2. What is type 1 diabetes?
Type 1 diabetes mellitus (DM) is a disorder where the
beta cells in the pancreas are destroyed or unable to
make enough insulin to support the body (American
Diabetes Association [ADA], 2015).
In type 1 DM, the person become insulin dependent
and requires close monitoring.
Diagnosis usually occurs in a person’s juvenile years,
but can happen at any time.
Type 1 DM accounts for approximately 5% of diabetes
cases (ADA, 2015).
3. Pathophysiology
The disease process begins through the destruction of
pancreatic beta cells (WebMD, n.d.).
Pancreatic beta cells produce insulin, which allows glucose to
enter cells
A person’s immune system sees the beta cells as foreign
and attacks them (WebMD, n.d.).
This can be due to hereditary factors or viral exposure
The pancreas is unable to produce insulin due to the
destruction of beta cells in the pancreas (WebMD, n.d.).
Without insulin, cells in the body do not gain enough energy
(glucose) for normal functioning
5. Long-Term Effects of Diabetes
Type One on the Body’s Organs
Type 1 diabetes can have
long-term effects such as…
1. Heart and Blood
Vessel Damage
2. Neuropathy
3. Nephropathy
4. Retinopathy
5. Complications
During Pregnancy
6. Peripheral Artery
Disease
Type 1 diabetes, or juvenile diabetes,
occurs mainly in children and young
adults, but it can develop at any age.
According to the American Diabetes
Association, only 5 percent to 10
percent of people with diabetes have
Type 1. Type 1 diabetes develops when
the body's immune system kills the
pancreatic cells that are responsible
for producing insulin. (Nash, 2011)
6. Impact on Adult Client
Mentally and emotionally
depression
fatigue and stress.
Chemical imbalances with swinging moods
Physically
Heart Disease, Stroke, hypertension, blindness, eye problems,
kidney, nerve diseases, amputations, dental diseases,
spontaneous abortions and large babies for pregnant mothers
and acute life threatening events
Sexually
Erectile dysfunction (ADA,2012)
7. Impact on Adult Client
Access to Health care
The federal health care reform legislation has it that a diagnosis
of diabetes will no longer be a lawful reason to deny health care
Insurance companies will not be allowed to limit benefits or drop
coverage when a person needs health care most
(American Diabetes Association, 2012)
Impact on Adult Client
Susceptibility to Substance abuse
People who suffer from diabetes may turn to alcohol or drugs in
order to ease the symptoms of depression.
Diabetics may develop a higher tolerance to alcohol (eHow
Health…Retrieved)
8. Impact on Adult Client
Prenatal care and childbearing.
major birth defects in 5% to 10% of pregnancies
spontaneous abortions in 15% to 20% of pregnancies
Occupational considerations and hazards.
Evaluation for employment
Evaluation for safety risks
Provision of accommodation (ADA,2009)
Ability to cope with stress.
fight-or-flight response is affected
Insulin is not always able to let the extra energy into the cells, so glucose piles up in the
blood.
Stress hormones that are designed to deal with short-term danger stay turned on for a
long time with long-term stress causing long-term high blood glucose levels (ADA,2012)
9. History of type 1 diabetes
1552: First known mention of the symptoms that people experienced
from diabetes (Everyday Health, 2009)
1675: “Mellitus," meaning honey, was added to the name "diabetes”
due to the sweet taste of urine from people who had the disease
(Everyday Health, 2009).
1700-1800: Strides were made with regards to disease control and
diet (Everyday Health, 2009)
1910: Insulin was discovered by English physiologist, Sir Edward
Albert Sharpey-Schafer (ADA, 2013).
1921: Dr. Banting and Dr. Best performed experiments with dogs
whose pancreases have been removed. They then injected the dogs
with insulin that had been removed from their pancreases. This
caused their glucose levels to decrease. James Collip then
reproduces the insulin so that it can be used in humans. Then in
1923, commercial production of insulin begins (ADA, 2013).
10. History of type 1 diabetes
1940: American Diabetes Association was founded
1949: Dr. Levine discovers that insulin allows glucose to enter a cell
1955: Sulfonylureas are released and used to assist in increased insulin
production.
1960’s: Glucagon is made available for the treatment of hypoglycemia and
first pancreatic transplant occurs at University of Minnesota
1970’s: The Ames Company releases first glucometer, first insulin pumps are
invented, and diabetes classification system is developed
1990’s: Metformin, Rezulin, and Prandin becomes available in the United
States
2000’s: New medications such as Byetta and Januvia become available.
Beta cell transplant research becomes heavily studied.
11. References
American Diabetes Association. (2015). Type 1 diabetes. Retrieved from,
http://www.diabetes.org/diabetes-basics/type-1/
American Diabetes Association. (2013). History of diabetes. Retrieved from,
http://www.diabetes.org/research-and-practice/student-resources/history-of-
diabetes.html
Everyday Health. (2009). The history of diabetes. Retrieved from,
http://www.everydayhealth.com/diabetes/understanding/diabetes-mellitus-
through-time.aspx
Type 1 Diabetes. (2015). Retrieved from,
http://www.medicinenet.com/script/main/art.asp?articlekey=42943
WebMD. (n.d.). Type 1 diabetes. Retrieved from,
http://www.webmd.com/diabetes/guide/type-1-diabetes
Notes de l'éditeur
Type 1 diabetes is a type of diabetes mellitus where beta cells in the pancreas are destroyed or unable to make enough insulin to support the needs of the body. Type 1 diabetes leads to the individual becoming insulin dependent, or in need of insulin injections. Close monitoring is needed in these individuals in order to reduce risks of complications. Type 1 diabetes is usually diagnosed in the juvenile years, hence its other name, “juvenile diabetes”. However, one can develop the disease at anytime in their life. Type 1 diabetes accounts approximately 5% of diabetes cases, according to research.
American Diabetes Association. (2015). Type 1 diabetes. Retrieved from, http://www.diabetes.org/diabetes-basics/type-1/
Type 1 diabetes begins through the destruction of pancreatic beta cells. Beta cells are located within the pancreas and are responsible for the production of insulin. Insulin allows glucose to enter cells for energy. When a beta cell is destroyed, the immune system sees it as a threat and attacks it. Sometimes we don’t know why this happens. However, some cases can be linked to a genetic component or viral exposure. In turn, the pancreas is no longer able to produce insulin. Without insulin, cells in the body are unable to obtain enough glucose needed for normal functioning.
WebMD. (n.d.). Type 1 diabetes. Retrieved from, http://www.webmd.com/diabetes/guide/type-1-diabetes
The following diagram depicts what occurs in a person who has type 1 diabetes. Once a person consumes food, it travels to the stomach where the stomach changes the food into glucose. The glucose then enters the bloodstream. In a normal person, the pancreas produces insulin, which would then enter the bloodstream and allow glucose to enter cells. However, in type 1 diabetes, there is little or no insulin so there is a buildup of excess glucose. This increases an individual’s glucose level, which leaves them at risk for hyperglycemia.
Type 1 Diabetes. (2015). Retrieved from, http://www.medicinenet.com/script/main/art.asp?articlekey=42943
1. Heart and blood vessels damage can include a heart attack, stroke, coronary artery disease, atherosclerosis (hardening of the arteries) and high blood pressure. According to the American Diabetes Association, 65 percent of people who have diabetes will die of some type of heart complication.
2. Neuropathy is damage to the nerves. Diabetic neuropathy leads to weakness, tingling, burning or numbness in the feet, legs, hands and arms. According to the Juvenile Diabetes Research Foundation, diabetic neuropathy affects more than 60 percent of Type 1 diabetics and is the most common cause of amputation (excluding accidents) in the United States.
3. Nephropathy is damage to the kidneys. The kidneys are the filtering system for the body. When the nerves become damaged from excess sugar, it can lead to kidney damage or end-stage kidney disease. The Juvenile Diabetes Research Foundation says that one-third of Type 1 diabetes patients will develop diabetic nephropathy.
4. Retinopathy is the progression of damage to the small blood vessels in the retina, leading to vision problems such as glaucoma, cataracts and impaired vision. The Juvenile Diabetes Foundation reports that people living with Type 1 diabetes for more than 20 years will show some signs of retinopathy. Twenty to 30 percent of Type 1 diabetics will develop an advanced form called proliferative retinopathy, which can cause blindness.
5. Complications During Pregnancy can be when a mother and baby are at risk when the mother is diabetic because the need for insulin increases in both the mother and baby. Diabetes that is not controlled leads to an increased chance of preeclampsia (high blood pressure), miscarriage, stillbirth and birth defects. The American Diabetes Association recommends that pregnant women have a team of health-care providers who have experience in caring for pregnant women with diabetes. The team should include an obstetrician, a pediatrician or a neonatologist, a registered dietitian and a diabetes educator.
6. Peripheral Artery Disease or (PAD) develops when blood vessels in the legs become narrow due to fatty deposits, resulting in decreased circulation to legs and feet. PAD increases the chances of stroke or heart attack. According to the American Diabetes Association, one in three diabetics older than 50 has developed PAD. Most people do not show any signs or symptoms; however, some people may experience pain when walking, or have cold feet and lower legs, numbness or tingling in the lower legs and sores on the foot or leg that are slow to heal. (Nash, 2011)
Clinical depression often affects those who suffer from diabetes. Depression can cause fatigue and stress. People who suffer from diabetes may turn to alcohol or drugs in order to ease the symptoms of depression.
Erectile dysfunction is one of the complications that come with diabetes. It can cause medical complications that affect the ability to work, spend time with family and friends, sexual functioning and overall quality of life.
Once the provisions of the law are fully in place, people with diabetes can no longer be denied insurance or forced to pay more for coverage simply because they have diabetes. Insurance companies will not be allowed to limit benefits or drop coverage when a person needs health care most. A diagnosis of diabetes will no longer be a lawful reason to deny health care, ending the current system that sanctions such discrimination.
Individuals with diabetes can and do serve as highly productive members of the workforce and reasonable accommodations should be made to allow people with diabetes to effectively perform the vast majority of jobs.
The effects of diabetes vary from person to person, so employers must consider each person's capacities and needs on an individual basis.
People with diabetes should always be evaluated individually with the assistance of experienced diabetes health care professionals.
The requirements of the specific job and the individual's ability to perform that job, with or without reasonable accommodations, always need to be considered.
The following two slides depict the history of diabetes.
In 1552, the first known mention of the symptoms that people experienced from diabetes was found in readings by researchers. In 1675, “mellitus," meaning honey, was added to the name "diabetes” due to the sweet taste of urine from people who had the disease. Diabetes was also suspected in people if after urinating, ants became attracted to it. This was due to the increase in sugar in the urine. Between 1700-1800, many strides were made with regards to disease control and diet. Researchers at that time found that people were affected by what they eat and symptoms could improve with changes in diet. In 1910, Insulin was discovered by English physiologist, Sir Edward Albert Sharpey-Schafer. In 1921, Dr. Banting and Dr. Best performed experiments with dogs whose pancreases have been removed. They then injected the dogs with insulin that had been removed from their pancreases. This caused their glucose levels to decrease. This, in turn, lead to James Collip reproducing the insulin so that it can be used in humans. Then in 1923, commercial production of insulin begins.
American Diabetes Association. (2013). History of diabetes. Retrieved from, http://www.diabetes.org/research-and-practice/student-resources/history-of-diabetes.html
Everyday Health. (2009). The history of diabetes. Retrieved from, http://www.everydayhealth.com/diabetes/understanding/diabetes-mellitus-through-time.aspx
In 1940, American Diabetes Association was founded. The American Diabetes Association have been the pioneers of diabetes research and treatment improvements for people. In 1949, Dr. Levine discovers that insulin allows glucose to enter a cell. In 1955, Sulfonylureas are released and used to assist in increased insulin production. In the 1960’s, Glucagon is made available for the treatment of hypoglycemia and first pancreatic transplant occurs at University of Minnesota. In the 1970’s, the Ames Company releases first glucometer, first insulin pumps are invented, and diabetes classification system is developed. In the 1990’s, Metformin, Rezulin, and Prandin becomes available in the United States. Since 2000 to present new medications such as Byetta and Januvia have become available. Beta cell transplant research becomes heavily studied.
American Diabetes Association. (2013). History of diabetes. Retrieved from, http://www.diabetes.org/research-and-practice/student-resources/history-of-diabetes.html
Everyday Health. (2009). The history of diabetes. Retrieved from, http://www.everydayhealth.com/diabetes/understanding/diabetes-mellitus-through-time.aspx