Medical Blog

Diabetes is a disorder in which blood glucose levels are high. In normal health, blood glucose levels are precisely controlled by the hormone insulin. It is made by the beta cells in the pancreas gland, an organ behind the stomach. Minute to minute control of insulin production by the beta cells normally keeps blood glucose levels constant. After a meal, the rate of insulin production rises sharply. Type 1 diabetes is the result of destruction of the beta cells in the pancreas.

This is most often caused by the body’s defence mechanisms attacking the cells as though they were invaders (an ‘autoimmune’ process). The process of beta cell destruction happens over a period of many months, but symptoms can start very suddenly once the number of functioning beta cells falls to a critical level.

Who gets type 1 diabetes?

Type 1 diabetes used to be called juvenile onset diabetes. It can occur any time from early childhood into late adult life, but starts most commonly in early adolescence. The condition is slightly more likely to occur if family members have type 1 diabetes, but many people have no such family history.

Approximately 0.2 per cent of children of school age have type 1 diabetes in the UK. In the population as a whole it affects around 0.3 per cent.

How does it present?
The main symptoms come on over a period of weeks and are:

• thirst
• passing large amounts of urine
• weight loss
• tiredness
• skin infections, especially thrush.

There will be glucose (sugar) present in the urine. Also, ketones are likely to be present in the urine. Ketones are the by-product of fat breakdown and are normal in trace amounts for anyone during fasting. However, excessive amounts of ketones are only present in urine when lack of insulin allows fat
to break down excessively.