Type 1 Diabetes: Diagnosis for Children and Adults in Israel

Treatment for type 1 diabetes in Top Ichilov (Israel) is provided by Doctor G. Shenkerman, the leading endocrinologist.

Even though type 1 diabetes requires consistent care, achievements in blood sugar monitoring and insulin capabilities have greatly improved the patients’ lifestyle and that of their parents.

Any type 1 diabetes patient must receive insulin replacement therapy to survive. Since gastric enzymes break down insulin taken orally, the only way to administer insulin is to inject it.

Types of Insulin:

• Rapid-acting insulin; starts working in 5-15 minutes and peaks 30 to 90 minutes after injection.
• Short-acting insulin; starts working 30-60 minutes after injection and peaks in 2-4 hours.
• Long-acting insulin; has no peak and works for 20-26 hours ensuring round-the-clock basic level of insulin.
• Intermediate-acting insulin; starts working in 1-3 hours and peaks 8 hours after injection.

At Top Ichilov, treatment depends on the patient’s age and personal needs; a doctor may recommend mixed insulin of several types.

Insulin Administration Options:

Insulin is often administered with a syringe and a thin needle or with an insulin pen. A pen contains a cartridge filled with insulin.

An insulin pump is a convenient option for children. This pump is a mobile phone-sized device. It may be programmed to ensure an acceptable insulin level depending on the patient’s diet, activity level and blood sugar level.

Price for the device (at least generation 3), fitting and customization of an insulin pump: $8,950.

Not long ago, there appeared new technologies that make the lives of type 1 diabetes patients much easier. For instance, special sensors may be attached to the body in order to record blood sugar levels and deliver the information to a smartphone or any other device. The most advanced gadgets help these sensors interact with the insulin pump and control the amount of insulin being administered depending on the blood sugar levels. This technology is called an “artificial pancreas” because it precisely imitates the function of the pancreas.

Doctor Galina Shenkerman

Senior Physician of Endocrinology Department

Type 1 diabetes commonly begins in childhood and consists in the inability of the pancreas to produce insulin. Type 1 diabetes is also known as juvenile diabetes or insulin-dependent diabetes.

Symptoms of Type 1 Diabetes:

• Increased thirst and frequent urination. When too much sugar builds up in the blood, liquid starts seeping from the tissues into the bloodstream to reduce the high sugar concentration. Dehydration of tissue leads to thirst, and as a result, the child drinks more liquid and urinates more frequently than usual.
• Insatiable hunger. When there is too little insulin to transport sugar into the cells, muscles and organs deplete their stored energy. This provokes intensive hunger.
• Weight loss. Even though the sick child eats more than usual to satisfy their hunger, they still lose weight quickly. Muscles and fat depots shrink without the energy provided by glucose. The unexplained weight loss is often the first sign to draw the parents’ attention.
• When the cells are deprived of sugar and energy provided by it, the child feels weary and tired.
• Irritability or unusual behavior. A child with undiagnosed type 1 diabetes may suddenly become capricious and irritable.
• Blurred vision. If the blood sugar levels are too high, liquid may drain from the eye chambers. This changes the curvature of the eyeball and causes vision deterioration.
• Fungal infections may cause moisture lesions and candidiasis of the reproductive system.

How The Disease Develops

The exact cause of type 1 diabetes is unknown. Researchers have revealed that in the majority of type 1 diabetes patients, their own immune system which normally fights harmful bacteria and viruses, mistakenly destroys the insulin-producing cells of the pancreas. The development of type 1 diabetes may also be associated with genetics and exposure to certain viruses.

Regardless of the cause, as soon as insulin-producing cells are destroyed, the body either decreases insulin production or stops it altogether. When everything functions properly, the pancreas releases a large amount of insulin into the blood during a person’s meal. The insulin reduces the amount of sugar in the blood, and when sugar levels drop, the pancreas stops producing and releasing insulin.

The liver is responsible for glucose storage. When the insulin levels are low (the person has had no meals for over 8 hours), the liver releases stored glycogen. The glycogen turns into glucose in order to sustain blood glucose levels within the normal range.

In type 1 diabetes, there is little or no insulin, and the glucose is incapable of entering the cells. Instead of being transported into the body’s cells, sugar builds up in the blood where it can cause life-threatening conditions.

Risk Factors For Type 1 Diabetes

The known risk factors include:

• Family health history. Any person with a parent or a sibling suffering from type 1 diabetes has a slightly increased risk of being diagnosed with the same disease.
• Certain genes indicate an increased risk of type 1 diabetes.

Potential risk factors for type 1 diabetes mellitus include:

• Exposure to Epstein-Barr virus, Coxsackievirus, epidemic parotitis or cytomegalovirus may trigger autoimmune destruction of cells in the pancreas.
• Low vitamin D levels. Studies show that vitamin D may protect from type 1 diabetes.
• Nitrates in drinking water may increase the risk of type 1 diabetes.

Complications of Diabetes Mellitus:

1. Cardiovascular diseases. Diabetes mellitus significantly increases the risk of various cardiovascular conditions including coronary artery disease, heart attack, stroke, atherosclerosis and high blood pressure.
2. Nerve damage (neuropathy). Excessive sugar may damage the walls of the capillaries feeding nerve fibers. This causes tingling, numbness, a burning sensation or pain. Nerve damage usually occurs gradually, over a long period of time.
3. Kidney damage (nephropathy). Diabetes can damage the numerous clusters of tiny blood vessels filtering body’s waste products out of the blood. Serious damage can lead to kidney failure or irreversible kidney conditions that may require dialysis or a kidney transplant.
4. Eye conditions. Diabetes may damage retinal blood vessels (diabetic retinopathy), which, in its turn, leads to blindness. Diabetes may also trigger cataracts and increase the risk of glaucoma (Israel).
5. Damage to small arteries in the legs in diabetes patients causes ischemia and trophic lesions on the legs, most often on the feet. These are trophic ulcers and necrotic areas that with time, lead to the condition called “a diabetic foot”. Progression of ischemia leads to the gangrene of the foot and the shin.
6. Skin conditions. Diabetes may make the patient prone to skin conditions including bacterial infections, fungal infections, and itching.
7. Osteoporosis. Diabetes reduces the mineral density of bone tissue and increases the risk of osteoporosis in older age.
8. Brain disorders. Even though the connection is not yet clear, people with diabetes have a higher risk of dementia and Alzheimer’s disease.

How To Receive Diagnosis And Treatment For Diabetes Mellitus In Top Ichilov

1. Call the clinic right now: +972-37621629
2. Or fill in the form below. Our doctor will contact you within 2 hours.