Type 1 diabetes is often considered a disease of rapid onset however its development is a much slower process involving progressive immunological damage. Recent research has also focused on the role of weight gain and insulin resistance as important accelerators of b-cell destruction in type 1 and type 2 diabetes. It is thought that autoimmune b-cell destruction is triggered by an infective or environmental stimulus in genetically predisposed individuals. This results in an absolute deficiency of the hormone, with patients having a lifelong dependency on exogenous sourcesĬurrent understanding of the pathogenesis of type 1 diabetes is based on a hypothesis first postulated by the American immunologist George Eisenbarth in the 1980s. Type 1 diabetes is fundamentally caused by the autoimmune destruction of these insulin-producing cells. Insulin is normally synthesised in the pancreas by the b-cells of the islets of Langerhans in response to a glucose stimulus.

This article will focus on the cause, clinical features and implications of type 1 diabetes. Other types of diabetes include monogenic diabetes and gestational diabetes. The pathophysiological processes that lead to the development of each type differ and so can manifest in clinically distinct patient groups. Diabetes is most commonly classified as type 1 or type 2. It is characterised by a lack of insulin production, a defect in how insulin is used by the body, or both. Insulin administration is needed to control blood glucose levels, and optimising overall glycaemic control can help prevent long-term micro- and macrovascular complications.ĭiabetes mellitus manifests as a chronically raised blood glucose level (hyperglycaemia) which can result in premature morbidity and mortality. Genetic and environmental factors are thought to play a part in the onset of the disease, which usually occurs in childhood and young adulthood.Ī capillary blood glucose level of greater than 11mmol/L alongside a history of classic osmotic symptoms (polyuria and polydipsia) supports a diagnosis of type 1 diabetes many patients will be admitted to hospital with diabetic ketoacidosis in the first instance. Type 1 diabetes is caused by the autoimmune destruction of the insulin- producing b-cells of the islets of Langerhans. Journal of Pharmaceutical Health Services Research.International Journal of Pharmacy Practice.Antimicrobial resistance and stewardship.