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Type 1 Diabetes and Starvation

By Chandan Sekhon - Medicine Student @ Peterhouse, Cambridge


Diabetes Mellitus is a collection of diseases where the blood glucose levels of an organism aren’t being maintained within an acceptable range. Insulin is the primary hormone responsible for maintaining blood glucose levels, although there are other messengers such as glucagon. Type 1 diabetes is an autoimmune disease where the immune system of an organism destroys beta cells, which are in islets of Langerhans in the pancreas. starvation can be defined as suffering or possible death due to a lack of food. Despite the difference between type 1 diabetes mellitus (T1DM) and starvation, the symptoms of T1DM can very closely resemble the effects of starvation if T1DM is left untreated.

In T1DM, the immune system of an organism recognises beta cells as ‘non-self’. This triggers an immune response where macrophages and other immune cells infiltrate the islets of Langerhans and destroy insulin-secreting beta cells. There is a genetic predisposition to T1DM – the inheritance of particular alleles can massively increase the risk of developing T1DM, so if someone’s parents or grandparents have T1DM, the chances of their offspring developing the disease are increased. There may also be an environmental trigger since some people develop the disease later in life (despite the disease mostly affecting younger age groups), although this potential trigger is currently unknown. Other risk factors for T1DM includes viruses. For example, children exposed to rubella as a foetus have an increased incidence of T1DM. Even the method of birth has been noted to have some effect on the incidence of the disease. This has been suggested due to the increased risk of developing the disease in children born by caesarean section.

T1DM can be compared to starvation in that the effects of starvation are very similar to the effects T1DM can have if left untreated. An individual can look like they are starving even when they aren’t – this is because there is no glucose uptake into skeletal and adipose tissues as it is all excreted. For both starvation and T1DM, the body recognises that there are very low intracellular glucose levels. This has multiple effects. The primary response will be glycogenolysis where glycogen molecules are hydrolysed to form glucose molecules, which the body uses as a temporary store of nutrients during both T1DM and starvation.

This cannot last long t