Parameters of oxidative stress in children with Type 1 diabetes mellitus and their relatives.
Oxidative stress (OS) plays an important role in the pathogenesis of Type 1 diabetes mellitus (DM). The aim of the study was to compare OS parameters in diabetic children and their first-degree relatives. Fifty diabetic children from the West Bohemian Region were examined as well as their 32 siblings (12 Boys and 20 girls) and 65 of their parents during a period of 6 months.
Thirty ealthy sex- and age-matched children studied before planned surgeries were normal controls for children, 40 healthy adult volunteers were controls for parents. OS parameters were evaluated in all participants of the study (superoxide dismutase, SOD; glutathione peroxidase, GSHPx; plasma antioxidant capacity, AOC; reduced glutathione, GSH; and malondialdehyde, MDA) and also Type 1 DM-associated antibodies (ICA and GADA). The results in diabetic children showed significantly lower GSHPx and AOC and increased MDA when compared with healthy children. Similar findings were found in their siblings but without statistical significance. It is consequently evident that decreased antioxidative protection and simultaneous free radical (FR) overproduction occur in diabetic children and that there is a similar, but not significant, tendency in their siblings. The findings warrant reducing OS in diabetic children and postponing disease onset in susceptible relatives.
Diabetes is a group of disorders that have in common high blood glucose (sugar) levels. People with diabetes either do not make enough insulin or do not use it properly. Insulin is a hormone from the pancreas. (A hormone is a chemical that is made in one part of the body but has its effect in another part). Insulin has numerous functions related to the conversion of starches, proteins, and fats to energy.
Blood glucose levels PEOPLE WITH DIABETES EITHER DO NOT MAKE ENOUGH INSULIN OR DO NOT USE IT PROPERLY.
Blood glucose (sugar) levels vary throughout the day, rising after a meal and returning to normal after two to three hours. Normally, the fasting glucose level (10 hours after the last meal) should be below 110 mg/dL(USA) or 6.1 mmol/L (Canada). Both the fasting and after-meal glucose levels tend to rise as we age.
Main types of diabetes
Type 1 diabetes: This accounts for about 10% of all diabetes in the United States. Type 1 diabetes is one of several diseases (called autoimmune) in which the body destroys its own cells. In the case of type 1 diabetes, these are cells in the pancreas called beta-cells, which are located in the islets of the pancreas. Many patients with type 1 diabetes have other autoimmune diseases (such as those involving the thyroid and adrenal glands). After the beta cells are destroyed, no insulin is produced and blood glucose levels rise.
Furthermore, without insulin which allows glucose to be used as energy, the body is dependent on fat for energy. This causes a life-threatening condition called ketoacidosis. Prior to the discovery of insulin, patients died from this shortly after diagnosis. This rarely happens today. Although type 1 diabetes usually presents in children and adolescents, it can occur at any age.
TYPE 1 DIABETES ACCOUNTS FOR ABOUT 10% OF ALL DIABETES IN THE UNITED STATES.
Type 2 diabetes: There are two reasons why blood glucose levels rise with this disease. First, insulin is not used properly by the tissues that take glucose from the blood (especially the muscle and liver). In addition,
although the body still makes insulin, not enough insulin is produced. Indeed, over time the insulin deficiency seen with type 2 diabetes becomes quite profound and insulin injections are required to prevent severe elevations in blood glucose levels. Although type 2 diabetes usually presents in adults, it can present at any age. Indeed, there is currently a dramatic increase in this disease presenting in adolescents, thought in part to be due to the sedentary lifestyle and obesity developing in these young individuals. There is usually a family history of diabetes, and this disease is usually associated with obesity.
Gestational diabetes: This is when high blood glucose levels occur in the second half of pregnancy. About 5% of all pregnant women develop this. Therefore, it is recommended that women be screened for gestational diabetes with an oral glucose tolerance test at approximately their 24th week of their pregnancy. Untreated, this condition leads to large babies resulting in difficult and possibly dangerous births. Although this condition disappears after the pregnancy, women with gestational diabetes have a high risk for developing type 2 diabetes later in life.
Risk factors for type 1 and type 2 diabetes
Although we don’t understand why most people get diabetes, there are some risks which increase the chance of developing diabetes.
Type 1 diabetes:
Family history: 10% of people with type 1 diabetes have a family history. If an identical twin has the disease, the risk of the other twin getting it is only 30-40%.
Type 2 diabetes:
Age: over 45 years in all adults
Ethnic groups: African Americans, Native Americans, Asian Americans, and Hispanics all have an increased risk of developing type 2 diabetes at ayounger age. Obesity and sedentary life style
Family history: If one identical twin develops type 2 diabetes, the risk of the other twin getting it is almost 100%.Women who have had gestational diabetes
Type 1 diabetes:
The diagnosis of type 1 diabetes is usually straightforward. These people
are usually losing weight, have high blood glucose levels, and often have
ketones in their urine. ALTHOUGH WE DON’T UNDERSTAND WHY MOST PEOPLE GET
DIABETES, THERE ARE SOME RISKS WHICH INCREASE THE CHANCE OF DEVELOPING
Type 2 diabetes:
To diagnose type 2 diabetes, one needs to have either
Fasting glucose (overnight) above 126 mg/dL (USA) or 6.9 mmol/L (Canada)
Random glucose above 200 mg/dL (USA) or 11.1 mmol/L (Canada) with frequent urination and excessive thirst
An abnormal oral glucose tolerance test (blood is taken two hours after aglucose drink)
If one of these three criteria is found, one of them must be repeated to confirm the diagnosis. Usually, this would be the fasting blood glucose.
Type 1 diabetes:
There are currently no recommendations for general screening for type 1
Type 2 diabetes:
For type 2 diabetes, screening with a fasting blood glucose test is recommended for the following situations:
All adults over the age of 45 years; if normal, screening should be repeated in 3 years.
Screening should occur earlier and more frequently for: women with a history of gestational diabetes or having a baby weighing greater than 9 pounds ethnic groups with an increased risk of developing type 2 diabetes (African Americans, Asian Americans, Native Americans, and Hispanics)
individuals with a family history of type 2 diabetes
individuals who are obese or have a sedentary lifestyle
individuals with hypertension or high triglyceride (blood fat) levels
A vaccine that could help wipe out Type 1 diabetes will be tested on patients next year.
Two teams of British scientists working on the vaccine said it halts the destruction of pancreas cells that produce insulin – the hormone needed to break down sugar in the body.
“It will be of help for people who have just been diagnosed [with Type 1 diabetes]. It might stop their insulin-producing cells from deteriorating further,” Dr. Colin Dayan, who’s spearheading the research, told the BBC.
“If it proves to be very safe, we would think about using it for people who are at high risk of developing Type 1 diabetes.”
Patients with Type 1 diabetes usually develop the condition before age 40 and must inject insulin every day to keep their blood sugar levels from becoming dangerously high. Worldwide, the disease affects 5 million people.
Although the exact cause of Type 1 is not known, the body’s defense system is thought to be involved — possibly waging an abnormal attack on its own cells.
The vaccine will be tested on 72 diabetic patients at King’s College London and Bristol University in England.
It contains a protein that promotes the production of protective immune cells to defend cells in the pancreas against attack.
The vaccine has been successfully tested in mice, although a human form could be five to 10 years from the market.
Apart from a vaccine, a number of other diabetes cures are now being studied, including the use of stem cells and organ transplants to restore insulin production.
Under the *worst* of circumstances, it results in death, or serious handicap, early in life, or in the prime of life, or prematurely in mid to late middle age.
Social security? Not much help for those who die an average of 15 years prematurely, before retirement age.
In any case, persons who have it must deal with it, and persons close to persons who have it have a variable by which they can either
1) decline to accept any responsibility, leaving the type 1 victim on their own to deal with the
disease, a rather cold-hearted approach, but one which many adopt
2) accept a begrudging degree of responsibility dealing with the disease by guilt-tripping the
type 1 victim, berating and scolding them and harping at them to be diabetes-obsessed,
and making certain that the type 1 victim is made aware that any blood sugar level not
near normal is the type 1 victim’s fault
3) attempt to be one with the type 1 victim, being fully aware that perfection is, while a noble goal,
not a realistic one, and knowing that helping and empathizing with the type 1 victim, creating
bridges and understanding, treating them with respect and admiration, loving them, caring
about them, honoring their individual aspirations, that is the ideal by which the best can be made
out of a situation which, short of a cure, is some – what akin to a living nightmare
I’m 25 years old and i have been diagnosed with type 2 diabetes 6
months ago.Until recently i had been able to maintain my blood glucose
to acceptable levels with diet and sports.But since 2 months my blood
glucose is higher and i find it very difficult to maintain it at
acceptable levels even if i do alot more physical activites and eat
well. I wonder if it’s possible that i have type 1 diabetes instead ?
I know that peoples with type 1 diabetes don’t produce any insulin and
need insulin injections.But does that “stop” of insulin production
happen immediately or is it over time ? i mean does one day your body
produces insulin normally and the next morning you wake up and your
body dosen’t make any insulin , or is it slowly decreasing over time
(1 year for example) ? And if it’s slowly decreasing , how much time
does it take on average ?
It is entirely possible that you are an adult-onset T1.
Adult-onset T1 are thought to outnumber juvenile-onset T1 by perhaps as much
An adult-onset T1 honeymoon (period in which insulin injections are usually
not absolutely necessary) varies in length from person to person. In
general, younger folk like you can expect to see “stuff happen” in 6 months
or so. Old F*rts like me can drag it out for a couple of years.
In general, it’s a slow and steady decrease in insulin production..
However, since most of an Adult-onset T1’s beta cells have already been
destroyed by the time anybody notices he’s diabetic, a little bit more
destruction can have a strong effect on blood sugars.
“Non-obese” and “well-exercised” are two very strong indicators of
adult-onset T1 in a newly diagnosed diabetic. If you fit that description,
you must be aware of a special danger which folks like you face:
You must never allow the simultaneous presence of
a. High blood sugars, over 200 mg/dL and
b. Ketones in your urine.
That’s a sign of Diabetic Ketoacidosis, a serious, life-threatening
condition which afflicts adult-onset T1 at the end of their honeymoon if
they don’t switch to insulin soon enough. The “cure” is immediate injection
DKA is always a problem for all T1 but if you know you are T1 and have
insulin in your possession, it’s easy to treat.
30,000 Americans are diagnosed with type 1 every year. Only 13,000 are children. Mary Tyler Moore is an example of one person who was diagnosed with “juvenile” diabetes as an adult at the age of 30. That is one reason juvenile diabetes is now called type 1, because of misconceptions like this.
Other people diagnosed as adults: former Miss America Nicole Johnson and Olympic swimmer Gary Hall, Jr. I could list many more…
Also, just because someone takes insulin does not mean they have type 1 diabetes. Type 1 is an auto-immune disease where the body’s immune system destroys the beta cells in the pancreas that make insulin.
Furthermore, with type 1 diabetes blood glucose fluctations are much different than with type 2 diabetes. Type 1 is much more labile than type 2 since you do not produce any insulin at all. Even with type 2, your body is still able to compensate for things like stress, illness, etc. With type 1 you can have blood glucose fluctuations as a result of stress, illness, hormones, fatigue, etc. etc.
My husband’s blood glucose increases when he gets overheated, stressed, or when he is sick. I’m talking fluctations up to 200, 300, etc. People with type 2 that have beta cell function do not have major fluctuations like this. Numbers like this are not because of something my husband has done “wrong”. My husband wears an insulin pump and checks his blood sugar about 10x a day. It is still totally impossible to duplicate the function of an organ that works so perfectly in a person who has functioning beta cells.
The following link is from the Juvenile Diabetes Research Foundation’s web site. Note that it says type 1 happens in adults, also. And, that type 1 is more difficult to manage with fluctuations as a result of stress, hormonal changes, periods of growth, physical activity, medications, illness/infection, and fatigue.
This is an interesting little study. (I haven’t ranked Diabetologia in the journal heirarchy, however).
Apparently the protective genes for Type 1 diabetes are not as protective as they used to be…………Also, the high risk genes for Type 1 diabetes are not as necessary– all while the incidence of Type 1 diabetes has increased 2.5 times in Finland in the last 40 years.
They theorize environmental pressure as the cause. Impossible as it is for some here to believe, the Finns must be way ahead of the USA since Type 1 diabetes is *not* a reportable disease here, and we have no incidence statistics, only things like “this town has not gotten any bigger than it used to be but we never had a pediatric endocrinologist in the past, and now we have two and you can’t get appointments with them they are so busy” and “When I was a teacher I never remember any kids with Type 1 diabetes and now I am a principal and it seems like there are a lot.”
Temporal changes in the frequencies of HLA genotypes in patients with Type 1 diabetes-indication of an increased environmental pressure?
The incidence of Type 1 diabetes has increased 2.5 times during the time period from 1966 to 2000 in Finland-a general trend seen in almost all developed countries that can only be explained by environmental
factors. The aim of this study was to test the possible effect of a changing environment on distribution of genotypes associated with disease susceptibility.
METHODS. HLA DRB1-DQA1-DQB1 genes and two diabetes-associated polymorphisms at IDDM2 and IDDM12 were analyzed. The frequencies of genotypes were compared between cases diagnosed with childhood-onset Type 1 diabetes during the period of 1939-1965 ( n=367) and those diagnosed between 1990 and 2001 ( n=736).
Chi-square statistics or the Fisher’s Exact test were used for the comparison of frequencies of analyzed haplotypes and genotypes in the two groups.
RESULTS. The frequencies of ( DR3) -DQA1*05-DQB1*02 and ( DR4)
-DQB1*0302 risk haplotypes and the high risk ( DR3)
-DQA1*05-DQB1*02/DRB1*0401-DQB1*0302 genotype were higher while proportion of patients carrying protective haplotypes-( DR15) -DQB1*0602 and ( DR1301)
-DQB1*0603-or protective genotypes was lower in patients diagnosed before 1965 as compared to those who developed disease after 1990.
No temporal variation was found in the frequencies of genotypes at IDDM2 and IDDM12.
Our data suggest that the need for genetic susceptibility to develop Type 1 diabetes has decreased over time due to an increasing environmental pressure and this results in a higher disease progression rate especially in subjects with protective HLA genotypes.
Immune-mediated diabetes (formerly called insulin-dependent diabetes) is a disease that affects the way your body uses food. Immune-mediated diabetes is also called type 1 diabetes.
In type 1 diabetes, your body destroys the cells in the pancreas that produce insulin, usually leading to a total failure to produce insulin. It typically starts in children or young adults who are slim, but can start at any age.
Without insulin, your body cannot control blood levels of sugar. And without insulin, you would die. So people with type 1 diabetes give themselves at least one shot of insulin every day.
An estimated 500,000 to 1 million Americans have this type of diabetes today.
Type 2 diabetes is a disease that affects the way your body uses food.
Type 2 diabetes used to be called non-insulin-dependent diabetes. The most common type of diabetes, it affects about 15 million Americans. Nine out of ten cases of diabetes are type 2.
It usually occurs in people over 45 and overweight, among other factors.
When you have type 2 diabetes, your body does not make enough insulin. Or, your body still makes insulin but can’t properly use it. Without enough insulin, your body cannot move blood sugar into the cells. Sugar builds up in the bloodstream. High blood levels of sugar can cause problems.