The public knows that diabetes mellitus generally affects adults or type 2 diabetes mellitus. It turns out that this has been suffered by children since childhood where the average peak occurs at the age of 4-7 years and 10-14 years, which is called type 1 diabetes mellitus. Type 1 diabetes mellitus consists of 2 types, namely, type 1A which is caused by an autoimmune mechanism (90%) and the rest is type 1B which has no known cause or is idiopathic. There is a variation of DMT1, namely Latent Autoimmune Diabetes in Adults (LADA) or DM type 1.5 occurs at the age of 20-40 years with the same mechanism as DMT1 but occurs very slowly.
Autoimmune mechanisms are the most common mechanism as a cause of DMT1, where genetically and inherited, the body produces auto-antibodies, namely antibodies against parts of the body itself, in this case against pancreatic beta cells that produce insulin, so that production decreases even to absolute zero. so blood sugar levels are high. It should be noted that insulin is a hormone whose role is to attract sugar in the blood to enter the cells and is used as a raw material for the formation of energy by the body.
DMT1 sufferers generally experience a condition of growth retardation (inappropriate height and weight for the age they should be) and/or puberty. In addition, you can also experience symptoms of diabetes in general, such as fast hunger and thirst, frequent urination, fatigue, easy to experience various infections in various organs such as pulmonary tuberculosis and urinary tract infections. What must be considered is that DMT1 sufferers will usually experience dangerous acute complications of diabetes quite often, namely: diabetic ketoacidosis, in which very high blood sugar levels are obtained accompanied by the breakdown of fat reserves so that acid levels in the blood increase sharply. In addition, DMT1 sufferers can also experience chronic complications of diabetes, such as kidney failure, cardiovascular disease, retinal disorders or blindness, skin and dental health problems, diabetic foot, and even stroke). As a sign of DMT1, various autoantibodies will be found in the patient's blood, such as anti-glutamic acid decarboxylase (GAD)-65, tyrosine phosphatase IA-2, insulin autoantibodies (IAAs), and islet cell autoantibodies (ICAs).
Children with DMT1 can live as healthy as other children and live long lives. Treatment that can be done for DMT1 in accordance with the basic mechanism is by administering insulin injections to control blood sugar levels, in order to avoid acute and chronic complications while ensuring optimal growth and development in children with DMT1. In addition, with the development of medical technology, there are drugs that are taken that can help treat DMT1, namely Inhibitors of sodium-glucose co-transporter 2 (SGLT-2 inhibitors) and dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) which can lower blood sugar levels from The results of several studies are able to provide protection against the kidneys and against autoimmune reactions against the pancreas.
The article was written by dr. Wardhana, Sp.PD, KEMD, FINASIM (Internal Medicine - Metabolic, Endocrine & Diabetes Consultant at EMC Alam Sutera Hospital).