Type 1 Diabetes Mellitus: The autoimmune disease
Type 1 diabetes (T1D), commonly known as juvenile diabetes due to its early onset, is a prevalent and autoimmune disease caused by the body’s inability to produce sufficient levels of insulin1. A type 1 diabetic typically has a defunct pancreas, where insulin producing ß-cells are destroyed by the body’s own immune system. As a result of a deficiency of insulin, the body is unable to absorb blood glucose in to cells for energy, resulting in high blood glucose (hyperglycemia). To balance out the high concentrations of blood glucose, water will be diffused out of cells and in to the blood to dilute these concentrations. This is often why symptoms of T1D consist of increased urination, excessive thirst, fatigue and lack of energy, among others 2.
Within T1D, there are 2 subtypes, classified by their different causes. Type 1A diabetes occurs mostly due to an autoimmune response by the body, while Type 1B occurs rather spontaneously, of no yet known cause and shows no evidence of autoimmunity to account for the occurrence3. Unfortunately even under these unfavorable causes, there is no known cure yet for the disease. Taking insulin shots can be used as a treatment, however unless a patient undergoes a pancreas transplant, they will forever be subjected to this disease4. Current research is now trying to develop strategies to understand and possibly develop a cure for T1D, which will be explored in the rest of this paper.
Before the discovery of insulin by Banting and Best, T1D was characterized as rare and fatal due to the lack of treatments available1. The growth, spread and distribution of the disease in the human population has been tracked by projects such as the DiaMond project and the EURODIAB study5. There were over 170 million people diagnosed with type 1 diabetes in 2011, and that number is steadily increasing3. The high incidence of this disease, as well as the lack of a known cure, has sparked strong beliefs that occurrences will double in our youth population by the year 20205. As a worldwide issue and a great health concern for many, there is still no clear-cut reason as to why or how this disease is triggered.
Recent epidemiological studies have found that there are multiple factors that may contribute to the occurrence of T1D, such as genetics, body size and weight, nutrition, ethnicity and location, in addition to autoimmunity5. Geography is a recently studied contribution factor, and it was found that comparatively, there is a higher incidence of T1D and an early age of onset in Europe as compared to Africa3. (Caucasians are of the highest risk-group for contracting this disease3.) Despite how little is known about the epidemiology of T1D in Africa, there are potential significant differences between susceptibility of different ethnic groups due to the finding that there is a lower prevalence of T1D diabetes in Africa, and a later age on onset, than in Europe. Perhaps the geographic location or the collective gene pool of different populations has an effect on the susceptibility of individuals developing T1D3.