by Anthony Khoo

Created on: October 11, 2008   Last Updated: May 01, 2009

Diabetes Mellitus (DM) is a condition with serious medical and social implications, not only for the person diagnosed with the disease, but also for their friends and families. DM of any kind is characterised by high blood sugar levels, a condition known as hyperglycaemia, and this typically asymptomatic state can result in severe and often permanent side effects.

Type 1 Diabetes Mellitus (T1DM) refers to a hyperglycaemia caused by autoimmune self-destruction of insulin-secreting cells in our pancreas (Pancreatic Beta cells). The body's own immune system targets and destroys these cells, and as a result, the pancreas is no longer able to secrete insulin into the blood.

Insulin is a peptide hormone released by our pancreas after meals, and plays an important role in converting sugar in our blood into storage forms within our cells (glycogen stores). Consequently, by reducing the body's ability to secrete insulin, T1DM causes sugar from our meals to remain in our bloodstream rather than being taken up into our cells in the post-meal state.

While this may not seem a very dramatic effect, high blood sugar levels can have very severe and wide-reaching consequences for the affected individual. Diabetes is the leading cause of blindness, as well as the leading cause of non-traumatic limb amputations worldwide. Although diseases such as Acquired Immune Deficiency Syndrome (AIDS) receive far more publicity, Diabetes is the leading cause of morbidity (ill-health) - affecting up to two hundred million people worldwide, with more cases diagnosed daily.

Type 1 Diabetes is usually diagnosed at an early age (under 20), and this diagnosis is typically achieved by measuring blood sugar levels after fasting for 24 hours. Other indications of diabetes include the presence of glucose in the urine (termed glucosuria), and this can be easily detected through the use of a non-invasive urine dipstick test. After the diagnosis of T1DM, management involves the use of manually administered insulin analogues which supplement the very low levels of insulin within the body.

There are two main artificial insulin analogues used in the management of Diabetes Mellitus, and these are aptly labelled as either long acting or short acting depending on the duration of their effect. Long acting insulin analogues maintain a basal level of insulin within the body which mimics normal human physiology; whereas short acting analogues are taken just before or after meals in order to manage increased blood sugar levels from our diet.

In conclusion, Type 1 Diabetes Mellitus is the leading cause of morbidity worldwide, and the chief contributor to blindness, kidney failure and non-traumatic limb amputations. A condition characterised by autoimmune self-destruction of pancreatic insulin producing cells, type 1 diabetes causes hyperglycaemia with a wide range of adverse affects for the individual concerned. While diabetes is a permanent condition, with no known treatment available, it is nonetheless relatively easily managed with appropriate medical guidance for the newly diagnosed and the support of family and friends.

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