Dr. Choi: How does Type 1 Diabetes work?

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Dr. Choi: How does Type 1 Diabetes work?앱에서 작성

ㅇㅇ(49.170) 2025.02.15 07:42:05

조회 79 추천 7 댓글 0

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Type 1 diabetes (T1D) is an autoimmune condition that primarily affects the pancreas, specifically the beta cells. To understand this in contrast to how a normal (non-diabetic) pancreas works, we can look at several factors: the pancreas, beta cells, glucose regulation, insulin, and the impact on muscles and fat in the body.

In a normal person, the pancreas plays a crucial role in regulating blood glucose levels through two key hormones:

Insulin: Secreted by the beta cells in the pancreas, insulin helps lower blood glucose by facilitating the uptake of glucose into cells, especially muscle and fat cells, for energy or storage.

Glucagon: Secreted by alpha cells in the pancreas, glucagon raises blood glucose levels by signaling the liver to release stored glucose (glycogen) when blood sugar is low.

When you eat carbohydrates, they are broken down into glucose, which raises blood sugar. The pancreas detects this and releases insulin to help the cells absorb glucose for energy, while storing excess glucose in the liver. This keeps blood sugar levels in a healthy range.

Type 1 Diabetes and Beta Cell Destruction:

In Type 1 diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. This happens due to an autoimmune response, where the body mistakenly targets its own cells as foreign invaders.

Key autoantibodies involved in this autoimmune response include:

ICA (Islet Cell Antibodies): These are antibodies that target the islet cells of the pancreas, where the beta cells reside.

GAD (Glutamic Acid Decarboxylase) Antibodies: These antibodies target the enzyme GAD, which is crucial for insulin production in the beta cells.

As these beta cells are destroyed, the pancreas loses its ability to produce insulin, leading to high blood glucose levels (hyperglycemia). Without insulin, glucose cannot enter the cells effectively, and instead, it accumulates in the bloodstream.

Impact of Insulin Deficiency

Without insulin, several metabolic processes are disrupted:

Amino Acids (Muscle Protein Breakdown):

In the absence of insulin, the body cannot store or use glucose effectively. The body then begins to break down muscle tissue for amino acids, which are converted into glucose via gluconeogenesis (a process that occurs primarily in the liver). This leads to muscle wasting and weakness, which is a common feature of uncontrolled Type 1 diabetes.

Fat Breakdown and Ketones:

When the body can’t use glucose as a primary fuel source, it turns to fat for energy. The breakdown of fat leads to the production of ketones (byproducts of fat metabolism). In healthy individuals, the body uses fat and glucose together for energy. However, in Type 1 diabetes, without insulin to regulate this process, ketone production can become excessive. This leads to a dangerous condition called diabetic ketoacidosis (DKA), where the blood becomes acidic due to the accumulation of ketones.

Summary of Key Differences:

Normal Person: The pancreas produces insulin, allowing glucose to enter cells. Insulin prevents excessive breakdown of fat and muscle and keeps blood glucose within a healthy range.

Type 1 Diabetes: The immune system destroys beta cells, leading to an absence of insulin. This causes elevated blood glucose, muscle breakdown for glucose, and excessive fat breakdown leading to ketone production. The person may experience muscle loss, weight loss, and in severe cases, diabetic ketoacidosis.

To manage Type 1 diabetes, people require external insulin (injections or an insulin pump) to replace the lost insulin function, helping to regulate blood glucose levels, prevent muscle breakdown, and avoid excessive ketone production.

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