BACKGROUND: Type 1 diabetes is usually diagnosed in children and young adults and was previously known as juvenile diabetes. In this disease, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar (glucose), starches and other food into energy for daily life. Inside the pancreas, beta cells make insulin. With each meal, the cells release the hormone to help the body use or store the blood glucose it gets from food. In people with type 1 diabetes, the beta cells have been destroyed, and they need insulin shots to use glucose from meals. Insulin must be injected into the fat under your skin for it to get into your blood. There are many different types of insulin for many different situations and lifestyles.

COMPLICATIONS: People with type 1 diabetes are at an increased risk for:
» Heart disease
» Kidney disease
» Eye complications
» Nerve damage/foot complications
» Skin complications
» Depression

EVERYDAY LIFE: Patients with type 1 diabetes must constantly check their blood sugar levels throughout the day. Keeping blood sugar levels as close to normal as possible can help prevent or delay the start of some diabetes complications. Ideally, this means keeping levels between 90 and 130 before meals and less than 180 two hours after starting a meal. Every bit you lower your blood glucose level helps prevent complications. No one knows why high glucose levels cause complications in people with diabetes.

A GENETIC FORM OF DIABETES: Recently, researchers have discovered a new, genetic form of the disease that was previously diagnosed as type 1 diabetes. This form of the disease -- known as monogenetic diabetes -- can be treated without insulin. Instead, patients are given a pill from the class of drugs called sulfonylureas. These drugs increase the amount of potassium in the pancreas cells, so patients can produce insulin on their own. They directly affect the mutant protein that allows potassium to flow out of the cells. The drugs are long lasting, so patients only need to take them twice a day instead of being hooked up to an insulin pump or giving themselves injections. Experts say taking a pill instead of insulin is advantageous because many patients on insulin have blood sugar highs and lows throughout the day that are unmanageable. It's also easier, less painful, and a big money-saver. Louis Philipson, M.D., from the University of Chicago, says: "The benefits are remarkable. It comes down to not checking 12 times a day. People do not realize it, but that is almost $12 a day in terms of supplies and blood testing, so multiply that by 365!" He adds, "It really is life-changing. It's hard to imagine anything more profound than to take a child who is being tested 10 to 12 times a day or someone who may be 18 or 19 years old and to convert them from insulin to pills."

WHO HAS THIS GENETIC FORM? Doctors believe the gene is a type of birth defect. So far, all the cases of this genetic diabetes are patients who were diagnosed before six months of age. Doctors believe diabetes diagnosed after six months has other causes, but more research is needed. They estimate between 400 and 2,000 patients in the United States could have this type of diabetes. So far, fewer than 10 patients have been identified in this country, but more than 150 have been identified in Europe. If a patient was diagnosed before six months of age, a simple genetic test is given to verify he/she has this form of the disease. Once the results confirm the diagnosis, doctors can help the patient stop their insulin therapy and start taking the drugs.