Type I diabetes
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April was diagnosed with type I diabetes at the age of 24, "I had never thought I could have type I diabetes."
Type I diabetes is an autoimmune disease, previously thought to only occur in the young, characterised by destruction of β-cells that results in insufficient insulin production. Patients often present with high blood glucose level, frequent urination leading excessive thirst, as well as weight loss. Acute medical complications of type I diabetes include diabetic ketoacidosis and coma that can lead to death. If not treated, long-term consequences of diabetes may arise and these include diabetic neuropathy, retinopathy, nephropathy and cardiovascular diseases.
Type I diabetes is an autoimmune disease, previously thought to only occur in the young, characterised by destruction of β-cells that results in insufficient insulin production. Patients often present with high blood glucose level, frequent urination leading excessive thirst, as well as weight loss. Acute medical complications of type I diabetes include diabetic ketoacidosis and coma that can lead to death. If not treated, long-term consequences of diabetes may arise and these include diabetic neuropathy, retinopathy, nephropathy and cardiovascular diseases.
Current treatment for type I diabetes
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The only currently available pharmacological treatment for type I diabetes is insulin replacement therapy. Insulin is given to reduce plasma glucose level and control hyperglycemia. Maintaining glucose level closest to the normal range is crucial and is the main goal of treatment in diabetes to delay or prevent complications. Insulin is administered intravenously as it gets metabolised by gut enzymes. It is commonly available in three types and the dosage regimen is dependent on the type of insulin:
Examples include regular insulin (Humulin R, Novolin R, others), insulin isophane (Humulin N, Novolin N), insulin lispro (Humalog), insulin aspart (NovoLog), insulin glargine (Lantus) and insulin detemir (Levemir).
In addition, insulin is also available in a pump device where a reservoir of insulin is connected to a catheter inserted subcutaneously. With this device system, rapid-acting insulin is steadily and continuously being “pumped”/secreted into the body establishing a basal insulin level. Upon a meal, the pump is adjusted according to the amount of carbohydrates being consumed and the current plasma glucose level. A bolus dose of insulin is subsequently released into the body to accommodate for changes in plasma glucose level induced by carbohydrate intake.
- Rapid-acting: has a rapid onset of action, normally taken pre-prandial (t1/2: 4hr)
- Intermediate-acting: twice daily or overnight (t1/2: 6hr)
- Long-acting: has a slow onset of action, once a day or overnight (t1/2: 18hr)
Examples include regular insulin (Humulin R, Novolin R, others), insulin isophane (Humulin N, Novolin N), insulin lispro (Humalog), insulin aspart (NovoLog), insulin glargine (Lantus) and insulin detemir (Levemir).
In addition, insulin is also available in a pump device where a reservoir of insulin is connected to a catheter inserted subcutaneously. With this device system, rapid-acting insulin is steadily and continuously being “pumped”/secreted into the body establishing a basal insulin level. Upon a meal, the pump is adjusted according to the amount of carbohydrates being consumed and the current plasma glucose level. A bolus dose of insulin is subsequently released into the body to accommodate for changes in plasma glucose level induced by carbohydrate intake.
T.N. Budi A.N. Khuong C. April | Copyright ©2012