Type 1 diabetes accounts for 5-10% of the diabetic population. It is often, but not always, diagnosed in children and young adults. It usually presents more acutely in younger patients and often requires hospitalization. Type 1 diabetes mellitus is a chronic medical condition that occurs when the pancreas, an organ in the abdomen, produces very little or no insulin. Insulin is a hormone that helps the body to absorb and use glucose and other nutrients from food, store fat, and build up protein. Without insulin, blood glucose (sugar) levels become higher than normal.
Type 1diabetes is a chronic disease that requires regular blood sugar monitoring and treatment with insulin.
THE IMPACT OF TYPE 1 DIABETES
Being diagnosed with type 1 diabetes is usually a frightening and overwhelming experience, and it is common to have questions about why it developed, what it means for long-term health, and how it will affect everyday life. The key is to remember that you can lead a totally normal life with diabetes—you just have to be on top of it. You are not ill or sick, you are simply missing a hormone, one that luckily can be replaced.
With a diagnosis of type 1 diabetes, you can still run a marathon, be CEO of a company, go out dancing all night, etc. It does not have to limit you in any way. You just have to control it, rather than let it control you. What does it mean to control it? It means to educate yourself and accept diabetes, rather than ignore it. If you are able to take it in as part of your life, then it will make dealing with it a much easier feat. Monitoring your sugars, perhaps the best thing you can do to gain control, should become like brushing your teeth—something you have to do as part of normal life, rather than something that you dread. READ MORE ABOUT MONITORING SUGARS.
You should talk with your doctor or nurse about resources that are available for medical as well as psychological support. This might include group classes, meetings with a nurse educator, a certified diabetes educator, a nutritionist, social worker, and other educational resources such as books, websites, or magazines.
CAUSES OF TYPE 1 DIABETES
Type 1 diabetes usually develops when the immune system destroys the cells in the pancreas which produce insulin. This is called an autoimmune response. This means that the body’s own immune system gets confused, and mistakes beta cells for foreign bodies, like bacteria, and it attacks and destroys these cells. When over 90% of beta cells are destroyed, a process which takes months or years to develop, not enough insulin is produced. At this point the sugars start to rise and the symptoms common to diabetes like thirst and frequent urination begin to appear.
Type 1diabetes can develop in people with or without a family history of type 1 diabetes. In either case, people who develop diabetes have one or more genes that make them susceptible to the disease. It is thought that environmental factors, such as exposure to certain viruses, or certain foods early in life, might trigger the immune response. First degree relatives of a person with type 1 diabetes have a 5-6% chance of developing diabetes vs. 0.4 % in someone with no family history.
DIAGNOSIS OF TYPE 1 DIABETES
The diagnosis of diabetes is based on your symptoms and blood tests.
Most people with type 1 diabetes have symptoms of high blood sugar levels (hyperglycemia) which include:
- Excessive thirst
- Feeling tired
- Frequent urination
- Losing weight
- Blurred vision
At times people experience symptoms of a problem called diabetic ketoacidosis (DKA). People with DKA have the symptoms of hyperglycemia, but in addition, often have as nausea and vomiting, belly pain, rapid breathing , feeling sluggish, trouble paying attention, and sometimes coma. DKA is a medical emergency and must be treated promptly in a hospital.
A simple blood test can diagnose diabetes. The test is usually repeated several times for confirmation. Having a higher than normal blood sugar level, as well as the symptoms described above, usually means that you have diabetes.
Determining whether it is type 1 or type 2 diabetes is usually straight forward, but sometimes it is not so clear. In those situations, family history, tests for antibodies (the autoimmune response), and clinical situation will help the doctor differentiate the two.
TYPE 1 DIABETES TREATMENT
Treatment of diabetes requires a team approach, including you and your family and healthcare providers (doctor, nurse, diabetes educator, dietitian), and sometimes other clinicians (exercise physiologist, podiatrist, etc). MORE ON TREATMENT OF TYPE 1 DM.
COMPLICATIONS OF TYPE 1 DIABETES
Keeping your blood sugar near-normal can reduce your risk of long-term complications. The long term complications of type 1 diabetes include neuropathy (nerve damage), nephropathy (kidney damage), retinopathy (eye damage), and others. However, now that we are able to control sugars much better than in previous decades, these complications can be avoided or be kept to a minimum. To avoid complications you will need to check your blood sugar several times per day, give yourself insulin shots or use an insulin pump, monitor what you eat, and see your doctor or nurse on a regular basis. MORE ON DIABETES COMPLICATIONS.
People with type 1 diabetes are also at increased risk of cardiovascular disease, which can cause heart attack, chest pain, stroke, and even death. MORE ON CARDIAC COMPLICATIONS OF DM.
You can significantly lower your chances of heart complications by not smoking, and managing blood pressure and high cholesterol with diet, exercise, and medications, and keeping your sugars controlled (keeping HbA1c under 7%). Some doctors recommend taking a low dose aspirin every day (if you are an adult).
PREGNANCY AND TYPE 1 DIABETES
Women with type 1 diabetes are usually able to become pregnant and have a healthy baby. However, sugars have to be tightly controlled before and during the pregnancy in order to minimize the risk of complications.