At this point of time type 1 diabetes (T1D) can neither be prevented nor cured. type 1 diabetes can be managed and a person with type 1 diabetes can lead a healthy life if proper measures are taken. Once a person develops T1D it cannot be gotten rid of.

What is type 1 diabetes?

type 1 diabetes (T1D) is a condition in which there is deficient insulin production and insulin has to be administered externally every day (1). T1D was earlier also called juvenile or insulin-dependent diabetes. type 1 diabetes is an autoimmune disease in which insulin-producing beta cells are destroyed. T1D occurs usually in children, teenagers, and young adults but it can develop at any age (2). 

It is a chronic disease most common in childhood and the prevalence is increasing, particularly in children below the age of 5 years (3). Its incidence is increasing in adults too.

Can we get rid of T1D?

T1D has become a predictable disease because of certain tests but a person cannot get rid of T1D. At least with the knowledge available at present, it cannot be cured. Depending on the research work going on and the results coming out it is more likely that prevention of T1D can be achieved in the future.

T1D can be predicted before onset by measuring the islet autoantibodies. If two or more antibodies are seen in the serum that means it is the preclinical stage of T1D. When multiple autoantibodies are seen then it advances to clinical T1D (3).

If the preclinical stage of T1D is identified early diabetic ketoacidosis incidence can be reduced and therapy with insulin can be started (3). Early identification may have the potential to delay or even prevent onset of T1D though this scenario will depend on the research results that is being carried out.

Islet autoantibody measurements not only can predict T1D but also can be used to measure latent autoimmune diabetes in adults who are non-insulin-treated patients. But this test is not routinely done yet (4).

Causes of type 1 diabetes

type 1 diabetes is caused by an autoimmune disorder in which the body’s immune system releases antibodies that destroy the beta cells of pancreas which secrete insulin (2). The destruction of pancreatic cells can go on for months or years before any symptoms are noticeable.

T1D is the immune mediated form of diabetes and it can now be predicted by measuring islet autoantibodies (3).

In some people there may be genetic predisposition for developing T1D. But it is not a must that if a person has the specific genes that type 1 diabetes will develop, it may not (2). T1D is a polygenic disorder which means many genes are responsible to varying extent for T1D development (3).

In some cases there may be a trigger present in the environment such as a virus which may cause type 1 diabetes(2). The mechanism by which a virus can trigger autoimmune response is not known.

Another environmental parameter which has been discussed is climate. The incidence of type 1 diabetes in the northern parts of the earth is more than the southern parts (2). 

Food habits and lifestyle patterns do not have any influence on getting type 1 diabetes (2).

Treatment of type 1 diabetes

Testing blood glucose levels and measuring haemoglobin A1c will help in the diagnosis of type 1 diabetes (5)

People with type 1 diabetes require insulin to be administered as part of their treatment (1). To utilize the glucose in blood, for converting it to energy insulin is required and since it cannot be administered by mouth in the form of a tablet it has to be injected. The dose and frequency is fixed by the health provider (2).  

Measuring haemoglobin A1c and blood glucose levels regularly and regulating glucose levels in blood is involved in long-term management of the disease. 

Though type 1 diabetes is a predictable chronic autoimmune disorder there are no available treatments to safe guard endogenous insulin production by pancreas (3).  Insulin pumps and continuous glucose monitoring help in managing type 1 diabetes which requires administration of insulin for life long (6).

Prevention of type 1 diabetes

At present with the information available prevention of type 1 diabetes is not known (1). In a review, it was concluded that T1D disease can be predicted by measuring the islet autoantibodies. In future general population screening methods for these autoantibodies and a safe therapy method need to be developed for type 1 diabetesintervention (3). 

The goal of research should be delaying the onset and progression of diabetes and finally preventing type 1 diabetes. 

Final word

With the knowledge the scientific community has at present one a person is diagnosed with T1D it cannot be cured but can be managed. 

References

1. World Health Organisation (2019). Diabetes

https://www.who.int/news-room/fact-sheets/detail/diabetes

1. Centers for Disease Control and prevention (2019). Type 1 Diabetes

https://www.cdc.gov/diabetes/basics/type1.html

1. Simmons, K. M. and Michels, A. W. (2015) Type 1 diabetes: A predictable disease, World journal of diabetes. Vol. 6(3).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4398895/

1. Bingley, P.J. (2010) Clinical Applications of Diabetes Antibody Testing, The Journal of Clinical Endocrinology & Metabolism. Vol. 95 (1).

https://academic.oup.com/jcem/article/95/1/25/2835111

1. Kahanovitz, L., Sluss, P. M. and Russell, S. J. (2017) Type 1 Diabetes – A Clinical Perspective, Point of care. Vol. 16(1).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606981/

1. Atkinson, M. A., Eisenbarth, G. S. and Michels, A. W. (2014) Type 1 diabetes, Lancet (London, England). Vol. 383(9911). 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380133/