Tip 1 Diyabet

Year 2007, Volume: 5 Issue: 1, 1 - 10, 01.06.2007

Ayhan Abacı Ece Böber Atilla Büyükgebiz

Abstract

Tip 1 diabetes mellitus DM çocukluk yaş grubunda pankreasın beta hücrelerinin süregelen otoimmün veya otoimmun dışı nedenlerle haraplanması sonucu gelişen insülin yetersizliği ve hiperglisemi ile karakterize kronik metabolik bir hastalıktır. Dünyada beş yaş civarındaki genel prevalans 1/1430, 16 yaşında ise 1/360 civarındadır. Ülkemizdeki prevalansı yaklaşık 1/2000’dir. Etiyolojisinde genetik ve çevresel birçok etken rol oynamaktadır. Poliüri, polidipsi ve kilo kaybı ile kendini gösteren tip 1 DM, insülin, egzersiz ve beslenmenin planlanması ile tedavi edilmektedir. Birçok farklı insülin rejimi yanısıra immünoterapi gibi yeni tedavi yöntemleri üzerinde de çalışılmaktadır

Keywords

Tip 1 diabetes mellitus

Type 1 Diabetes

Abstract

Type 1 diabetes mellitus DM is a chronic metabolic disease of childhood characterized by insulin insufficiency and hyperglycemia due to the destructin of the beta cells of the pancreas caused by autoimmune and non-immune mechanisms. The general prevalance of the disease in the world is 1/1430 around five years of age and 1/360 at sixteen. The prevalance in our country is approximately 1/2000. A number of genetic and environmental factors play a role in the etiology. Type 1 DM usually presents with polyuria, polydipsia, and weight loss and treatment consists of insulin, exercise, and nutritional planning. Alongside with various insulin regimens, research on new modes of treatment such as immunotherapy is continued.

Keywords

Type 1 diabetes mellitus

References

• Alemzadeh R, Wyatt D.T. Diabetes Mellitus. In: Behrman R.E, Klieg- man R.M, Jenson H.B (eds). Nelson Textbook of Pediatrics. 17 edi- tion. Pennsylvania: Elsevier Saunders; 2004. p.1947-72.
• Morales A.E, She J.X, Schatz D.A. Genetics of Type 1 Diabetes. In: Pescovitz O.H, Eugster E.A (eds). Pedaitric Endocrinology. 1 edition. Philadelphia (USA): Lippincott Williams and Wilkins; 2004. p.403-10.
• She JX, Marron MP. Genetic susceptibility factors in type 1 diabe- tes: linkage, disequilibrium and functional analyses. Curr Opin Im- munol 1998; 10:682-9.
• Norris A.W, Wolfsdorf J.I. Diabetes Mellitus. In: Brook G.D.C, Clay- ton P.E, Brown RS, Savage M.O (eds). Clinical Pediatric Endocrino- logy. 5 edition. Massachussetts (USA): Blackwell Publishing Ltd; 2005. p.436-91.
• Fiallo-Scharer R, Eisenbarth G.S. Patophysiology of İnsulin-Depen- dent Diabetes. In: Pescovitz O.H, Eugster E.A (eds). PediatricEn- docrinology. 1 edition. Philadelphia (USA): Lippincott Williams and Wilkins; 2004. p.411-26.
• Atkinson MA, Eisenbarth GS. Type 1 diabetes: new perspectives on disease pathogenesis and treatment. Lancet 2001; 358:221-9
• Haller MJ, Atkinson MA, Schatz D. Type 1 diabetes mellitus: eti- ology, presentation, and management. Pediatr Clin North Am 2005; 52:1553-78.
• Saka H.N. Diabetes Mellitus. In: Günöz H, Öcal G, Yordam N, Kurtoğlu S (eds). Pediatrik Endokrinoloji. 1. Baskı. Pediatrik Endokrinoloji ve Ok- soloji Derneği Yayınları, Ankara: Kalkan Matbaacılık; 2003. p.415-55.
• Rosenbloom A.l, Silverstein J.H. Diabetes in the Child and Adoles- cent. In: Lifshitz F (eds). Pediatric Endocrinology. 4 edition. New York (USA): Marcel Decker; 2003. p.611-51.
• EURODIAB ACE Study Group. Variation and trends in incidence of childhood diabetes in Europe. Lancet 2000; 11:873-6.
• Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J. Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group. Diabetes Care 2000; 23:1516-26.
• LaPorte RE, Matsushima M, Chang YF. Prevalence and incidence of insülin –dependent diabetes.Bethesda (MD): National Institutes of Health; 1995. p.37-46.
• Onkamo P, Vaananen S, Karvonen M, Tuomilehto J. Worldwide inc- rease in incidence of Type I diabetes--the analysis of the data on published incidence trends. Diabetologia 1999; 42:1395-403.
• Green A, Patterson CC. Trends in the incidence of childhood-onset diabetes in Europe 1989-1998. Diabetologia 2001; 44:B3-B8.
• Escobar O, Becker D.J, Drash A.L. Manangment of the Child with Diabetes. In: Lifshitz F, (eds). Pediatric Endocrinology. 4 edition. New York (USA): Marcel Dekker; 2003. p.653-67.
• Sperling M.A. Diabetes Mellitus. In: Sperling M.A (eds). Pediatric Endocrinology. 2nd edition. Pennsylvania (USA): Saunders Elseiver Science; 2002. p.323-66.
• Larsson K, Elding-Larsson H, Cederwall E, et al. Genetic and peri- natal factors as risk for childhood type 1 diabetes. Diabetes Metab Res Rev 2004; 20:429-37.
• Bodansky HJ, Staines A, Stephenson C, Haigh D, Cartwright R. Eviden- ce for an environmental effect in the aetiology of insulin dependent diabetes in a transmigratory population. BMJ 1992; 18:1020-2.
• ISPAD. Consensus Guidelines for the Management of Insulin- dependent Diabetes in Childhood and Adolescence. 2000. http://www.ispad.org/
• Todd JA. From genome to aetiology in a multifactorial disease, type 1 diabetes. Bioessays 1999; 21:164-74.
• Douek IF, Gillespie KM, Bingley PJ, Gale EA. Diabetes in the par- ents of children with Type I diabetes. Diabetologia 2002; 45:495-501.
• Redondo MJ, Fain PR, Eisenbarth GS. Genetics of type 1A diabetes. Recent Prog Horm Res 2001; 56:69-89.
• Hamalainen AM, Knip M. Autoimmunity and familial risk of type 1 diabetes. Curr Diab Rep 2002; 2:347-53.
• The Eurodiab Ace Study Group and The Eurodiab Ace Substudy 2 Study Group. Familial risk of type I diabetes in European children. Diabetologia 1998; 41:1151-6.
• Kelly MA, Mijovic CH, Barnett AH. Genetics of type 1 diabetes. Best Pract Res Clin Endocrinol Metab 2001; 15:279-91.
• Buzzetti R, Quattrocchi CC, Nistico L. Dissecting the genetics of type 1 diabetes: relevance for familial clustering and differences in incidence. Diabetes Metab Rev 1998; 14:111-28.
• Knip M, Veijola R, Virtanen SM, Hyoty H, Vaarala O, Akerblom HK. Environmental triggers and determinants of type 1 diabetes. Diabetes 2005; 54:125-36.
• Anjos SM, Tessier MC, Polychronakos C. Association of the cyto- toxic T lymphocyte-associated antigen 4 gene with type 1 diabetes: evidence for independent effects of two polymorphisms on the same haplotype block. J Clin Endocrinol Metab 2004; 89:6257-65.
• Blom L, Nystrom L, Dahlquist G. The Swedish childhood diabetes study. Vaccinations and infections as risk determinants for dia- betes in childhood. Diabetologia 1991; 34:176-81.
• Bober E, Dundar B, Buyukgebiz A. Partial remission phase and metabolic control in type 1 diabetes mellitus in children and adolescents. J Pediatr Endocrinol Metab 2001; 14:435-41.
• Abdul-Rasoul M, Habib H, Al-Khouly M. 'The honeymoon phase' in children with type 1 diabetes mellitus: frequency, duration, and inf- luential factors. Pediatr Diabetes 2006; 7:101-7.
• Schatz D, Krischer J, Horne G, et al. Islet cell antibodies predict in- sulin-dependent diabetes in United States school age children as powerfully as in unaffected relatives. J Clin Invest 1994; 93:2403-7.
• Yang M, Charlton B, Gautam AM. Development of insulitis and dia- betes in B cell-deficient NOD mice. J Autoimmun 1997; 10:257-60.
• Liu E, Eisenbarth GS. Type 1A diabetes mellitus-associated autoim- munity. Endocrinol Metab Clin North Am 2002; 31:391-410.
• Winter WE, Haris N, Schatz D. Immunological Markers in the Diag- nosis and Prediction of Autoimmune Type 1a Diabetes. 2002; 20:183-91.
• Ginsberg-Fellner F, Witt ME, Fedun B, Taub F, Dobersen MJ, McEvoy RC, et al. Diabetes mellitus and autoimmunity in patients with the congenital rubella syndrome. Rev Infect Dis 1985; 7:170-6.
• Sadeharju K, Hamalainen AM, Knip M, Lonnrot M, Koskela P, Vir- tanen SM, et al. Enterovirus infections as a risk factor for type I dia- betes: virus analyses in a dietary intervention trial. Clin Exp Im- munol 2003; 132:271-7.
• Sadeharju K, Lonnrot M, Kimpimaki T, Savola K, Erkkila S, Kal- liokoski T, et al. Enterovirus antibody levels during the first two years of life in prediabetic autoantibody-positive children. Diabetologia 2001; 44:818-23.
• Hyoty H, Hiltunen M, Knip M, Laakkonen M, Vahasalo P, Kar- jalainen J, et al. A prospective study of the role of coxsackie B and other enterovirus infections in the pathogenesis of IDDM. Child- hood Diabetes in Finland (DiMe) Study Group. Diabetes 1995; 44:652-7.
• Viskari HR, Roivainen M, Reunanen A, et al. Maternal first-trimes- ter enterovirus infection and future risk of type 1 diabetes in the ex- posed fetus. Diabetes 2002; 51:2568-71.
• Honeyman MC, Coulson BS, Stone NL, et al. Association between rotavirus infection and pancreatic islet autoimmunity in children at risk of developing type 1 diabetes. Diabetes 2000; 49:1319-24.
• Blomqvist M, Juhela S, Erkkila S, et al. Rotavirus infections and development of diabetes-associated autoantibodies during the first 2 years of life. Clin Exp Immunol 2002; 128:511-5.
• Hviid A, Wohlfahrt J, Stellfeld M, Melbye M. Childhood vaccination and nontargeted infectious disease hospitalization. JAMA 2005; 294:699-705.
• Hiltunen M, Lonnrot M, Hyoty H. Immunisation and type 1 diabetes mellitus: is there a link? Drug Saf 1999; 20:207-12.
• DeStefano F, Mullooly JP, Okoro CA, et al. Childhood vaccinations, vaccination timing, and risk of type 1 diabetes mellitus. Pediatrics 2001; 108:E112.
• Mayer EJ, Hamman RF, Gay EC, Lezotte DC, Savitz DA, Klingens- mith GJ. Reduced risk of IDDM among breast-fed children. The Colorado IDDM Registry. Diabetes 1988; 37:1625-32.
• Virtanen SM, Rasanen L, Aro A, et al. Infant feeding in Finnish child- ren less than 7 yr of age with newly diagnosed IDDM. Childhood Diabetes in Finland Study Group. Diabetes Care 1991; 14:415-7.
• Kostraba JN, Cruickshanks KJ, Lawler-Heavner J, et al. Early ex- posure to cow's milk and solid foods in infancy, genetic predis- position, and risk of IDDM. Diabetes 1993; 42:288-95.
• Johnston CS, Monte WC. Infant formula ingestion is associated with the development of diabetes in the BB/Wor rat. Life Sci 2000; 66:1501-7.
• Gerstein HC. Cow's milk exposure and type I diabetes mellitus. A critical overview of the clinical literature. Diabetes Care 1994; 17:13-9.
• Pietropaolo M, Castano L, Babu S, et al. Islet cell autoantigen 69 kD (ICA69). Molecular cloning and characterization of a novel dia- betes-associated autoantigen. J Clin Invest 1993; 92:359-71.
• Norris JM, Beaty B, Klingensmith G, et al. Lack of association bet- ween early exposure to cow's milk protein and beta-cell autoim- munity. Diabetes Autoimmunity Study in the Young (DAISY). JAMA 1996; 28:609-14.
• Couper JJ, Steele C, Beresford S, et al. Lack of association bet- ween duration of breast-feeding or introduction of cow's milk and development of islet autoimmunity. Diabetes 1999; 48:2145-9.
• Hypponen E, Laara E, Reunanen A, Jarvelin MR, Virtanen SM. In- take of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 2001; 358:1500-3.
• Zella JB, McCary LC, DeLuca HF. Oral administration of 1,25-dihyd- roxyvitamin D3 completely protects NOD mice from insulin-depen- dent diabetes mellitus. Arch Biochem Biophys 2003; 417:77-80.
• The EURODIAB Substudy 2 Study Group. Vitamin D supplement in early childhood and risk for Type I (insulin-dependent) diabetes mellitus. Diabetologia 1999; 42:51-4.
• Collins J, Pien FD, Houk JH. Insulin-dependent diabetes mellitus associated with pentamidine. Am J Med Sci 1989; 297:174-5.
• Rees DA, Alcolado JC. Animal models of diabetes mellitus. Diabet Med 2005; 22:359-70.
• Lombardo F, Valenzise M, Wasniewska M, et al. Two-year prospec- tive evaluation of the factors affecting honeymoon frequency and duration in children with insulin dependent diabetes mellitus: the key-role of age at diagnosis. Diabetes Nutr Metab 2002; 15:246-51.
• Prazny M, Skrha J, Limanova Z, et al. Screening for associated autoimmunity in type 1 diabetes mellitus with respect to diabetes control. Physiol Res 2005; 54:41-8.
• Cooke D.W, Plotnick L.P. Manangment of Type 1 Diabetes Mellitus. In: Pescovitz O.H, Eugster E.A, editors. Pediatric Endocrinology. 1 ed. Philadelphia: Lippincott Williams and Wilkins; 2004. p.427-49.
• Wolfsdorf JI. Improving diabetes control in adolescents. Diabetes Care 1999; 22:1767-8.
• Havas S, Donner T. Tight control of type 1 diabetes: recommen- dations for patients 1. Am Fam Physician 2006; 74:971-8.
• Aly T, Devendra D, Eisenbarth GS. Immunotherapeutic approaches to prevent, ameliorate, and cure type 1 diabetes. Am J Ther 2005; 12:481-90.
• Lipton R, LaPorte RE, Becker DJ, et al. Cyclosporin therapy for prevention and cure of IDDM. Epidemiological perspective of ben- efits and risks. Diabetes Care 1990; 13:776-84.
• Soran H, Younis N. Insulin detemir: a new basal insulin analogue. Diabetes Obes Metab 2006; 8:26-30.
• Havas S, Donner T. Tight control of type 1 diabetes: recommen- dations for patients. Am Fam Physician 2006; 74:971-8.
• Vajo Z, Fawcett J, Duckworth WC. Recombinant DNA technology in the treatment of diabetes: insulin analogs. Endocr Rev 2001; 22:706-17.
• Chakkarwar PN, Manjrekar NA. Insulin glargine: a long acting in- sulin analog. J Postgrad Med 2005; 51:68-71.
• Hordern SV, Russell-Jones DL. Insulin detemir, does a new century bring a better basal insulin? Int J Clin Pract 2005; 59:730-9.