What to know about type 1 diabetes

Condition 1 diabetes requires treatment that lasts a lifetime once it progresses. The body is not producing enough insulin, so blood glucose levels remain high unless someone takes steps to control high blood sugar.

An estimated 0.55 percent of adults in the United States have condition 1 diabetes. This accounts for about 5 percent of people with diabetes.

While there is no complete cure for this type, the variety of management options means a person with the disorder may lead a full, active life.

In this post, we discuss what causes type 1 diabetes, how it can be treated and how the symptoms can be identified.

What is type 1 diabetes?

A child receiving type 1 diabetes test
Type 1 diabetes can occur in people of all ages.

Diabetes occurs when glucose, or sugar, is poorly controlled and constantly high in the blood.

Type 1 occurs when the body does not produce enough hormone for the absorption and use of glucose by the cells. The hormone is known as insulin.

While a person may prevent type 2 by avoiding a diet rich in sugar and an inactive lifestyle, it is not possible to prevent type 1. The immune system attacks clusters of pancreatic cells which would normally produce insulin, called islets, stop or slow the production of insulin.

Glucose can not reach the cells without enough insulin, and stays in the bloodstream.

A person with type 1 diabetes will have to take insulin the rest of his or her life. Failure to do so can lead to ever increasing levels of blood sugar and dangerous complications.

Type 1 diabetes can occur at any age although in children and young adults it is more common.

Symptoms

The physical effects of type 1 diabetes include:

  • increased hunger and thirst
  • frequent urination
  • blurred or unclear vision and problems with sight
  • tiredness and fatigue
  • weight loss without an apparent trigger or cause

Refer any clear signs of diabetes to a primary care physician, who will administer tests to confirm that these are a result of diabetes.

The honeymoon phase

The islet cells responsible for insulin secretion can continue to produce the hormone for a while before ceasing after obtaining a diagnosis of type 1 diabetes.

A person will need fewer shots of insulin during this time to maintain healthy blood glucose levels.

This is what doctors call the “honeymoon period” or honeymooning.

This step may lead an person with type 1 diabetes to wrongly think they are getting better. Although giving the impression of improving symptoms, the honeymoon phase still requires close supervision and daily insulin dosing changes.

It is important that you stick to the recommended treatment plan when honeymooning.

Complications

If a person does not manage these symptoms, a range of dangerous complications might develop.

These include:

Diabetic retinopathy: Excess glucose causes the walls of the retina to fail, the part of the eye that senses light and colour. When retinopathy progresses, small blood vessels will form behind the eyes that could burst and bulge, causing problems with vision.

Diabetes among the working-age population is one of the leading causes of blindness.

Diabetic neuropathy: High blood sugar inhibits circulation, affects the nerves in the hands and feet and contributes to loss of sensation or irregular symptoms such as burning, tingling and pain.

Because diabetes can also reduce the body’s healing ability, minor cuts which injuries can lead to more permanent damage, especially as a person may not notice them immediately.

Diabetic nephropathy, or kidney diabetic disease: blood glucose development of the kidneys. Too much glucose can overwork them, and can eventually cause kidney failure, which can progress to dialysis requirement.

Cardiovascular disease: Diabetes can lead to an array of complications that affect heart and artery function, including heart attack, stroke, and peripheral vascular disease.

As a result of poor circulation, diabetes can also increase the risk of amputations.

Gum disease: Type 1 diabetes can increase the risk of gum disease and tooth loss, which means a person with this type should be very careful about maintaining dental health.

Depression: Depression has strong ties to diabetes.

Diabetic ketoacidosis (DKA) is an acute diabetes complication that occurs when a person fails to meet an insulin requirement, and the body is under extreme stress.

Diabetic ketoacidosis results in extremely high blood sugars. The body experiences a metabolic change, and starts to break down fat instead of sugar, producing ketones as a waste product.

Ketones will cause harm to the body, and acidosis. DKA is a medical emergency requiring hospitalization and intravenous insulin treatment etc.

Carefully managing type 1 diabetes can significantly reduce the risk of such complications. A landmark study called the Diabetes Care and Control Trial (DCCT) has shown that effective blood sugar control can minimize microvascular complications risk significantly.

Many of the initial blood tests show diabetes but do not clarify what type of diabetes is present.

Doctors use clinical and laboratory indications to differentiate between the two types of diabetes.

While there may be exceptions, people with type 1 diabetes tend to develop at a much younger age, and are lean. Individuals suffering from type 2 diabetes are usually older and overweight.

The doctor will then scan against pancreatic cells in the blood for the autoantibodies. While antibodies can help the immune system fight diseases and infections, autoantibodies occur when the immune system is unintentionally attacking healthy tissues.

The doctor will also be able to measure C-peptide, an indicator of how much insulin the body produces. We expect it to be lower in type 1 diabetes, since this relates to insulin-producing cell death.

Treatment

Individuals with type 1 diabetes have to take insulin several times a day, including around mealtimes, since the hormone is no longer produced by the body.

Insulin can be administered in a number of ways, such as through multiple daily doses or through a pump. Now available is inhaled insulin, although it is only for use around meal times.

Bottles of insulin
People with type 1 diabetes will need to take insulin for the rest of their lives.

The timing of an insulin shot is crucial, and a doctor can work out a plan with a diabetic person to regulate their glucose levels in the best way.

Different insulin forms function over different periods.

With the advent of continuous blood sugar monitors, integration with an insulin pump is now possible as part of a closed-loop hybrid system which serves as an artificial pancreas.

The patient wears an insulin pump and a continuous blood sugar monitor. The two communicate amongst themselves.

But the individual is still responsible for manually monitoring their blood sugar and taking insulin before mealtime, even with this technology. There isn’t yet a fully automated system without patient input.

Takeaway

Type 1 diabetes is less common than type 2 diabetes. It is an autoimmune disorder in which the immune system attacks and kills healthy tissue that would otherwise produce insulin in the pancreas.

As a result, insulin in the body is inadequate or non-existent and a person with class 1 diabetes will need to take insulin for life. Symptoms include weight loss, heightened hunger and thirst and eye problems.

Those symptoms can turn into nerve damage, heart complications, and blindness without treatment.

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