Type 1 Diabetes

Type 1 diabetes—previously known as juvenile diabetes or insulin-dependent diabetes—is a chronic condition in which the pancreas doesn’t make any, or makes very little, insulin, a hormone responsible for helping blood sugar enter cells where it can then be used as energy. Type 1 diabetes is less common than type 2, and it’s typically diagnosed in childhood.
By Jessica Migala
Updated June 29, 2021

Type 1 diabetes, which is often diagnosed in children or young adults, is treated with insulin. Type 1 diabetes is caused by an abnormal immune reaction that destroys the insulin-producing cells of the pancreas.

It's believed that a combination of genes and an environmental trigger, such as a virus, interact to cause type 1 diabetes. Some symptoms include excessive thirst and urination, slow wound healing, tingling and numbness in feet, fatigue, and unexpected weight loss. While there is no cure, the condition can be properly managed with insulin therapy and a healthy lifestyle. A wide range of support and education for patients with type 1 diabetes is crucial for successful blood sugar control.

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What Is It?

Diabetes is a disease where blood sugar levels are too high. The majority of diabetes diagnoses are type 2 diabetes, which is why the general public may be less familiar with type 1. Still, type 1 diabetes makes up 5 to 10 percent of people who have diabetes, and there's evidence that it's on the rise. Currently, there are 1.5 million Americans who have type 1 diabetes, and 64,000 people are diagnosed every year in the U.S.

Type 1 diabetes is a chronic autoimmune condition where your pancreas—the digestive organ located behind the stomach—doesn't make insulin, a hormone that helps push blood sugar from your bloodstream into your cells where it can give you energy. When blood sugar levels are high and stay elevated, other organs and body structures can be damaged, including the heart and blood vessels, nerves, kidneys, eyes, feet, and skin.

While type 1 diabetes can develop at any time, it's most often diagnosed in people during childhood or as a young adult. The latest statistics show that the incidence of type 1 diabetes is increasing in children and adolescents, particularly among Hispanic, non-Hispanic Asian, and Pacific Islander youth.

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Types

There are three main types of diabetes:

Type 1 diabetes: An autoimmune condition where the body destroys the beta cells in the pancreas that produce insulin.

Type 2 diabetes: This is the most common type of diabetes. Type 2 diabetes develops when the body does not make enough insulin or your cells do not use insulin well, leading to high blood glucose levels.

Prediabetes is when your blood sugar is elevated but not yet in the range for type 2 diabetes and affects one in three adults in the US. Prediabetes can be reversed through lifestyle changes.

Gestational diabetes: Occurs in about 10 percent of people who are pregnant and increases the risk of pregnancy complications. It is treatable with diet, exercise, and insulin injections, if necessary.

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Symptoms

Damage from type 1 diabetes can take years to accumulate. But once the insulin-producing cells in the pancreas—beta cells—incur enough damage, symptoms can arise rather suddenly, which can be alarming.

They may include:

* Frequent urination: When excess sugar builds up in your bloodstream, your kidneys may try to get rid of it by prompting you to pee a lot. You may also notice that you often wake up in the middle of the night to urinate. Children may begin abnormally wetting the bed.

* Excessive thirst: Because your kidneys are flushing out fluid, you may become dehydrated, and your body responds by stimulating your desire to drink liquids.

* Increased hunger and unintended weight loss: If insulin cannot drive blood sugar into cells, you will not get energy from the food you eat. That may drive up hunger levels and contribute to weight loss.

* Fatigue: Similar to the reason for increased hunger, without adequate energy into your cells, you may feel fatigued even if you've gotten enough sleep.

* Dry skin: Thanks to dehydration, you may notice that your skin is drier and more itchy than normal.

* Tingling and numbness in feet: Chronically high blood sugar levels cause nerve damage. This can feel like a pins and needles sensation in your feet.

* Sores or wounds that heal slowly: Diabetes affects circulation, causes nerve damage, and affects the immune system, all of which impair the body's normal wound healing response and increase the risk of infection. Nerve damage can make these problems go unnoticed, further worsening the problem.

* Blurry eyesight: High blood sugar damages even the small blood vessels that feed the retina in the eye, which is essential for clear vision.

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Causes

Type 1 diabetes is an autoimmune condition. This means that the body mistakenly views its own tissues as foreign and mounts an attack against them, causing damage in the process. In this disease, it is the beta cells in the pancreas—those responsible for producing insulin—that are attacked.

Autoimmune diseases like type 1 diabetes can happen seemingly at random, though there may be a combination of genetic factors plus environmental triggers, like a virus, that prompt the disease to develop. Family history of the disease may make you more susceptible, along with a younger age.

What's important to know is that it's not the fault of the person who has type 1 diabetes. This is not a disease that is caused by diet choices or other lifestyle habits.

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Diagnosis

Type 1 diabetes can be diagnosed through:

* A blood test that analyzes blood sugar levels.

* An autoantibody test to confirm an autoimmune condition

* A urine test to look for ketones, which indicates that your body is not using glucose for fuel—its preferred source—but it's relying on fat instead.

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Treatment

There is no cure for type 1 diabetes. Instead, doctors look to help patients manage the condition. That said, patients can manage type 1 diabetes well and live full lives filled with everything they want to do. This is done by controlling blood glucose levels to prevent both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar).

The most important change after diagnosis is that you will need to monitor your blood sugar regularly and give your body the insulin that your pancreas is no longer making. An outside source of insulin is necessary for survival. Missing insulin doses can lead to a life-threatening complication called diabetic ketoacidosis.

Insulin management can be done with insulin injections (e.g. via a syringe or pen), an inhaler, or wearing an insulin pump, a device that will provide your body with continuous insulin throughout the day.

Insulin is also necessary to prevent hypoglycemia (low blood sugar), which can result in symptoms such as dizziness, nausea, weakness, and an accelerated heartbeat. This can advance into a medical event that leads to seizures and death, and so it's important to recognize and promptly treat symptoms of low blood sugar.

In addition, controlling blood sugar levels with insulin therapy will help keep your body well over the long-term and decrease the risk of complications, such as nerve and kidney damage.

Putting together a diabetes care team can be immensely helpful in managing blood sugar levels, learning how to live with the disease, and watching for potential complications. Your team might include a:

* Primary care physician

* Endocrinologist

* Podiatrist

* Ophthalmologist

* Dentist

* Pharmacist

* Registered dietitian nutritionist (RDN) or a certified diabetes care and education specialist (CDCES).

Lastly, a healthy lifestyle can go a long way in regulating blood sugar levels:

* Manage stress. High levels of cortisol can increase blood sugar levels.

* Eat a healthy diet that includes vegetables, fruits, complex carbohydrates, lean protein, and healthy fats.

* Exercise, which helps muscles use blood sugar for energy

* Sleep well. Proper sleep plays a role in blood sugar regulation.

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Prevention

Unfortunately, there is no known way to prevent type 1 diabetes, as it is an autoimmune condition, and researchers are still working on understanding how these develop and if there is any way to step in early and stop damage to insulin-producing cells.