Type 1 Diabetes

Diabetes has increasingly become a widespread disease. In Germany alone, around eight million patients were treated for this metabolic condition in 2017. Diabetes mellitus—the medical term—refers to a disorder of insulin regulation in the body. When too little or no insulin is produced, glucose cannot be properly processed and is excreted in the urine.

According to the International Classification of Diseases (ICD-10), diabetes is divided into several categories. These classifications play a key role in determining treatment approaches, medications, disease management, and therapeutic options.

Categories and Background of Diabetes

Among all types of diabetes (E10–E14), type 2 diabetes (E11, non-insulin-dependent) and type 1 diabetes (E10, insulin-dependent) are the most common. While type 2 diabetes involves the body’s inability to effectively use insulin, type 1 diabetes is an autoimmune disorder.

In type 1 diabetes, the immune system attacks and destroys the insulin-producing cells in the pancreas. Once most of these cells are damaged, glucose can no longer be processed properly, leading to elevated blood sugar levels. If left untreated, this condition can progress to a diabetic coma.

Causes: Still Not Fully Understood

There is no single known trigger for this autoimmune disease. Instead, current research suggests that type 1 diabetes is caused by a combination of factors. Genetic changes in chromosomes are considered a key component.

In addition, several environmental factors may contribute, such as respiratory illnesses in newborns, cesarean delivery (which may affect gut microbiota), and certain substances ingested through food, such as the inhibitor bafilomycin.

Treatment and Medications

Treatment primarily focuses on replacing the missing insulin. The most common approach is conventional insulin therapy, where insulin is injected several times a day at fixed intervals without prior blood sugar measurement.

In intensive insulin therapy, long-acting insulin is typically administered about every 12 hours. Blood sugar levels are measured before meals, and additional insulin is given as needed.

For younger or highly active individuals, insulin pumps are often used. These devices continuously monitor blood sugar levels and deliver insulin as needed into subcutaneous tissue.

In addition to insulin therapy, managing type 1 diabetes often requires dietary adjustments and additional medications aimed at lowering or stabilizing blood sugar levels. Some medications also help prevent related conditions and complications, such as:

• Simvastatin: Reduces the risk of stroke and heart attack

• Carbamazepine: Used to prevent seizures and may help manage certain neurological or psychiatric conditions

• Delix (ramipril): Supports heart function and reduces cardiovascular strain

All of these medications require a prescription, and their use must be tailored to the individual patient’s condition and overall health status.

Cure in the Future?

A complete cure for type 1 diabetes is currently not available. However, with proper management, individuals can lead a nearly normal life by keeping the condition under control.

The most effective approach today combines regulated insulin therapy, medications, a controlled diet (carbohydrate counting), and regular physical activity.

Research in this field is ongoing and explores several promising approaches. These include targeted modulation of the immune system, replacement of damaged beta cells using donor cells (including from animal sources such as pigs), development of genetic vaccines, and regeneration of insulin-producing cells in the islets of Langerhans.