Hi there, I’m Dr Golly and today I’m going to discuss type-1 diabetes. Australia has the 6th highest incidence of type-1 diabetes in the world, with 2,500 new cases diagnosed in Australia, in the last year alone. It’s very different to type-2 diabetes, which is usually diagnosed in adults, but I’ll describe that a little later.
The full medical terminology is diabetes mellitus. Diabetes comes from the Greek diabain – meaning syphon, or pass through – this is because people who are first diagnosed with type 1 diabetes will often pass huge amounts of urine. Mellitus is Latin for sweet, because of the high sugar – or glucose – levels in the bloodstream. Let’s jump to the whiteboard and take a quick look at what causes type-1 diabetes.
Glucose is the most important fuel in our body. Cells use glucose to function, and while some cells can use fat as a fuel source, certain organs – like the brain – can only use glucose to function. When we eat a meal, our stomach absorbs glucose from the food and it enters our bloodstream. Too much glucose in the blood is not ideal, so in response – the pancreas pumps out the hormone INSULIN. This reduces the blood’s glucose levels, by helping the glucose to enters cells in our muscles, liver and other organs. The higher the glucose level, the more insulin released. This ensures a nice, steady glucose level.
Children with type 1 diabetes have an auto-immune response, where the body mistakenly attacks the cells of the pancreas that make insulin. This means that they can’t keep a lid on their blood glucose levels. It also means that some cells aren’t able to get the glucose they need to function optimally. Let’s take a look at what effect this has on different parts of the body.
As the blood glucose level gets higher and higher, it becomes concentrated like cordial. This often makes people feel nauseous. The body then tries to dilute this by sending more water into the bloodstream, which makes the diabetic urinate more frequently, become dehydrated and develop an insatiable thirst. The inability to utilize glucose for energy means the body uses fat instead, and this leads to sudden, dramatic weight loss. Without treatment with rehydration and insulin, this can be life-threatening.
Type 2 diabetes is a very different disease and typically affects adults and the elderly. It’s caused by chronically raised blood glucose levels, so that the pancreas pumps out so much insulin that eventually the body stops listening to it – and/or – it begins to run out faster than it can be replaced.
Obesity and poor diet are two of the more common risk factors for developing type 2 diabetes.
If your child has been unusually thirsty and had increased urine production for more than a week, sometimes associated with being overly tired or dehydrated, take your child to the nearest hospital emergency department. Once the immediate problems have been dealt with, you and your child will receive loads of education, to start learning how to manage your child’s diabetes. Insulin is given via small injection into the skin, to take over the role of the insulin-producing cells in the pancreas, that are no longer there.
Living with type-1 diabetes requires constant care and attention. Glucose levels need to be watched closely to ensure they don’t drop too low or rise too high. But with strict compliance, almost all children with diabetes can lead a full and active life. Just ask 5-time Olympic gold medal winning swimmer Gary Hall Junior, or St Kilda Aussie Rules footballer Paddy McCartin!
You’ve been watching another episode of The Art of Patients. I’m Dr Golly, I’ll see you next time.