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Type 1 Diabetes (Juvenile Diabetes): Basics

by Brian Alverson, MD
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    00:01 In this lecture we're going to discuss, Insulin Dependent Diabetes Mellitus Type 1 or Type 1 Diabetes.

    00:08 So type 1 diabetes is a metabolic disorder of hyperglycemia and ketosis.

    00:17 It results from a deficiency of insulin production in the pancreas.

    00:21 It's the most? the most common age of presentation for patients with type 1 diabetes is around 5 to 7 years of age.

    00:30 And then also, patients can present in adolescence.

    00:34 And the rate of type 1 diabetes in the developing world is much less than it is in a developed world.

    00:43 And in the United States, the risk is on the rise.

    00:47 This is much like other autoimmune disease.

    00:49 So let?s go through the pathophysiology of type 1 diabetes.

    00:55 It's both a environmental and a hereditary condition.

    01:01 Identical twins, for example, only have a 50% chance of developing diabetes type 1 if the sibling has it.

    01:10 Likewise, if two siblings were not identical have it there's about a 10% risk for the second child to have the disease.

    01:18 And if a parent has the disease, there's around to 3 to 5% chance.

    01:23 So it's not really following any one easy genetic inheritance pattern and there, it does seem to be something about the environment as well.

    01:31 So this figure here on the slide encapsulates in a sense what?s going on.

    01:37 From the start of life, the first thing that?s really responsible is genetic configuration of the patient at the individual.

    01:45 If they have those genes and there's certain HLA types for example which put people at increased risk for diabetes, they're going to be at increased risk.

    01:54 Then some sort of environmental phenomenon happens which predisposes them to developing the disease.

    02:03 Then they have a trigger, this could be a viral infection or something going on with them.

    02:09 They could have some problem or something in their diet, for example, that predisposes them to developing an autoimmune response towards the islet cell of their pancreas.

    02:21 That?s where that little green cross is.

    02:23 At that time the number of pancreatic cells which is started at the hundred percent starts to decline.

    02:30 Once 80% of the pancreatic islet cells are gone, that patient is going to start developing the symptoms of diabetes.

    02:39 The lower squiggly line is this patient?s glucose over time.

    02:43 Obviously, there?s a little bit of daily fluctuation but then as that pancreatic cells start to disappear, there?s less insulin handling this patient?s glucose and the glucose starts to rise.

    02:56 Once it rises to the point where they're having symptoms, they're gonna present with diabetes.

    03:03 So let?s go through this more carefully and in detail in terms of how we manage patients with diabetes.


    About the Lecture

    The lecture Type 1 Diabetes (Juvenile Diabetes): Basics by Brian Alverson, MD is from the course Pediatric Endocrinology.


    Included Quiz Questions

    1. Honeymoon period.
    2. Incorrect diagnosis.
    3. Medicine is long acting.
    4. Medicine is over-concentrated.
    5. Patient is not clearing medicine from blood.

    Author of lecture Type 1 Diabetes (Juvenile Diabetes): Basics

     Brian Alverson, MD

    Brian Alverson, MD


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