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o Type 1 DM (5%-10% of cases) usually results from autoimmune destruction of pancreatic -cells, leading to absolute deficiency of insulin.The autoimmune process is mediated by macrophages and T lymphocytes with autoantibodies to -cell antigens (eg, islet cell antibody, insulin antibodies).Amylin suppresses inappropriate glucagon secretion, slows gastric emptying, and causes centrally mediated satiety.It usually presents in children and adolescents but can occur at any age.
• Type 1 DM (5%-10% of cases) usually results from autoimmune destruction of pancreatic -cells, leading to absolute deficiency of insulin. It usually presents in children and adolescents but can occur at any age. The disorder is believed to be initiated by exposure to an unknown environmental trigger in a genetically susceptible individual. The autoimmune process is mediated by macrophages and T lymphocytes with autoantibodies to -cell antigens (eg, islet cell antibody, insulin antibodies). Amylin (a hormone cosecreted from pancreatic -cells with insulin) is also deficient in type 1 DM due to -cell destruction. Amylin suppresses inappropriate glucagon secretion, slows gastric emptying, and causes centrally mediated satiety.
After the initial diagnosis, a period of transient remission called the "honeymoon" phase may occur, during which insulin doses can be reduced or withdrawn before continued -cell destruction requires lifelong insulin replacement therapy.
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