When a child is diagnosed with type 1 diabetes, the parents are usually flabbergasted. Only a few recognize early warning signs and assign these to other diseases.
Type 1 diabetes is the most common metabolic disease in children. Nevertheless, the disease is usually recognized late. Sometimes only when serious metabolic imbalances have occurred.
In an interview with t-online, Professor Anette-Gabriele Ziegler, Director of Diabetes Research at Helmholtz Munich, explains what warning signs parents should look out for in their children and what early detection options there are.
t-online: What is type 1 diabetes and what makes the disease so dangerous?
Prof. Dr. Anette Gabriele Ziegler: People with type 1 diabetes have an autoimmune disease that develops over time into a chronic metabolic disease – the most common in childhood and adolescence. Your own immune system attacks the insulin-producing beta cells in the pancreas. This process is called islet autoimmunity.
The beta cells are destroyed by the autoimmune reaction. The body can then produce little or no insulin itself. Without insulin, the sugar from the blood can no longer be absorbed into the cells of the organs. As a result, blood sugar rises to critical levels and the organ cells are no longer supplied with sufficient energy.
Professor dr. Anette-Gabriele Ziegler is Director of the Institute for Diabetes Research at Helmholtz Munich. She holds a professorship at the Chair of Diabetes and Gestational Diabetes at the Technical University of Munich, is an honorary professor at the Technical University of Dresden and chairwoman of the Diabetes Research Group. V
What are the implications?
Clinical symptoms appear and the metabolic disease manifests itself. Those affected now have to control their blood sugar levels “from the outside” with permanent insulin therapy. This therapy has been saving people’s lives for 100 years. To date, however, it has not been possible to achieve a physiological adjustment of blood sugar over the entire course of the chronic disease. This promotes the occurrence of diabetic sequelae associated with reduced quality of life and life expectancy.
Another problem with type 1 diabetes is that the disease is often only recognized and treated when serious metabolic disorders have already occurred. If, on the other hand, an increased risk of type 1 diabetes is already known in children, the disease can be detected and treated early by advising the families and regular follow-up examinations. Participation in studies to prevent the development of the disease can also be useful.
What is the difference between type 1 and type 2 diabetes?
Type 1 diabetes is an autoimmune disease that usually occurs in childhood or adolescence. The pancreas no longer produces any insulin. In type 2 diabetes, on the other hand, too little insulin is produced or the effect of the insulin on the cells is disturbed. The patients are usually over 40 years old.
What is known about the causes of type 1 diabetes?
Type 1 diabetes is a complex disease resulting from the actions and interactions of genetic and environmental factors. The genetic factor in the risk of type 1 diabetes is estimated to be around 50 percent. The genetic predisposition to develop islet autoimmunity is inherited. Incidentally, in over 90 percent of people with type 1 diabetes, this predisposition comes from parents without type 1 diabetes. This means that the disease can in principle affect anyone.
At what age does the disease often appear?
The early childhood years appear to represent a highly susceptible or “vulnerable” period in life, when exposure to environmental factors favors the onset of islet autoimmunity in genetically predisposed individuals. The autoimmune disease usually begins in the first two years of life.
Who is at increased risk for type 1 diabetes?
If parents have type 1 diabetes, their children’s risk is significantly increased. In Germany, around 3 to 4 out of 1,000 people will develop type 1 diabetes during their lifetime.
That means the risk is 0.3 to 0.4 percent in the general population. In contrast, the risk of developing the disease is 3, 5 and 8 percent if the mother or father or a sibling already has type 1 diabetes. If two close relatives have type 1 diabetes, for example a mother and father or a parent and a sibling, the risk of type 1 diabetes increases to 25 percent.
However, nearly 90 percent of children who develop type 1 diabetes do not have a close relative who also has the disease.
So can any child get the disease?
Yes. The risk of type 1 diabetes varies depending on the genetic predisposition, which in principle every child can inherit. Although this occurs more frequently in the group of relatives, this group represents only a relatively small proportion of those affected.
If children have an increased risk of type 1 diabetes, it depends on whether they develop islet autoimmunity or not. If not, your risk is reduced. However, when they develop islet autoimmunity, it increases significantly and is independent of family history.