However the rate of distraction of the islet cells by the immune system is much greater than the ability of the islet cells to regenerate.
There are adult centers for islet cell transplant who harvest islet cells from 3-4 human cadavers for a single person transplant into human liver. But the use of immunosuppressant medications in this case is not safe in most adults and will not be considered for children. These islet cell transplants using human cadaver with immune suppressing medication will only last for few years as the transplanted islet cells also get lost with time. Various immune modulating agents were used in the past with little success.
There is ongoing research aimed at islet cell regeneration. When stem cell technology, islet cell regeneration technics and islet cell engineering advances, there may be a cure for type 1 diabetes in the future. That time will be one of the greatest accomplishment in medicine as the discovery of insulin in 1921 was one of the most glorious events in medical history.
With proper treatment, type 1 diabetic can live a healthy happy normal life, like any person. Their longevity may be closer to that of the average person when diabetes is treated well. The life expectancy was about 10 years shorter than average person, but, with the advent of sophisticated insulin pumps, blood glucose monitors, and sensors an excellent glycemic control is feasible (HbA1c<7.5%). If good glycemic or diabetes control is achieved there is no reason why a diabetic patient would not have a life expectancy much closer to the average person ( currently 78 years for men and 81 years for women).
Going back to you daughter: Your daughter has type 1 diabetes for the last three years. You seem to manage her diabetes well. And I hope you continue to do so. At this time there is no cure for type 1 diabetes. And type 1 diabetes typically is not reversible. So far most established autoimmune diseases are not reversible, though some do but typically type 1 diabetes is not one of them. Until there is a cure, which we hope will come in the future, you need to focus on managing her diabetes well, as you seem to be doing now. Use the best available diabetes gadgets we have. Perform frequent blood glucose testing and administer proper amount of insulin and promote healthy diet and weight as to maintain reasonable blood sugars. And limit day to day blood sugar variations. Do not stress your self and don't stress your daughter as well. Only do your best and things will be fine. Get help when you need them and work with your doctor closely.
Good luck
SHE WILL HAVE IT FOR THE REST OF HER LIFE. WE HAVE NOT FOUND JUST THE ISLETA CURE YET. ONCE THE BETA CELLS OF THE PANCREAS DIE AS THEY DO IN TYPE 1 DM, THEY DO NOT REGENERATE. WE CAN TRANSPLANT A NEW ONE BUT THATHAS A LOT OF HAZARDS & THE TRANSPLANTS DON'T LAST A LIFETIME. WE ARE WORKING ON TRANSPLANTING JUST THE ISLETS ENCASED IN A WRAPPING THAT PREVENTS THE IMMUNE SYSTEM FROM GETTING TO THEM TO KILL THEM BUT WE HAVEN'T GOTTEN THERE YET. SHE CAN LIVE WITH IT TO A RIPE OLD AGE IF SHE KEEPS IT IN CONTROL. I HAVE MANY PTS. WITH DIABETES FOR 50,60,70 YRS. I HAVE HAD IT FOR 26 YRS. SO HANG IN THERE & HAVE A HAPPY FULL LIFE. THERE ARE WORSE THINGS IN LIFE THAN DIABETES.
Type 1 diabetes disease is a lifetime chronic condition. Currently the only final treatment is a pancreas transplant.
