By Wen Hui Tan
Diabetes mellitus has been characterized by the Centers for Disease Control and Prevention as a “growing public health concern.” The CDC noted between 1958 and 1997 the number of people diagnosed with the disease increased from 1.6 million to 10 million. Today, more than 16 million people have diabetes and five million of them don’t know it. Another 800,000 people are diagnosed each year.
With the national media fixated on the childhood obesity epidemic and its link to type 2 diabetes, it’s easy to forget that type 1 diabetes is just as devastating. According to the National Institutes of Health, type 1 diabetes affects one in 400 to 600 children and adolescents. An additional 13,000 young people, most younger than age 10, are diagnosed with it each year.
Two groups where type 1 diabetes is most common are 4- to 6-year-olds and 10- to 14-year-olds, said Dr. Shamsul Alam, a nephrologist at the Northwest Health Center in Bentonville. However, the disease can occur in other age groups. For example, one-fifth of type 1 diabetes patients first develop the disease when they are adults, Alam said.
Understanding diabetes requires understanding how the body regulates blood glucose levels. Cells break down glucose to fuel the body. The hormone insulin regulates the amount of glucose that enters cells from the bloodstream. Insulin is produced in the beta cells of the Islets of Langerhans, clusters of specialized cells in the pancreas that generate hormones. Type 1 diabetes is an autoimmune disease in which the body attacks its own cells, halting insulin production. This sets it apart from type 2 diabetes, in which the body makes insulin but doesn’t respond to it.
While there is still much to learn about this disease, Alam said race and geography combined can create interesting results. For example, if a Chinese child moved to the United States, his risk of developing type 1 diabetes would increase, despite the fact that his race typically has a lower chance of developing the disease.
For reasons not understood, type 2 diabetes often strikes people who are old, don’t exercise, or are overweight, and as a result, type 2 diabetes is stigmatized as a “fat person’s” disease. Hence, some type 1 patients believe their plight deserves more sympathy and research dollars. To them, it is not their fault their body is at war with itself. However, both are linked to genetics, environment and nutrition in ways not fully understood and a significant fraction of patients with type 1 diabetes are overweight as well.
Yet, no matter the population affected, the complications arising from type 1 diabetes are dire and varied.
“This is one of the diseases that cause severe long-term health problems in terms of complications that this disease induces in patients affected with it,” said Dr. Matthias von Herrath. A professor and researcher at the La Jolla Institute for Allergy and Immunology in San Diego, von Herrath has devoted the last 15 years to finding a cure for type 1 diabetes.
“These are complications of the vessels system,” he said. “It puts patients at severe risk for heart attack and kidney problems.”
Other long-term complications include blindness and nerve damage.
The affects of type 1 diabetes are known, but physicians are still in search of a cure.
“We’re hoping that will come,” Alam said.
Alam’s specialty is kidneys, but he said he is still affected by diabetes because more than half of his patients’ kidney problems stem from the disease. When dealing with diabetes, he suggested being watchful of signs of the disease, having a good medical family history and educating the community about diabetes.
Although type 1 diabetes is incurable, it is manageable.
To find a cure for type 1 diabetes, researchers must first understand what causes beta-cell death in the first place, something that has confounded scientists for years. Despite research, the mechanism behind type 1 diabetes remains a mystery. Scientists disagree over which source sends the signal for beta cells to die.
Despite these challenges, researchers have made significant strides in finding a cure. One strategy being explored is to partially suppress B cells, the cells in the immune system that produce antibodies. Because B cells have been implicated in the development of diabetes in mice, researchers are testing whether B cell-depleting drugs like Rituxan (Genentech) can be used against type 1 diabetes. Another avenue is to inject certain kinds of regulatory T cells to prevent the death of the insulin-producing beta cells. In the immune system, regulatory T cells are a “self-check,” ensuring that the immune system does not attack the body’s own
tissues.

The Morning News’ correspondent Antoinette Grajeda contributed to this report.