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Re: [IPk] DKA how soon?

> Sorry to disappoint you John but yes, I have been in situations where I was
> not able to get insulin for over a day. Also your definition of getting
> diabetes applies ideally to type2 diabetes, but not (to most) type1, the
> theory behind causes of type1 is that the body's immune system kills the
> islets of langerhands, it does not take years to do that, if it did we would
> all be sufferring from colds for years. I agree it does not do it
> immediately but it does not take very long.

Hello Jeremy and anyone else monitoring this debate !

I haven't been taking part in many discussions lately mainly because I have been
busy writing my thesis concerning islet cell death. So you can probably guess
that this is a subject close to my heart. As a diabetes reserach scientist and a
pumper myself I think I possess a fairly broad range of knowledge and experience
concerning Type I. Type I diabetes is certainly caused by the total destruction
of the pancreatic islet beta cells found in the islets of Langerhans.  There are
four cell types in islets and only the insulin producing beta cells are
destroyed leaving the person incapable of producing insulin. The bodies immune
system targets the beta cells and initiates an autoimmune attack. Nobody is
quite sure why the attack is triggered. However the time course of the beta cell
destruction can vary greatly in individuals. It can take days, weeks, months or
in some cases years for the beta cell mass to be reduced to less than 90% at
wich point symptoms of diabetes become apparent. You can carry on with very few
islets and still produce insulin. When most people are diagnosed they probably
have around 10% of their original beta cell mass left and quite often after they
start insulin therapy and the islets have a chance to rest they can produce a
bit of insulin and experience the so called honeymoon period, which I did in
fact experience. However at the moment the continued destruction of the
remaining islets is unavoidable and eventually there will be none left. I feel
strongly that if scientists concentrated on arresting the autimmune attack then
even people diagnosed might have a chance to recover some beta cell mass and
consequently recover from their diabetes. However it would take lots of money
and targeted research to achieve this. At the moment research funds are targeted
in so many different directions that the money is spread very thin. I am
straying off topic here, sorry , I get very excited about the whole thing, I
apologise if I have blithered on in horrible detail. I think my point was that
the amount of time someone can go without insulin depends on loads of factors
including length of time since diagnosis, remaining beta cell mass at time of
diagnosis, health, stress, and nine million other things. It takes some time to
die of DKA and I don't think missing out a few hours of insulin would be fatal.
Most pumpers (and all responsible pumpers) check their bgs before going to bed
and when they wake up in the morning. For most people that means the very most
they could go without insulin if the blockage alarm didn't go would be eight
hours, definitely not enough to kill them off ! Phew, sorry to be so long
winded, guess I am making up for lost time ! Okay, thats me done for now,

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