When my younger brother was twelve years old, he was diagnosed with Type I diabetes, which is a common age for diagnosis. I vividly remember people asking me how it was possible for him to have diabetes because he was and still is quite lanky and skinny. There was a major learning curve for our entire family upon his diagnosis, and the first part was understanding the difference between type 1 and type 2 diabetes. While type 2 is caused by being overweight, type 1 is an autoimmune disorder in which your body destroys the beta cells in the pancreas that create insulin to regulate your blood glucose levels. The second part of the education, which we continue to grapple with, is how to use prescribed insulin. My brother is now seventeen and has been managing his blood sugar levels for five years, but not without frustration. Technologies, such as his insulin pump and constant glucose monitor, have made it easier to manage, but there is nothing to help with the constant fluctuations of his blood sugar. Every time he eats, he has to check his blood glucose levels and there is a constant worry about letting them get too high or fall to low (both are dangerous and detrimental to his health). As an athlete it is particularly difficult, although exercise is healthy for people with type 1 diabetes, the adrenaline from a game causes his blood sugar to spike and then it rapidly falls.
In the past few years my family has attended the Juvenile Diabetes Research Foundation (JDRF) Type One Nation Summit in Boston. It is amazing to hear about the new developments in research and experience the community of people that are affected by type 1 diabetes. While the advancements in the field are impressive there is still a need for a larger understanding of the long-term effects that type 1 can have on an individual, and it is something that is always in my mind as my brother could experience them later in life if his condition is not properly managed.
A study conducted by Dr. Elizabeth Seaquist in 2015 to further understand the impact that Type-1 Diabetes has on brain structure and function adults with type 1 diabetes were measured against normal participants in a series of tests. The one major finding revolved around recurrent low-blood sugar, a dangerous state for diabetics. In humans who produce their own insulin there are ways for the body to regulate the their low-blood sugar, but in diabetics it can be life threatening and they must consume fast-acting sugar to spike their blood sugar if they are going “low”. According to this study, recurrent bouts of hypoglycemia can result in neuronal loss or dysfunction when it comes to visuospatial orientation (Seaquist, 2015). The results around other areas of brain function were inconclusive, but it is clear that aging with type 1 diabetes can have an impact on how the brain works, and in some cases impair certain abilities.
The good news is that research in the field of type 1 diabetes is advancing rapidly. In 2019, The Center for Beta Cell Therapy in Diabetes and ViaCyte, Inc. started a clinical trial in Europe where the patients receive PEC-Direct. This is technology is protected beta cells that are put in the pancreas to create insulin without the immune system intervening, and hopefully restore control over blood glucose levels (DLife, 2019). Although in the early stages of clinical testing, trials like these are what suggests that there could be a cure in the near future.
I am constantly impressed by the families and people that deal with type 1 diabetes on a daily basis. My parents are constantly monitoring my brothers blood glucose levels in the middle of the night and making sure that they remain stable, and checking in with him during the school day to ensure he is managing. Most of all, I am always in awe of the responsibility that my brother has assumed in taking on his condition, he is often frustrated that he can’t eat whatever he wants and that he has to constantly check and monitor his blood sugar, but he pushes through and I can only hope that in the near future it becomes easier for him.
Seaquist, S.R., 2015. The impact of diabetes on cerebral structure and function. Psychosomatic Medicine, 6, 616-621. doi: 10.1097/PSY.0000000000000207