Insulin dependent

Insulin dependent diabetes mellitus is also known as type 1 diabetes, or juvenile-onset diabetes. The necessary components of insulin-dependent diabetes include hyperglycemia requiring exogenous insulin, onset at younger than 30 years, profound thirst, increased urination, weight loss and ketoacidosis.

The etiology of the disease results from a cellular-mediated autoimmune destruction of the beta cells within the pancreas.

Increased levels of glucose occur in the blood and urine when this lack of insulin occurs.

Symptoms of insulin-dependent diabetes include polyuria (frequent urination), polydipsia (increased thirst), polyphagia (increased hunger) and weight loss. These symptoms often lead to diagnosis.

Incidence rates are estimated to be between eight to 17 per 100,000 in northern Europe and the United States. The rate may be as high as 35 per 100,000 in Scandinavia and as low as one per 100,000 in Japan and China.

Insulin-dependent diabetes will ultimately be fatal unless it is treated with insulin. The most common method of insulin administration is via injection, but insulin pumps and inhaled insulin also may be used. Pancreatic transplants have been used in some cases, and pancreatic islet cell transplantation is an experimental method. Treatment usually continues indefinitely but does not impair normal life activity. However, diligence is required, and patients with this disease must be aware of blood sugar levels at all times, monitoring for hyperglycemia and ketoacidosis. Apart from insulin treatment, insulin-dependent diabetics also must be observant of diet and exercise habits.

People can have type 1 diabetes but be otherwise healthy. According to experts, the cause of insulin-dependent diabetes may be immunological, but evidence is not conclusive. Those with a gene or genes near or within the human leukocyte antigen locus may be more susceptible.

Some of the common risk factors for insulin dependency and type 1 diabetes include:

Family history — those with a parent or sibling with type 1 diabetes carry a slightly higher risk for developing the disease.
Genetics — the presence of certain genes can translate into an increased risk for type 1 diabetes.
Geography —type 1 diabetes incidence increases as you travel away from the equator. Populations living in Finland and Sardinia display the highest incidence of insulin dependency, about two to three times higher than rates in the US and up to 400 times the rate among those in Venezuela.
Age — type 1 diabetes usually appears in children during one of two age ranges, between 4 and 7 years old, and between 10 and 14 years old. However, type 1 diabetes can occur at any age.

Additional information may be found at these websites:

http://bloodjournal.hematologylibrary.org/cgi/collection/gene_expression

http://www.nlm.nih.gov/medlineplus/ency/article/003706.htm

http://www.mayoclinic.com/health/metabolism/WT00006/

http://www.nature.com/jcbfm/index.html

http://www.nutritionandmetabolism.com/

http://www.hormone.org/Public/endocrinologist.cfm

http://www.nlm.nih.gov/medlineplus/ency/article/002257.htm

http://www.ncbi.nlm.nih.gov/books/NBK22/?depth=10

http://endo.endojournals.org/

http://www.mayoclinic.org/medicalprofs/glucocorticoid-induced-diabetes.html

http://www.nlm.nih.gov/medlineplus/steroids.html