Definition
Diabetes Mellitus Type 1 ek chronic metabolic disorder hai jisme pancreas insulin produce nahi karta ya bahut kam karta hai, jisse blood glucose level increase ho jata hai (hyperglycemia). Ye autoimmune destruction of beta cells (islets of Langerhans) ke wajah se hota hai.
Epidemiology
●Usually childhood or adolescence me start hota hai.
●5–10% of all diabetes cases Type 1 hote hain.
●Genetic aur autoimmune tendency dono important role play karte hain.
Causes & Risk Factors
●Autoimmune destruction of pancreatic beta cells.
●Genetic predisposition (HLA-DR3, DR4).
●Viral infections (Coxsackie, mumps, rubella).
●Environmental triggers.
●Family history of autoimmune diseases.
Pathophysiology
●Immune system beta cells ko attack karke insulin secretion destroy kar deta hai.
●Insulin deficiency hone se glucose cells me enter nahi kar pata.
●Blood me glucose accumulate hota hai → hyperglycemia.
●Body fat aur muscle breakdown karna start karti hai for energy → ketone formation → diabetic ketoacidosis (DKA).
Symptoms / Clinical Manifestations
●Polyuria (frequent urination)
●Polydipsia (excessive thirst)
●Polyphagia (increased hunger)
●Weight loss despite good appetite
●Fatigue, weakness
●Blurred vision
●In children: bed wetting, irritability
●DKA signs: fruity breath, nausea, vomiting, deep breathing (Kussmaul respiration)
Complications
●Acute: Hypoglycemia, Diabetic Ketoacidosis (DKA)
●Chronic: Retinopathy, nephropathy, neuropathy, cardiovascular disease
Diagnosis & Investigations
●Fasting blood sugar (≥126 mg/dl)
●Random blood sugar (≥200 mg/dl with symptoms)
●HbA1c ≥ 6.5%
●Urine test for glucose & ketones
●C-peptide level (low in Type 1 DM)
●Autoantibody test (GAD, ICA, IAA positive)
Treatment
●Lifelong insulin therapy (main treatment):
●Short-acting, intermediate, or long-acting insulin
●Insulin pump or multiple daily injections
●Balanced diet (carbohydrate counting, small frequent meals)
●Regular exercise under supervision
●Blood sugar monitoring (glucometer/self-testing)
●Education on managing hypoglycemia (glucose tablets, juice, etc.)
Nursing Management
●Educate patient & family about insulin administration techniques.
●Monitor blood glucose & urine ketones regularly.
●Observe for signs of hypo- or hyperglycemia.
●Promote dietary compliance (adequate carbs, low fat).
●Encourage regular physical activity.
●Maintain foot care & skin hygiene.
●Support emotional & psychological adjustment (especially in children).
●In hospital: monitor DKA patients closely for dehydration, electrolytes & acid-base balance.
Prevention
●Currently no absolute prevention (autoimmune cause).
●Early detection & proper insulin therapy can prevent complications.
●Education & lifestyle maintenance important.
Prognosis
●With proper insulin therapy & lifestyle management → normal lifespan possible.
●Poor control → risk of severe complications & DKA.
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