Diabetes

425 million people in the world have diabetes today and this figure is expected to rise to 642 million by 2040, of which 10-20 percent are anticipated to be diagnosed with autoimmune diabetes.

It is estimated that more than half a million children have type 1 diabetes and that approximately 96,000 children are diagnosed with type 1 diabetes every year. The Nordic countries have the highest incidence of type 1 diabetes in the world. In Sweden, two children are diagnosed with type 1 diabetes every day. The disease has a significant impact on the lives of those affected and their family members. It is usually a traumatic experience for the whole family when a child develops type 1 diabetes.

Autoimmune Diabetes

No one knows today what triggers the autoimmune attack leading to type 1 diabetes, although risk factors such as family history of diabetes, genetics and viral infections have been identified. The beta cells are gradually destroyed during a period that varies from months to several years before any clinical symptoms appear. Children and adolescents with type 1 diabetes usually only come into contact with the healthcare system when just 10-20 percent of the beta cell function is left.

Type 1 diabetes can be detected before any clinical symptoms occur by a blood test revealing the presence of specific autoantibodies, including GAD antibodies. The presence of two or several autoantibodies predicts the coming life-threatening stage of the disease.

LADA patients characteristically have antibodies to GAD, which is a sign of the ongoing autoimmune attack on the insulin-producing cells. This means that LADA patients can be diagnosed via an antibody test.

Type 2 Diabetes

The exact cause of type 2 diabetes is not yet known. In some patients, the cells’ insulin receptors do not function properly, while in others the insulin-signaling mechanism is defective. However, the body’s own insulin production is considered to be functional in these patients. Type 2 diabetes is the result of a combination of many triggering factors such as heredity, lifestyle and environment. Type 2 diabetes primarily affects adults, but today more and more children are also developing the disease. Approximately 10 percent of all patients diagnosed with type 2 diabetes actually have the autoimmune LADA.

Autoimmune Diabetes

There is currently no cure for autoimmune diabetes and the disease cannot be prevented. To survive type 1 diabetes, intensive treatment with insulin is needed every day for life, either through injections or an insulin pump, and the blood sugar must be checked 7-10 times daily.

Type 2 Diabetes

Changes in diet and exercise can prevent and improve many aspects of type 2 diabetes, but the progressive disease often requires permanent oral medication or insulin treatment.

Diabetes Complications

All types of diabetes can lead to associated diseases and complications. People with diabetes often develop serious complications resulting in great suffering and premature death. Diabetes has both acute and long-term complications which can affect several different organs. Life expectancy is lower in diabetes patients than in healthy individuals.

Acute Complications

Acute complications mainly comprise:

• severe hypoglycemia, a state of dangerously low blood sugar levels, which can lead to an acute hypoglycemic coma, brain damage and even death
• ketoacidosis, a state of complete lack of insulin in the body where large amounts of ketone metabolites are released leading to a lowering of the pH of the blood, a life-threatening condition requiring intensive care to be reversed

Long-Term Complications

Consistently elevated blood sugar levels cause typical long-term diabetes complications including:

• cardiovascular disease, such as heart attack, stroke and impaired circulation that may lead to amputation
• nephropathy (kidney disease), such as kidney failure sometimes requiring dialysis or a kidney transplant
• neuropathy (nerve disease) such as loss of sensation and severe pain in extremities and erectile dysfunction
• retinopathy (eye disease) such as impaired vision, and in some cases even blindness