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JAMA Patient Page
October 22, 2003

Type 1 Diabetes

JAMA. 2003;290(16):2216. doi:10.1001/jama.290.16.2100

Our bodies need fuel for proper function. Glucose (sugar) is the fuel that our cells use to produce energy. In order to process the sugar we eat in various foods, our bodies produce insulin. Insulin is a hormone made by beta cells, clusters of cells in the pancreas (an organ located in the upper abdomen). In type 1 diabetes, the beta cells in the pancreas are unable to make insulin because of autoimmune disease. This means that the body's immune system makes autoantibodies that attack and destroy the pancreatic beta cells. Type 2 diabetes is the result of the body's not being able to properly use the insulin made by the pancreas, and it occurs in adults and children who are overweight. Because type 1 diabetes usually starts in childhood, it is sometimes called juvenile diabetes. Type 1 diabetes is a serious illness that cannot be cured, but it can be treated and controlled. The October 22/29, 2003, issue of JAMA includes an article about type 1 diabetes.

Characteristics of untreated type 1 diabetes

  • Thirst

  • Frequent urination

  • Weight loss

  • Poor infant growth

  • High blood glucose level

Complications of type 1 diabetes

  • Diabetic ketoacidosis—a life-threatening medical condition, also known as diabetic coma, is caused by the body's need to break down fats for energy instead of using sugars

  • Kidney failure

  • Diabetic retinopathy—damage to the retina of the eye

  • Gastroparesis—the stomach does not empty properly, allowing partially digested food to accumulate

  • Diabetic neuropathy—loss of sensation and nerve control of body functions

  • Increased occurrence of infections

  • Poor circulation, especially in the feet and legs

  • Coronary heart disease

Management of type 1 diabetes

  • Insulin injections—oral medications do not work

  • Diet

  • Exercise

  • Frequent checks of blood glucose levels

  • Management of other medical problems including high blood pressure and coronary heart disease

  • Screening for and early recognition of diabetes complications

  • Kidney dialysis or transplantation for kidney failure

  • Pancreas transplantation

For more information

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on diabetes and the kidney was published in the June 25, 2003, issue; one on insulin was published in the May 7, 2003, issue; one on diabetes was published in the May 15, 2002, issue; one on type 2 diabetes in children was published in the September 26, 2001, issue; and one on managing type 2 diabetes was published in the January 12, 2000, issue.

Sources: National Institute of Diabetes & Digestive & Kidney Diseases; American Diabetes Association

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