PREVENTION AND MEDICINE FOR DIABETES TYPE 1

 

Introduction 

 Diabetes type 1 is autoimmune disorder in which immune system attack on beta cells of pancreas and destroy them as a result diabetes type 1 occur. If someone have faimly histroy it might be possible for them through treatment to delay the attacking of immune cells on beta cells of pancreas. 

There are three stages of diabetes type 1 the person when  immune system attack on the beta cells they will no get at first all sign and symptoms initially every step make that person an insulin dependent but when they approach at stage three all sign and symptom will appear.

Type 1 diabetes stages

Stage 1

 When the immune system declared  beta cells as a foreign it begins to attack on them and the counting of beta cells begin to falls slowly and it doesn't affect the concentration of glucose in this stage glucose sustainable by insulin.

This stage only be recognize by   lab test (C peptide test )by  decreasing insulin

Counting of beta cells it takes months to year in this stage the suffered one look like a healthy one.

Stage 2

 This stage of diabetes also have no sign and symptoms but it would be asses through lab test (C peptide test). In this stage as a  result of attacking immune system on beta cells deceased the counting of beta cells more and increase blood glucose. But the person sometimes get episodes of thirst and fatigue.

Stage 3

In this stage of diabetes almost 90% of beta cells destroyed by immune cell as a result glucose begin to accumulate in the blood and the patients should expose all sign and symptom of diabetes type 1 it would be diagnosed through insulin test, HbA1c test, fasting and random blood sugar test, C peptide test , GAD 65 test, IAA, IA-2 and ZNT8 test  with all sign and symptoms.

Prevention form type 1 Diabetes

1.It is not happened due to high intake of sugar.

2. Obesity is not a cause of type 1 diabetea

3. This type does not happen due to lifstyle

4. It happen due to autoimmune disorder

5. It occur due to genetic factor

6. It happen due to environmental factor e.g due to the similarity of foreign particle with the beta cells of immune system as a result immune system attack both of them and caused diabetes type 2.

7. Prevent your children earlier exposure with the cow milk because some studies expose that ear exposer with cow milk cause autoimmune stree they lead in future diabetes type1.

8. According to who the duration of brestfeeding should be minimum 6 months and maximum 2 year if the duration should be decreased it might be possible for that person to get type 2 diabetes

8. Take clean food

9. Drink clean and germfree water 

10. Some virus e.g Rubella, Enterovirus and Coxsackie virus are similar to beta cell when they attack on body immune system destroy both of them as result diabetea type 2 occur for this purpose vaccine must be important for any type of infection.

11. Balance diet and Vitamin D should should be more recommendable for whole life.

 Medicine for type 1 diabetes

There is no only medicine to treat type 1 diabetes. Insulin should be recommended to suffered one for whole life.

There are several type of insulin

1. Rapid acting insulin

 1. It takes before 10- 15 minutes before meal

  2. It starts work in 10-15 minutes

3. It work for 3-5 hours

 Example of rapid acting insulin

1. Rispro  insulin

2. Aspart insulin

3. Glulisine insulin

2. Short acting insulin

1. It take 30 minutes before meal

2. It works 6 to 8 hours

 Example

1.Human regular insulin 

2. Actrapid

3. Intermediate  acting insulin

1. It take two or one time a day if it take two time one at breakfast and second at bedtime.

2. If it take for one time time  bedtime is recommendable

3. It works for 4 - 12 hours

4. It should takes 30minutes before breakfast and some time before bed time.

4. Long acting or Basal insulin

1. It works for 24 hours

2. No need before meal take in any fixed time

Examples

1. Glargine insulin

2. Detemire insulin

5. Ultra long acting insulin

1. It works for 36- 42 hours

2. No need to take before meal take it with any fixed time.

Example

1. Degludec insulin

Emergency medicine for type 1 diabetes

 These should be recommended during emérgency belong to diabetes

1. Oral glucose tablet

2. IV dextrose

3. Glucagon injection

 Medicine not to take in type 1 diabetes

1.Sulfonylureas

Glipizide, Gliclazide and Glibenclamide

In diabetes the suffered person require insulin to decrease the level of glucose when we used this medicine it will exaust beta cells because they are also in very few amount

May cause weight gain

2.DPP-4 inhibitors

Sitagliptin, Saxagliptin

1. It cause rarely pancreatist 

2. Renal problem

3. It is more expensive than other drug

4. It cause low level of lowering glucose but we require high amount its lowering 

3.GLP-1 agonists

Liraglutide and Semaglutide

1. Very expensive 

2. It cause vomiting , Nausea and diarrhea

3. It is injectable but some patient avoid injection

4. It is not for those patients who have Family history of Medullary thyroid  cancer and pancreatitis 

4.SGL-2 inhibitors

Empagliflozin, Canagliglozin

1. Some. time cause urinary tract and gential organ infection due to high glucose in urine

2. Early Cause .  dehydration and hypotension

3. Not that patients whose GFR is less than 30 ml/min

4.  High risk of Fournier's gangrine and ketoacidosis

References

 WHO -World Health Organisation

NIH- National Institute Of Health)

 CDC- Centre for Disease Control and prevention