Type 1 Diabetes 당뇨병

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Type 1 Diabetes

The Role of the Pancreas

• Endocrine Function:
  • Secretes insulin, a hormone that regulates blood glucose levels.
• Beta Cells:
  • Located in the islets of Langerhans in the pancreas.
  • Release insulin in response to rising blood glucose levels after meals.
• Insulin Action:
  1. Insulin binds to receptors on the surface of target cells (e.g., skeletal muscle, adipose tissue).
  2. This triggers glucose transporter proteins in the cell membrane to open.
  3. Glucose enters the cells for cellular respiration, reducing blood glucose levels.

Type 1 Diabetes Pathophysiology

• Definition:
  • A chronic condition where the pancreas produces little or no insulin.
• Cause:
  • Autoimmune destruction of pancreatic beta cells by lymphocytes and antibodies.
  • Results in hyperglycemia (high blood glucose) due to the inability to transport glucose into cells.
• Consequences of Insulin Deficiency:
  • Glucose remains in the blood, causing:
    • Glycosuria: Glucose in urine.
    • Polyphagia: Excessive hunger.
    • Polydipsia: Excessive thirst.
    • Polyuria: Increased urine output.
  • Energy Shortage in Cells:
    • Body breaks down fats and proteins for energy.
    • Fat breakdown produces acidic byproducts (ketone bodies), leading to:
      • Ketosis: Accumulation of ketones.
      • Diabetic ketoacidosis: A life-threatening condition.

Complications of Type 1 Diabetes

• Long-term tissue damage from chronic hyperglycemia may cause:
  • Atherosclerosis (artery hardening).
  • Blindness (retinopathy).
  • Neuropathy (nerve damage).
  • Renal dysfunction (kidney damage).

Treatment and Management

1. Insulin Replacement Therapy:
   • Delivered via syringe or insulin pump.
   • Injection sites (rotate to prevent tissue damage):
     • Abdomen, upper arms, buttocks, front thighs.
   • Restores metabolic balance by:
     • Reducing blood glucose levels.
     • Suppressing ketosis.
2. Monitoring Blood Glucose Levels:
   • Daily glucose checks:
     • Pre-meal: 70–130 mg/dL.
     • Two hours after a meal: <180 mg/dL.
   • Hemoglobin A1c Tests:
     • Measures glycated hemoglobin over 2–3 months.
     • Goal: A1c <7% to reduce complication risks.
3. Lifestyle Modifications:
   • Diet control: Balanced meals to maintain glucose levels.
   • Consistent exercise: Helps regulate blood sugar.