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  • Causes of type I diabetes mellitus

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    Type I diabetes is a disease of an autoimmune nature( ie, it occurs as a result of a violation of the function of the human immune system), which can develop as a result of the effect of some viral infection on the body, as well as under the influence of a number of other environmental factors affectingagainst the background of the existing hereditary predisposition to diabetes mellitus. When unfavorable factors influence pancreatic tissue, the structure of β -cells that secrete insulin changes. This leads to the development of an autoimmune process, in which antibodies to the cells of its own pancreas are formed in the body. Under their influence, damaged β -cells are destroyed. A decrease in the body's resistance to glucose is observed when approximately 75% of the β pancreatic cells die. If against this background there is a development of any stressful situation, for example, surgical intervention or the introduction of an infectious agent into the body, the first signs of diabetes mellitus appear. If 80-90% of

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    β cells are affected, type 1 diabetes mellitus is manifested without additional adverse factors.

    The structure of the β pancreatic cell can be altered by a number of factors that may be viral infections, the effects of hereditary factors, environmental factors, and the nature of the diet. The leading role in the development of diabetes mellitus belongs to the influence of infectious agents, as evidenced by the frequent detection in the blood of persons with this disease of antibodies to such viruses as rubella virus, cytomegalovirus, mumps virus, Coxsackie virus, encephalomyelitis virus and several others. In the event that a woman has recovered from rubella during pregnancy, in about 25% of cases her child develops type I diabetes during her lifetime. There is also information about the existence of a hereditary predisposition to the development of type I diabetes, but its role has not yet been fully elucidated. In the case of diabetes mellitus type I, the probability of developing the same disease in a child does not exceed 5% in a child. If there is a disease in the mother, the probability does not exceed 2.5%.In the case of diabetes mellitus type I, in both parents the probability of developing the disease in a child rises and is about 20%.Hereditary nature of the disease is observed only in 5-10% of children suffering from diabetes mellitus.

    The first manifestations of type I diabetes occur at the age of 40 years, and most often in 14 years. The nature and the set of symptoms of the disease in each case is individual. In diabetes mellitus, the amount of insulin produced in the pancreas decreases, which leads to an increase in the level of sugar in the blood. At the same time, the amount of urine released by a person increases during the day. In addition, the thirst center located in the brain is stimulated, which explains the increased thirst for this disease. Normally, with a decrease in the amount of glucose in the blood, there is an increase in its formation in the liver from glycogen. This mechanism is aimed at covering the energy expenditure of the organism.

    Type I diabetes mellitus is characterized by a low level of insulin in the blood or its complete absence. In this case, there is no normal formation of glycogen and its stock in the liver. In the case of a decrease in the amount of glucose in the blood, the process of its formation from liver glycogen does not occur. However, the activation of the process of glucose formation from other substances occurs, which can lead to severe disruption of the state, up to the formation of a ketoacidotic coma. Insulin normally leads to an increase in the synthesis of protein and fat in the body, ie, it has an anabolic effect( stimulates the synthesis of substances).In the case of a decrease in the insulin content in the blood, a violation of the course of these processes occurs, which leads to a decrease in body weight, the appearance of progressive muscle weakness and a decrease in ability to work, even to its complete loss. Absence of insulin in the body leads to the breakdown of the protein and the inclusion of the processes of glucose formation from amino acids due to their appearance in the free form in the bloodstream. There is a decrease in muscle mass. The process of oxygen supply to tissues of the body is broken, that is, hypoxia develops. Disturbance of metabolic processes and the development of ketoacidotic coma can occur against a background of various infections or traumas. The increase in blood glucose levels causes an increase in the amount of urine and dehydration of the body. When there is a lack of insulin in the bloodstream, activation of the decomposition of body fats occurs, which, in turn, leads to an increase in the number of free fatty acids in the blood. Since diabetes mellitus in the liver disrupts the processes of fat synthesis, free fatty acids are included in the metabolic process. At the same time in the blood there are such products of disturbed metabolism, as acetone and acetoacetic acid. They are ketone bodies and lead to the development of ketosis, and then ketoacidosis. In the event that the body continues to lose fluid, i.e. undergoes progressive dehydration, a ketoacidotic coma sets in. Emerging in the bloodstream ketone bodies cause irritation of the peritoneum and the appearance of signs of "acute abdomen," which include primarily intense sharp pain that spreads throughout the abdominal region. In addition, nausea and vomiting may occur.

    Type I diabetes mellitus may occur in children with pyelonephritis or urinary tract infection. After starting the treatment of diabetes with insulin preparations for a fairly long period of time, the doses of the drug may remain small and be even less than 0.3 U / kg. This period of time, when the dosage remains minimal, is indicated by the phase of remission. In the case of the development of the state of ketoacidosis, the production of insulin by the available functionally capable β -cells of the pancreas is reduced by 10-15%.The use of insulin preparations in this period leads to the restoration of the function of the surviving cells. At their expense provides the body with insulin at a minimum level. In the event that you follow the prescribed diet and correctly dose your physical load, the remission phase can last a fairly long period. If the body maintains the minimum production of insulin, it can compensate for the necessary level of the hormone in the blood. The minimum production of insulin in the body lasts longer, if treatment with insulin preparations is carried out from the very beginning of the disease.