Type 1 diabetes: symptoms, diagnosis, and treatment

Type 1 diabetes is a chronic medical condition characterized by the immune system mistakenly attacking and destroying insulin-producing cells in the pancreas. This results in a deficiency of insulin, a hormone necessary for regulating blood sugar (glucose) levels in the body.

Some key points about type 1 diabetes, include:

• Autoimmune disorder: Type 1 diabetes is an autoimmune disease, which means the body's immune system attacks and destroys its own healthy cells. In this case, it attacks the insulin-producing beta cells in the pancreas.

• Insulin dependency: People with type 1 diabetes are insulin-dependent, which means they must take insulin regularly through injections or an insulin pump to maintain proper blood sugar levels.

• Onset in childhood or young adulthood: Type 1 diabetes often develops in childhood or early adulthood, though it can occur at any age.

• Blood sugar management: Proper management of blood sugar levels is essential in type 1 diabetes to prevent complications. This involves monitoring blood sugar, counting carbohydrates, and adjusting insulin doses as needed.

• Complications: If not well-managed, type 1 diabetes can lead to serious complications such as heart disease, kidney problems, nerve damage, and eye issues.

• Lifelong condition: Type 1 diabetes is a lifelong condition, and there is currently no cure. However, with proper treatment and lifestyle management, individuals with type 1 diabetes can lead healthy and fulfilling lives.

 

Signs and symptoms of type 1 diabetes

The early warning signs of type 1 diabetes can be subtle and may develop over a short period of time. Recognizing these signs is crucial for early diagnosis and effective management. Here are some early warning signs:

• Increased thirst

• Frequent urination

• Unexplained weight loss

• Fatigue

• Blurred vision

• Increased hunger

• Irritability

• Yeast infections

• Bedwetting in children

 

What can cause type 1 diabetes?

• Genetic predisposition: Individuals with a family history of type 1 diabetes are at a higher risk of developing the condition. Specific genes that increase susceptibility to type 1 diabetes have been identified.

• Autoimmune response: Type 1 diabetes is classified as an autoimmune disease. It occurs when the body's immune system mistakenly identifies the insulin-producing beta cells in the pancreas as foreign invaders and attacks and destroys them.

• Environmental triggers: While genetics plays a significant role, environmental factors are believed to trigger the autoimmune response in susceptible individuals. These triggers may include viral infections, such as certain enteroviruses or the mumps, and exposure to certain toxins.

• Early childhood onset: Type 1 diabetes often develops in childhood or young adulthood, suggesting that early life exposures and immune system development may play a role.

• Geographic variations: The incidence of type 1 diabetes varies among different geographic regions, which suggests that environmental factors, such as climate or diet, may contribute to its development.

• Dietary factors: Some research has explored the role of early diet in the development of type 1 diabetes. For instance, there is ongoing investigation into whether the timing of introducing cow's milk or certain dietary components might influence risk.

• Viral infections: Certain viral infections have been associated with an increased risk of developing type 1 diabetes. These infections may trigger an autoimmune response in individuals with genetic susceptibility.

 

Diagnosing type 1 diabetes

• The diagnosis often begins with a healthcare professional taking a detailed medical history and conducting a physical examination. The healthcare provider will ask about common symptoms of type 1 diabetes, such as increased thirst, frequent urination, unexplained weight loss, fatigue, and blurred vision.

• Blood glucose (sugar) levels are a key indicator of diabetes. The following tests may be performed:

  • Fasting Blood Sugar Test: A blood sample is taken after an overnight fast. A fasting blood sugar level of 126 milligrams per deciliter (mg/dL) or higher on two separate tests indicates diabetes.

  • A1C Test: This blood test measures average blood sugar levels over the past two to three months. An A1C level of 6.5% or higher is often used to diagnose diabetes.

• In some cases, an Oral Glucose Tolerance Test (OGTT) may be conducted. It involves fasting overnight and then drinking a sugary solution. Blood sugar levels are measured at intervals over several hours. A blood sugar level of 200 mg/dL or higher two hours after drinking the solution is indicative of diabetes.

• Ketones are substances that the body produces when it breaks down fat for energy. High levels of ketones in the blood or urine can be a sign of diabetic ketoacidosis (DKA), a serious complication of type 1 diabetes. Ketone testing may be done if symptoms like vomiting or rapid breathing are present.

• To confirm the autoimmune nature of type 1 diabetes, blood tests may be conducted to check for the presence of specific autoantibodies, such as glutamic acid decarboxylase (GAD) antibodies or insulin autoantibodies. The presence of these autoantibodies indicates an autoimmune response against the insulin-producing beta cells in the pancreas.

• This test measures the level of C-peptide, a substance produced when insulin is made. Low levels of C-peptide along with the presence of autoantibodies suggest type 1 diabetes, as the pancreas is producing little or no insulin.

 

What you need to know about managing your type 1 diabetes

• Regular check-ups: Schedule regular check-ups with your health care provider, usually an endocrinologist or diabetologist, to monitor your condition and make necessary adjustments to your treatment plan.

• Blood sugar monitoring: Regularly monitor your blood sugar levels using a glucose meter. This helps you make real-time adjustments to your insulin doses and detect trends in your blood sugar control.

• Carbohydrate counting: Learn how to count carbohydrates in your meals and adjust your insulin doses accordingly. This allows you to better manage blood sugar levels.

• Healthy eating: Follow a balanced diet that includes a variety of foods. Focus on whole grains, lean proteins, fruits, vegetables, and healthy fats. Limit sugary and high-carbohydrate foods.

• Physical activity: Regular exercise can help improve insulin sensitivity and blood sugar control. Consult with your healthcare provider to create an exercise plan that is safe and effective for you.

• Regular eye and foot exams: Schedule regular eye and foot exams to detect and prevent potential diabetes-related complications.

• Emergency plan: Have an emergency plan in case of severe hypoglycemia or diabetic ketoacidosis (DKA). Ensure that family members and close friends are aware of the plan.

• Support system: Build a support system that includes healthcare professionals, family, and friends who understand your condition and can offer support and encouragement.

 

Type 1 diabetes treatment

The goal of treatment is to replace the missing insulin, maintain stable blood sugar levels, and prevent complications. Here are the key components of treatment for type 1 diabetes:

• Insulin therapy:

  • Multiple daily injections: Many individuals with type 1 diabetes use multiple daily injections of insulin. Short-acting (fast-acting) and long-acting insulin types are typically used to mimic the body's natural insulin release.

  • Insulin pump: An insulin pump is a device that delivers a continuous supply of insulin throughout the day, with additional doses as needed for meals. It offers more flexibility and precise control over insulin delivery.

• Medication adjustments: Work closely with your endocrinologist to make adjustments to your insulin regimen based on changes in lifestyle, physical activity, and individual needs.

• Blood pressure and cholesterol control: Manage blood pressure and cholesterol levels through lifestyle modifications and, if necessary, medications. Individuals with diabetes are at a higher risk for heart disease.

Diabetes is a lifelong condition, but with the right treatment and self-care, people with diabetes can lead healthy, fulfilling lives. Consult with your St. Joseph Health endocrinologist to create a personalized plan based on your specific condition.