Diabetes and a little about Anti-Infectives




1. Previously it was known as Insulin Dependent or Juvenile Diabetes Mellitus (IDDM)
2. It constitutes about 5% of the diabetes in our country. The incidence of this type is very high in European and Western population.
3 Type-1 diabetes mellitus or Juvenile diabetes results from cellular mediated auto-immune destruction of B-Cells of pancreas that means sell destruction of body’s own insulin producing B-cells in pancreas by the defence system of body cue to failure of differentiation between invading viruses and body’s own cells.
4. Type-1 diabetes mellitus commonly occurs in childhood and adolescence but it can occur at any age even in the 8th and 9th decades of life.
5. In Type-1 diabetes rate of destruction of Beta Cells (insulin producing) is quite variable being rapid in some individuals (mainly infants and childhood) and slow in others (adults).
6. Onset of Type-1 diabetes is usually acute and develops within a short period of time, generally at an age of 5-6 years and 11-14 years. Some Type-1 patients, particularly children and adolescents, may present with ketoacidosis as first presentation of diabetes.
7. As in Type-1 diabetes mellitus, insulin producing Beta-cells in pancreas are totally destroyed and thus insulin is not produced at all. For their survival they are dependent on insulin from external site. Withdrawal of insulin in these patients leads to a serious complication which is acute in nature, known as diabetic Ketoacidosis or diabet;c coma. These are the patients who are advised not to discontinue their insulin injections and should remain under medical supervision.
8. Type-1 diabetes has a strong H.L.A. (Human Leucocytie Antigen) association.
9. This type of diabetes can be diagnosed by markers of immune destruction of beta cells and includes (1) ICAs ”Islet Ce!ls Antibodies) (2) IAAS (Autoantibodies to Insulin) (3) GAD Antigen (Glutamic Acid Decarboxylase
Although patients are very obese, when they present with this type of diabetes the presence of diabetes is not incompatible with the diagnosis. This type of diabetes is also prone to other auto-immune disorder.