Juvenile Diabetes

Institution

Diabetes mellitus type1 normally referred to as juvenile diabetes, IDDM, or Type 1 diabetes is a type of diabetes that occurs as a result of destruction of the autoimmune by the insulin- producing beta cells found in the pancreas. The consequential deficiency in insulin results to increased glucose in urine and blood. It is highly characterized by frequent urination, increased thirst, increased hunger, and the loss in weight as in the case of Hannah. This type of diabetes is known to be dangerous unless insulin treatment is administered. This is mostly done by use of injections. The treatments that are known are pancreas and islets transplant. But islets transplant is still under evaluation (frank, 2010).

This type of diabetes is thought to have an immunological origin. Ongoing studies have shown a strong bond between diet and the development of juvenile diabetes. It is believed that diet has a role to play in influencing intestinal permeability and gut’s immune functions.  In the diagnosis process of type 1 diagnosis there are two tests that are carried out: Glucose tolerance tests and Glycosylated hemoglobin tests.

The type 1 diabetes is mostly shown by hyperglycemia which is recurrent in nature. And is mostly diagnosed if either the following exists in the patient: level of fasting glucose being 126mg/dL and above, plasma glucose being at 200mg/dL or above in a span of two hours after loading of oral glucose in the glucose tolerance test, existence of hyperglycemia symptoms and casual plasma glucose at 200mg/dL and above, and may be hemoglobin A1Clevel being at or above 6.5. In the whole world 75% of people with diabetes mellitus have been seen to develop a certain kind of metabolic acidosis which is known to be cause by the increasing levels of ketone bodies which results from the breakdown of fatty acids and amino acids deaminition.

In case the tests show that unequivocal hyperglycemia is absent, several tests should be carried out in on various days. Most physicians goes for measuring of fasting glucose level since is it easy to be carried out and it takes a considerate time amounts which is relatively 2 hours and offering no prognostic merit over the fasting testing. Patients with the fasting glucose level being 5.6 to 6.9mol/L are said to be fasting glucose impaired, those with glucose at 140-200mg/dL are said to be glucose tolerance impaired. In this case, the victims with impaired glucose tolerance are more likely to progress to full brown diabetes mellitus which in most cases is also coupled with cardiovascular diseases. (Medline, 2007)

The treatment of the type1 diabetes, as earlier outlined includes either insulin therapy and or pancreatic transplantation. Pancreatic transplantations administered to avoid recurrent administration of insulin. It occurs in the case where there is a self regulating insulin source. Since it is difficult and unadvisable to perform the whole pancreas transplant, pancreatic beta cells are done.  Islet transplant though in the experimental stage is also a viable option since as studies have shown there are success rates of about 90%. This shows that practicality of beta cell transplants may become possible in future.

The other form of type1 diabetes treatment is administration of insulin. In Subcutaneous administration, it is taken inform of injections which are subcutaneous by use of syringes  and needles, use of insulin pumps, or may be use of insulin pens with needles repeatedly.  Insulin can also be administered in inhalation process.  There are claims that inhaled insulin is as effective as injected one, in reducing the level of glucose and blood half-life. Transversal administration of insulin involves jet and pulsatile administration. They attain this by using ionotophoresis to make the skin porous and hence the easy way to administer insulin (Mayoclinicstaff, 2010).

In our case study Hannah having ten years, it is the responsibility of the parent to liaise with the medical physician who is  attending to her in order to know the best type of treatment to be given to her daughter. And since the common cause of this disease is diet related much care must be put in place to ensure that the condition does not worsen.

References

frank, J. (2010, October 6). Type 1 Diabetes Mellitus:. Retrieved November 23, 2010, from diabetesmellitus-information: http://www.diabetesmellitus-information.com/type1diabetes.htm

Mayoclinicstaff. (2010, October 15). Type 1 diabetes - MayoClinic.com:. Retrieved November 23, 2010, from Mayoclinic: http://www.mayoclinic.com/health/type-1-diabetes/DS00329/METHOD=print

Medline. (2007). Diagnosis and classification of diabetes mellitus. Diabetes Care , S42-7.