Type 1 diabetes

In most countries around the world, there has been an increase in the number of children and young people with diabetes. While in general it is relatively easy to distinguish whether a child or teenager has type 1 diabetes or type 2 diabetes, in some cases, young people have elements of both kinds of the condition. This new phenomenon has been labelled ‘double diabetes’ or ‘hybrid diabetes’. Francine Kaufman reports on the existence of double diabetes and the implications of this condition for the initial categorization and treatment of young people who are diagnosed with diabetes.

Despite his 13 years of experience as a voluntary fire fighter, Stuart Murdoch’s application to become a professional member of the fire brigade in his home town of Fish Hoek, South Africa was rejected – because he had type 1 diabetes. Upon hearing of his employers’ decision to discriminate against him on the grounds of his condition, Stuart felt indignant and deflated; but he was not defeated. This is his account of how his successful struggle against ignorance and discrimination changed the law for people with diabetes in South Africa.

Since the first vaccine, when Edward Jenner in England used an extract of cow pox to prevent small pox, vaccines have become a part of most people’s life. Many millions of people have received a vaccine of some kind – in most cases, many

Editor-in-Chief's editorial

After the discovery of insulin in the 1920´s, available insulin was from natural sources (animal pancreas) until human insulin was made available in the early 1980s. None of these insulins was ideal for injection under the skin. Now, new

A new generation of treatments for Type 1 diabetes is likely to come from within our own bodies. We know that a wide range of cell types have the ability to regenerate. Although some of these cells are found outside the pancreas, their regenerative capacity can be harnessed to replenish the insulin-producing islet cells in the pancreas that are destroyed in diabetes. In this article, Denise Faustman looks at the potential benefits and pitfalls of four biologically based therapies, all of which take advantage of the body’s own capacity for healing and renewal.

Recent research from Australia has implicated infections of common garden vegetables as a possible source of chemicals which cause damage to the pancreas, the organ that makes insulin. This damage could thereby cause Type 1 diabetes, the insulin-dependent form of the disease.

There are no contraceptive methods that are specifically contraindicated in women with diabetes. Given the increased risks associated with unplanned pregnancy, methods with proven high degrees of effectiveness are to be preferred. The most important medical factor which affects the choice of contraception is the presence of vascular complications. For this reason women with diabetes should be evaluated by a physician before making their contraceptive choices. Contraceptive counselling should be an integrated part of care for all women with diabetes of childbearing age.

The metabolic control of diabetes tends to deteriorate during the adolescent years, and this deterioration is more pronounced in teenage girls than boys. Efforts to achieve and maintain excellent blood glucose control are more difficult and less successful in adolescents than in adults. This suggests that the teenage years are a highly vulnerable period for girls with Type 1 diabetes, a time when the risk for the later development of diabetes-related complications may become accelerated.

The insulin pump offers advantages to some people with Type 1 diabetes, freeing them from the chore of administering a number of injections every day. However, the high cost of the pump and the need for careful supervision will limit its use to wealthy patients who can count on sophisticated medical support. This article proposes the use of "beta cell therapy" in order to create surrogate insulin-producing cells.