7 Type 1 Diabetes Symptoms to Know, According to Experts
The sooner you recognize the symptoms of type 1 diabetes, the sooner you can start the treatment you need.
What is type 1 diabetes?
Type 1 diabetes is an autoimmune disease that causes the pancreas to stop producing insulin. Essentially, when you have type 1 diabetes, your immune system attacks and destroys the cells in the pancreas that make insulin. Insulin is a hormone responsible for maintaining normal blood sugars," Rachel Arakawa, MD, Assistant Professor in the Division of Endocrinology, Diabetes, and Bone Disease at Mount Sinai Hospital, tells Health. It acts like a messenger, carrying sugars out of the blood and into other cells in your body, which use the sugar for energy.
When your body doesn't make insulin, it has no way of moving sugars (or glucose) out of your blood. "When glucose is unable to move, it makes your blood more concentrated—like a honey syrup," Akankasha Goyal, MD, an endocrinologist at NYU Langone Health, tells Health.
So, without insulin, you end up with too much sugar in your blood and no sugar for other cells to feed on, both of which lead to a host of symptoms. Most of the time, the symptoms of type 1 diabetes show up in childhood, though they can present at any age. And although there's a myth that type 1 diabetes is genetic, it's just that: a myth. "Most people with type 1 diabetes don't have a family history of it," Emily Breidbart, MD, a pediatric endocrinologist at NYU Langone, tells Health.
There's no way to prevent or cure type 1 diabetes. The best thing you can do is watch for telltale symptoms that can become life-threatening quickly. If type 1 diabetes progresses fast, the body can enter a very dangerous state called diabetic ketoacidosis (DKA), which is a medical emergency. "Diabetic ketoacidosis is basically when the body has to break down fat as fuel. Usually, our bodies make energy by using glucose," says Dr. Breidbart. When your body breaks down fat instead of glucose, it creates something called "ketones," which can be very dangerous when they build up. "They can actually make your blood acidic," says Dr. Breidbart. "And that, in turn, can make you very, very sick."
Despite the seriousness of the disease, it's highly treatable. Controlling your glucose levels will help prevent long-term complications. The sooner you notice something is wrong, the sooner you can be treated. Talk to your doctor if you experience these signs of type 1 diabetes.
Having to pee all the time is one of the three main symptoms of type 1 diabetes. Without insulin, sugar accumulates in your bloodstream—again, thickening it like a syrup, says Dr. Goyal. Your kidneys act as a filter for your blood, removing anything that doesn't belong. So, when you have too much blood sugar, your kidneys have to work in overdrive, says Dr. Goyal.
Peeing way more than usual during the day and waking up to pee more often at night can both be red flags that you might have type 1 diabetes. If you're a parent looking out for symptoms in your kids, watch for accidents in kids who've already been potty trained or for wetter or more frequent diapers than you're used to, says Dr. Breidbart.
Frequent urination, also called polyuria, is usually easier to detect in kids than in adults, because parents tend to worry when their kids start having accidents. Without treatment, frequent urination can lead to dehydration and kidney damage among people with type 1 diabetes.
Excessive thirst, also called polydipsia, is a common sign of both type 1 and type 2 diabetes. Because you're peeing more often, your body is losing a lot of fluid and you naturally drink more to try to replenish what's lost, says Dr. Goyal. Then you end up with a vicious cycle: Feeling thirsty leads to drinking more leads to urinating more and on it goes. (You may also feel hungrier than usual if your body isn't getting the energy it needs.)
If you're peeing more and not taking in enough fluids, you can become dehydrated, and dehydration causes even more symptoms, including dizziness, headaches, nausea, and fainting. Dehydration can also raise blood sugar levels, escalating the problem.
Unexplained weight loss
With no sugar to sustain them, starving cells start looking for alternative energy sources. When your body starts breaking down fat and muscle to use for energy, it can cause rapid weight loss even if you're eating normally.
But weight loss also happens because your body isn't getting the calories it needs from glucose. "When your body can't utilize glucose, you're basically peeing out all of those calories," says Dr. Breidbart. "So, you're really not making energy or absorbing calories from what you're eating."
While it can be difficult to spot weight loss as a problem in adults, it should be a major red flag in kids. "No kids should be losing weight, they should be gaining weight as they grow," says Dr. Breidbart. If you notice your kid losing weight, it's a sign that you should take them to see their pediatrician immediately.
Fatigue is a relatively common symptom of any autoimmune disease. When your body is attacking itself, it can be very difficult to find the energy you need for daily activities. For those who have type 1 diabetes, your body literally doesn't have the energy. Insulin transports glucose from the blood into cells, which essentially use the sugars as their food. "Without insulin, your cells don't have energy, which is why people get exhausted," says Dr. Goyal.
Fatigue can show up in multiple ways, including being extremely tired or breathing really heavily when you haven't exerted yourself that much, according to the American Diabetes Association.
Fruity-smelling breath and urine
Most of us probably aren't sniffing our urine, so spotting this symptom comes down to recognizing sweet-smelling breath.
You'll notice sweet-smelling breath after your body starts breaking down fat to use as energy because it can't access glucose. When it needs a new source of energy, your body turns to fat and inside fatty acid are ketones, including one you might be familiar with: acetone. It's the acetone that you smell on your breath, which (as you might know from nail polish) has a kind of sweet, fruity smell, says Dr. Goyal.
Fruity-smelling breath is one sign that your body has entered diabetic ketoacidosis, says Dr. Arakawa. "Type 1 diabetes can appear suddenly. Call 911 if you or a family member develops symptoms of severe nausea and vomiting, abdominal pain, fruity-smelling breath, rapid breathing, or decreased levels of consciousness."
Stomach pain is a complication of acidosis, says Dr. Goyal. "When patients come in with nausea and vomiting and have high blood sugar, we start looking at diabetes," she says.
Abdominal pain is one of many signs of diabetic ketoacidosis, including: chest pain, nausea and vomiting, rapid breathing, weakness, drowsiness, and confusion. The condition can reach crisis levels within 24 hours and is sometimes the first sign of type 1 diabetes. Diabetic ketoacidosis can also happen after you are diagnosed. Either way, the mainstays of treatment are IV fluids and insulin.
The more concentrated sugar is in your blood, the more likely it will be to affect your eyes. High blood sugar can cause something called hyperosmolarity, which draws water out of organs in the body, says Dr. Goyal. So, high levels of glucose in your bloodstream can cause fluid in your eyes to start leaking into the lens. This can make the lens swell and change shape, which can lead to blurry vision.
Once you start getting your blood sugar under control, your vision should become sharper as the fluids in your eyes shift, which takes about six weeks.
This is different from the eye damage that can occur if blood sugar levels are consistently high over long periods of time, which can lead to blindness.
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