Type 1 Diabetes is a chronic disease in which the body does not produce enough insulin. Insulin is a hormone which helps sugar (glucose) enter our cells, which then is used to produce energy.  Unless a person takes medicine to control their blood sugar level, the body does not produce enough insulin, and the blood sugar level remains high.

Unless treated with appropriate medication, persons with type 1 diabetes will have high blood sugar levels, which eventually leads to complications including damage to multiple organs.

Type 1 diabetes is not reversible. However, with medical assistance, a person's illness can be controlled, and they can have a full and active life.

In this Diabetic & Me article, we look at the causes, symptoms, treatment goals and management strategies of type 1 diabetes mellitus.

What is Type 1 Diabetes?

When you have type 1 diabetes, your immune system destroys the cells in your pancreas that produce insulin. These cells are known as Beta cells. In a small number of people, type 1 diabetes is also caused by unknown mechanisms which do not involve the immune system. Juvenile diabetes was the previous name for the ailment because it is typically diagnosed in young adults, adolescents, and teenagers.

Similar to type 1, secondary diabetes occurs when your beta cells are destroyed when the functioning of the beta cells is impaired by other factors, such as an illness or damage to your pancreas, as opposed to your immune system.

These two conditions differ from type 2 diabetes, in which your body does not respond to insulin as it ought to.

In type 1 diabetes, your pancreas either doesn't create insulin or either does not produce insulin or produces very little. In the absence of insulin, blood sugar cannot enter cells, and too much sugar accumulates in the bloodstream. The body is harmed by high blood sugar, which contributes to many of the consequences and symptoms of diabetes.

Symptoms of Type 1 Diabetes

Type 1 diabetes symptoms may not be seen for months or years. It's is typically diagnosed either in childhood, between 4 to 6 years or in teenage years, between 10 and 14 years of age. Type 1 diabetes symptoms might appear in as little as a few weeks or months. When symptoms emerge, they might lead to severe illness and need for hospitalization.

Some symptoms of type 1 diabetes can initially be non-specific, leading to delays in patients seeking medical assistance. Don't make a guess! If you suspect you have type 1 diabetes, consult your doctor and get your blood sugar levels checked. Diabetes, if left untreated, can cause serious, even fatal, health concerns such as blindness, neurological problems, kidney failure as well as an increased risk of stroke and heart disease.

The risk factors for type 1 diabetes are not as apparent as they are for type 2 diabetes and prediabetes. The symptoms of type 1 diabetes include:

  •  Increased thirst
  • Hazy vision
  • Dry mouth
  • Urine frequency
  • Unexplained weight loss despite eating and feeling hungry
  • Heightened hunger (especially after eating)
  • Vomiting and upset stomach
  • Fatigue and lethargy, e.g. in a child
  • Difficulty breathing
  • Infections of the skin, urinary tract, or vagina
  • Irritability or mood swings
  • Bedwetting in a child who has previously been dry at night

Type 1 diabetic emergency symptoms include:

  • Confusion, shaking, and possible delirium
  • Rapid breathing
  • Your breath has a fruity scent
  • Pain in the abdomen
  • Loss of Consciousness (this is a common symptom of diabetic ketoacidosis and an indicator of severe illness)

Causes of Type 1 Diabetes

Type 1 diabetes and its precise origin is still a mystery, although studies show that genetic, immunological as well as environmental factors play a part. Insulin aids in transporting glucose, or sugar, into the cells in our body, which is then used by our tissues as fuel.

In type type 1 diabetes mellitus, the beta cells in the pancreas are unable to produce Insulin. Due to a lack of insulin, glucose cannot enter your cells. As a result, sugar builds in your blood, starving your cells. Over time, this leads to damage to tissues in vital organs, including nerve damage, vision impairment and kidney failure.

Dehydration

This happens due to increased loss of body fluids in the form of urine. You urinate more when there is more excess sugar in your blood. That is how your body is removing it. Your body dries out because a significant amount of water is expelled from that urine.

Loss of weight

When you urinate, glucose leaves your body and carries calories with it. Because of this, a lot of people with high blood sugar lose weight. Dehydration also contributes.

Diabetic ketoacidosis (DKA)

When your body runs out of glucose for fuel, it breaks down fat cells. The resultant substances are known as ketones. To assist, your liver releases the sugar it has stored. But without insulin, your body can't utilize it, accumulating in your blood along with the acidic ketones. Ketoacidosis, a condition marked by excess glucose, dehydration, and acid accumulation, can be fatal if untreated quickly.

Complications

The neurons and tiny blood arteries in your eyes, kidneys, and heart can become damaged over time by high blood glucose levels. They may also increase your risk of atherosclerosis or hardening the arteries, which can result in heart attacks and strokes.

Type 1 diabetes cannot be prevented. Doctors are unaware of all the contributing factors. But they are aware that your genes are involved.

They also know that type 1 diabetes can develop when an outside factor, such as a virus, causes your immune system to attack your pancreas. Autoantibodies, which are produced during this process, are commonly detected in persons with type 1 diabetes. When their blood sugar is high, they are present in practically everyone with the illness. There is an increased risk of other autoimmune conditions, such as Graves or vitiligo in persons with type 1 diabetes.

Type 1 Diabetes Risk Factors

There is little knowledge about the risk factor for type 1 diabetes. They resemble diabetes causes in many respects.

This is because some people may not be affected by the exact causes that produce type 1 diabetes in other people.

Researchers have found some potential risk factors:

Race

Type 1 diabetes risk may be influenced by race. Caucasians may be more genetically predisposed to type 1 diabetes since they are more likely to develop it. Type 1 diabetes is noted to occur most commonly in Finland and Sardinia (37 to 65 per 100,000 children younger than the age of 15 years. In the USA, about 22 children and adolescents per 100,000 are diagnosed yearly.

External variables

Additionally, some infections can cause type 1 diabetes. However, knowledge of these causes is limited.

Likewise, type 1 diabetes is more prevalent in residents of colder locations. Additionally, doctors detect more type 1 patients in the winter than in the summer. Who develops type 1 diabetes may be influenced by a number of other factors.

Genetic influences

Researchers are unsure about the precise causation of type 1 diabetes. However, they think that your genes—both the ones you inherit and the history of diabetes in your family—may be involved.

Type 1 diabetics have a higher risk of having the condition later in life. It does seem to be carried down through families' generations. Uncertainty surrounds the pattern's operation and the reasons why some members of a family will get diabetes while others won't.

Researchers have found specific gene variants to raise a person's risk potential. Parents and children can pass these variations down through the generations. Not everyone with these genes, though, gets type 1 diabetes.

Because of this, scientists think that genes are only one component of the puzzle. They believe that those who have inherited genes are susceptible to a trigger. Undoubtedly, a virus is a trigger.

Identical twins, for instance, who share every gene, might not both experience the syndrome. If one twin has type 1 diabetes, the other twin will most likely only get it half as often. This implies that genes aren't the only determining factor.

Diagnosis for Type 1 Diabetes

Urine glucose testing was a popular screening option for Type 1 diabetes. But since urine sugar tests are not usually as accurate as blood, blood tests are presently more widely accepted and used by healthcare providers.

Your doctor may opt for a urine glucose test when blood testing is not feasible. Some popular tests to diagnose Type 1 diabetes include;

  • Random blood sugar test
  • Fasting blood sugar test
  • Glycated hemoglobin (A1C) test

Goals of Treatment

  • Achieve strict control of blood sugar levels, which in turn reduces the risk of complications and organ damage with time. This is done while also taking steps to avoid hypoglycemia (dangerously low blood sugar levels). 
  • Educating the patient and their caregivers in day-to-day management of the condition and strategies to avoid and treat low blood sugar levels. 
  • Maintain normal physical development and emotional maturation while supporting independence and daily self care as the patient grows older. 

Treatment is often provided by a team of healthcare professionals working jointly, including a medical doctor (family physician, sometimes a specialist doctor, i.e. Endocrinologist), specialist Diabetes nurses, dietician, psychologist and social worker. 

Diet Recommendations

The American Diabetes Association (ADA) posits that healthy diets consisting of plant-based foods help maintain a healthy weight and prevent or delay type 1 diabetes complications.

It can be a little challenging to get your diet right for diabetes because you will have to go for maximum nutrition while ensuring moderation of carbs, fats, and protein intake. That's why you may need an expert for this.

To make the most of your diet plans as a diabetic, you don't only need to know WHAT TO EAT but also WHEN TO EAT. Timing your food intake and eating smaller meals make monitoring your glucose levels easier and preventing them from spiking.

Moreover, with diabetes, healthy diets are nothing without regular exercise! Getting more active will help you maintain a healthy blood sugar level and avoid diabetes complications relating to heart and blood pressure.

Some healthy food options for Type 1 diabetes include,

  • Whole grains (brown rice, whole wheat, oatmeal, quinoa, etc.)
  • Non-starchy vegetables (greens, mushrooms, broccoli, and cauliflower)
  • Legumes and beans (Lentils, kidney beans, pintos, black beans, and garbanzo beans)
  • Nuts (almonds, Brazil nuts, walnuts)
  • Seeds (pumpkin, chia, sunflower seeds)
  • Snacks (a boiled egg, hummus and oatcakes, celery sticks, and nut butter)
  • Stay hydrated

Treatment of Type 1 Diabetes

When type 1 diabetes is identified, your body is unable to produce insulin on its own. You must take insulin to aid your body in utilizing the blood sugar.

Other therapies might potentially be effective in reducing type 1 diabetic symptoms.

Insulin

Diabetes type 1 patients need to take insulin shots daily. In most cases, an injection is used to provide insulin.

A few individuals utilize insulin pumps. Through a port in the skin, the insulin pump administers insulin. An insulin pump may be less complicated for some people than self-needling insulin injections. It might also aid in balancing out highs and lows in blood sugar.

Your daily insulin requirements change as the day progresses. People with type 1 diabetes measure their blood sugar levels frequently to determine how much insulin they require, either little or no insulin. Blood sugar levels can be impacted by both food and activity.

There are various insulin varieties. To determine which one suits you the best, your doctor might have you try several.

Insulin varieties:

  • Rapid-acting takes about 15 minutes to begin to work. After you take it, it reaches its peak and works for another two to four hours.
  • Short-acting or regular start working in roughly 30 minutes. It works continuously for 3 to 6 hours, peaking between 2 and 3 hours.
  • Intermediate-acting will take 2 to 4 hours after your injection to enter your bloodstream. It operates for 12 to 18 hours and peaks between 4 and 12 hours.
  • Long-acting medications last roughly 24 hours and take a while to enter your system.

Metformin

One type of oral diabetic treatment is Metformin. It was restricted to those with type 2 diabetes for a long time.

However, insulin resistance can happen in certain type 1 diabetics. This indicates that the insulin they receive via injection doesn't function as it should. Nowadays, doctors occasionally recommend Metformin to people with type 1 diabetes.

By lessening the liver's ability to produce sugar, Metformin aids in lowering blood sugar levels. Your doctor could suggest that you take Metformin along with insulin.

Lifestyle Improvements

Exercise is crucial in the management of type 1 diabetes. In patients with diabetes, the ADA recommends 150 min/week (distributed over at least 3 days) of moderate aerobic physical activity with no gaps longer than 2 days. Resistance exercise and balance training are also known to be beneficial.

However, it's not as easy as going for a run. Your blood sugar levels will change after exercise. Therefore, you must balance your insulin dosage and diet when engaging in any activity, even simple household or gardening chores.

The power of knowledge. Before, during, and after physical activity, check your blood glucose to see how it affects you. Your levels will increase in some situations while not in others. To prevent it from falling too low, you can lower your insulin or eat a snack that contains carbohydrates.

Check for ketones, which are the acids that might appear when blood glucose levels are high (over 240 mg/dL). You ought to be fine, if they're alright. Skip the workout if they are intoxicated.

Additionally, you must comprehend how food affects your blood glucose. You may create a healthy eating plan that helps keep your levels where they should be once you understand the functions of protein, lipids, and carbohydrates in your diet. You can get started with assistance from health professionals or a diabetes educator.

Type 1 Diabetes Complications

If type 1 diabetes is not effectively controlled, it can cause other health problems. The following are complications:

Cardiovascular disease

You are more likely to develop blood clots in your heart and blood vessels, high blood pressure, and high cholesterol if you have diabetes. These may result in cardiac failure, a heart attack, a stroke, or chest pain.

Skin conditions

Bacterial or fungal infections are more prevalent in people with diabetes. Blisters or rashes may also result from diabetes. Persons with poorly controlled diabetes may also experience poor wound healing.

Gum disease

Too much plaque, little saliva, and poor blood circulation can all result in oral health issues.

Obstetrical issues

Preeclampsia, early delivery, and birth abnormalities, stillbirth are all more common in women with type 1 diabetes.

Retinopathy

About 80% of persons with type 1 diabetes for more than 15 years experience this eye condition.

It's uncommon before puberty, regardless of how long you've had the condition. Maintain proper control of your blood glucose level, cholesterol, and triglycerides to prevent them and preserve your vision.

Digestive and Kidney diseases

Nephropathy affects 20% to 30% of individuals with type 1 diabetes. Over time, the chances rise. It usually appears 15 to 25 years after diabetes first appears. Other severe issues like kidney damage and heart disease can result from it.

Damage to the nerves (neuropathy) and poor blood flow

A lack of blood flow to your feet and a loss of feeling is caused by damaged nerves and hardened arteries. This increases your risk of getting hurt and hinders the healing of open wounds and sores.

If it takes place, you can lose a limb. Additionally, digestive issues, including nausea, vomiting, and diarrhea, can be brought on by nerve injury

You can take precautions to avoid issues:

  • Try your best to maintain stable blood sugar levels.
  • Keep an eye on your cholesterol and blood pressure.
  • Exercise and eat healthily.
  • Stop smoking if you do.
  • Look after your teeth and feet.
  • Get regular eye, dental, and medical checkups.

Preventing Type 1 Diabetes

Type 1 diabetes currently has no clinical prevention measures. However, investigations are ongoing on possible ways to prevent the disease. Researchers are working towards discovering how to prevent further damage to the islet cells in newly-diagnosed people.

With many clinical trials for Type 1 diabetes prevention currently available, you can discuss your eligibility for one of them with your doctor. Always remember that certain risk levels are always associated with clinical trials. Thus, you must weigh your options regarding the possible pros and cons.

Conclusion

While having type 1 diabetes can be extremely serious and demanding, those who manage their blood sugar levels, make healthy food and exercise choices, and adopt other healthy lifestyle practices can thrive. You can get started with assistance from a diabetes educator.

People with type 1 diabetes can pursue careers as elite athletes, parents, and even judges on the Supreme Court!

The possibilities for your life are limitless as long as you give your type 1 diabetes the attention it requires.

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About the Author

Ely Fornoville

Hi, I'm Ely Fornoville and I am the founder of Diabetic & Me. Being a type 1 diabetic since 1996 I developed a passion to help people learn more about diabetes. I write about diabetes and share stories from other diabetics around the world. I am currently using a Medtronic Guardian 4 and a Minimed 780G insulin pump with Humalog.

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