What Is Type 1 Diabetes?

Diabetes, also called diabetes mellitus, is a group of metabolic disorders marked by elevated blood sugar levels that extend over long periods of time. Diabetes usually results from insufficient quantities of insulin or from insulin’s resistance to properly regulating blood sugar levels. In the case of type 1 diabetes, the body attacks the pancreatic cells that produce insulin. This leaves it incapable of manufacturing insulin in quantities sufficient to control blood sugar levels. 

Type 1 diabetes is relatively rare, affecting only about five percent of all patients with diabetes. It typically appears early in life, with a majority of cases being reported in children, adolescents, and young adults. Type 1 patients must inject insulin on a recurring basis.

What Are the Symptoms of Type 1 Diabetes?

Type 1 diabetes is marked by several symptoms. These can appear suddenly, with very little warning:

• Extreme thirstiness
• Exaggerated hunger
• Frequent urination and bedwetting
• Physical weakness and fatigue
• Blurred or unfocused vision
• Irritability and mood swings
• Unplanned-for weight loss

If you or someone in your family experiences these symptoms, see your physician immediately.

What Causes Type 1 Diabetes? What Are the Risk Factors?

Insulin is a hormone produced by a pancreatic region called the islets of Langerhans. Its primary function is to help store converted food energy, sugar or glucose, inside cells, where it can be used to power the chemical operations that are essential to life. Persons with type 1 diabetes have an immune system that sabotages this process, by targeting the centers of insulin production. This allows glucose to build up in the bloodstream rather than in the cells, which is detrimental to good health and associated with serious medical complications. 

Medical researchers are uncertain as to why some immune systems treat the islets of Langerhans as pathogens. Genetics might play a role, along with viral infections or other aspects of the environment.

Scientists have been successful in identifying several risk factors for type 1 diabetes:

• Age: Type 1 diabetes can occur at any point in life but the most common ages of onset are in the young, especially 4 to 7 year olds and 10 to 14 year olds.
• Genetics: Inheriting certain genes makes type 1 diabetes more likely.
• Family history: A parent, brother, or sister with type 1 diabetes means that you’re at greater risk of developing the disease.
• Geography: Type 1 diabetes is more common in people living in high latitudes than near the Equator.

How Is Type 1 Diabetes Diagnosed?

Your physician can perform one or more tests to confirm a suspected diagnosis of type 1 diabetes:

• Glycated hemoglobin (A1C) test: An A1C test determines your average blood sugar levels over the most recent 2 to 3 month period. It does this by measuring the percentage of hemoglobin in red blood cells to which glucose molecules are attached. A percentage of 6.5 percent or greater indicates elevated blood sugar levels, and supports a diabetes diagnosis. 
• Random blood sugar test: A second test focuses on glucose levels in randomly drawn blood samples. The units of measure are milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Readings equal to or higher than 200 mg/dL or 11.1 mmol/L are indicative of diabetes, especially in conjunction with other known symptoms.
• Fasting blood sugar test: A third test utilizes blood samples following an overnight fast. A healthy reading is below 100 mg/dL or 5.6 mmol/L. A prediabetic condition falls between 100 and 125 mg/dL (5.6 to 6.9 mmol/L). If your glucose level is above the high end of these ranges in at least two tests, then you are, by medical definition, diabetic. 

Your physician will continue to monitor your blood sugar levels after you’ve been diagnosed with diabetes. He or she will focus on the A1C reading, which provides a longer-term perspective than the other two. Other tests will center on organ function, blood pressure, and cholesterol levels.

How Is Type 1 Diabetes Treated?

There is no known cure for type 1 diabetes. There are, however, steps you can take to control the disease, minimizing its impact on your life and well-being. These steps include:

• Taking Insulin: There are several types of insulin, ranging from short- to long-acting. These are administered by means of injections or an insulin pump, which is a device worn outside the body that dispenses insulin through a catheter. A more comprehensive version of an insulin pump, known as an artificial pancreas, was recently approved by the Food and Drug Administration. This device is implanted in the body, and also includes a continuous glucose monitor. 
• Monitoring blood sugar: Diabetics should be in the habit of checking their glucose levels several times a day. Studies have shown that persons who regularly check blood sugar levels are more likely to maintain them within healthy ranges. This can be done either by the standard fingerstick method or by means of a continuous glucose monitoring system. 
• Eating a healthy diet: There is no perfect diet for diabetics, since all foods are a source of chemical energy (glucose). However, a diet that emphasizes low-fat, high-fiber foods, including vegetables, whole grains, and fruits, has a better nutritional profile than a diet focused on animal products, starches, and refined carbohydrates. 
• Exercising regularly: Being overweight can add to the health issues faced by diabetics. Accordingly, aerobic exercise – walking, running, swimming, and cycling – is particularly important as part of a program of intentional weight loss. However, because exercise decreases glucose levels, there is an attendant risk of hypoglycemia – too-low levels of blood sugar. Glucose monitoring and awareness of hypoglycemia symptoms are critical to exercise safety for diabetic individuals.

What Are the Long-term Effects of Type 1 Diabetes?

Type 1 diabetes is an incurable condition that affects nearly every part of the body. It is a major health risk in and of itself, but also as a contributor to other life-threatening diseases and conditions. Some of diabetes’s potential consequences are:

• Cardiovascular disease, including chest pain, heart attack, stroke, and hardening of the arteries
• Nerve damage, numbness, and loss of feeling in the extremities
• Kidney damage, including organ failure and end-stage renal disease
• Eye damage leading to cataracts, glaucoma, and blindness
• Foot damage, slow-healing cuts, and, in the worst cases, amputations
• Skin conditions, including bacterial and fungal infections
• Hearing impairment
• Alzheimer’s disease and other forms of dementia
• Depression and melancholy

Diabetes should be managed under a physician’s guidance throughout a person’s life. 

Can I Prevent Type 1 Diabetes?

There is no known means of preventing type 1 diabetes. It is impossible to predict who will develop it or when it might manifest itself. 

Can I Manage Type 1 Diabetes?

On the other hand, it is possible to successfully manage type 1 diabetes. Below are some things you can do to limit the impact of your condition that go beyond insulin dosing and other required medical treatments:

• Commit yourself to a lifelong process of diabetes management
• Schedule yearly physical and eye exams
• Pay close attention to your feet, which are especially vulnerable to diabetes-related complications
• Keep up to date with your immunization requirements
• Watch your cholesterol and blood pressure
• If you smoke, stop – and don’t use other tobacco products either
• Drink alcohol responsibly and in moderation
• Keep your stress levels in check
• Wear some form of identification with information about your diabetic condition