Type l Diabetes

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Edith W.M.T. terBraak and Aline M.E. Stades

Contents

Introduction

Epidemiology

Pathophysiology

Short-Term Complications

Long-Term Complications

Treatment

Lifestyle

Living With Diabetes References

Abstract

Type 1 diabetes is a life long metabolic disorder that is characterized by absolute insulin deficiency resulting in hyperglycemia and lipolysis. Type 1 diabetes accounts for 5-10% of the total diabetes population, the majority of the other patients has type 2 diabetes. Insulin deficiency originates with autoimmune mediated P-cell destruction. Without insulin treatment, type 1 diabetes leads to dehydration and ketoacidosis and can ultimately be fatal. Prolonged exposure to hyperglycemia is responsible for microvascular damage in the eye, kidneys and nervous system and contributes to macrovascular disease of the coronary, cerebral and peripheral arteries. Limited joint mobility and the diabetic foot are other complications related to chronic hyperglycemia. currently, the corner stone of the treatment of type 1 diabetes is exogenous insulin substitution aiming to restore near-normal glycemia in order to prevent or delay long-term complications. Recurrent hypoglycemia is a frequent complication and a serious burden for both patients and their significant others. Additional therapeutic interventions consist of lifestyle modifications, particularly aiming

From: Contemporary Diabetes: Diabetes and the Brain Edited by: G. J. Biessels, J. A. Luchsinger (eds.), DOI 10.1007/978-1-60327-850-8_1 © Humana Press, a part of Springer Science+Business Media, LLC 2009

to reduce cardiovascular risk factors. In the future,the necessity for substitution with exogenous insulin may be replaced by P-cell transplantation or even preventive P-cell preservation. Patients must receive proper education and support, since they have to manage their chronic disease on a daily basis.

Key words: Type 1 Diabetes; Insulin; Ketoacidosis; Hyperglycemia; Hypoglycemia; Autoimmune; P-cells; Long-term complications; Education; Self-care.

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