Type 1 diabetes is an autoimmune disease in which the pancreas doesn't make enough insulin. It commonly affects children and adolescents so that in the past it was called juvenile diabetes.
However, it may have an onset later in life as well. According to the latest National Diabetes Statistics Report, 187,000 children and adolescents under 20 and 1.4 million adults in the US have the condition.
In this post, we'll take a closer look at type 1 diabetes signs and symptoms, see how it differs from type 2 diabetes, review the causes and risk factors, and discover what lifestyle changes you can make to manage the condition.
What Is Type 1 Diabetes?
Type 1 diabetes is a chronic condition that leads to an abnormal increase in blood sugar (glucose) levels. Cells in the body need insulin to absorb glucose, which results from the breakdown of food. Glucose is the main source of energy for cells, and it normally circulates through the bloodstream to the muscles and other organs that need it.
Insulin is secreted by the pancreas, an organ located behind the stomach. In type 1 diabetes, the immune system mistakenly launches an offensive against beta cells in the pancreas. This damages the islets of Langerhans, the area within the pancreas that secretes insulin.
Without enough insulin, muscles and other tissues in the body cannot use glucose effectively, leading to a variety of symptoms and possibly life-threatening complications. In people with type 1 diabetes, the pancreas may not produce enough insulin, or it may not produce any insulin at all.
Type 1 diabetes can give rise to many complications including heart and blood vessel disease, nerve damage, vision problems, kidney disease, cuts and blisters that don't heal, foot damage, skin and mouth conditions, and pregnancy complications.
While there is no cure for type 1 diabetes, insulin injections and diet and lifestyle changes enable those with the condition to manage their blood glucose levels and lead a normal life.
Signs and Symptoms
The most common signs and symptoms of type 1 diabetes include:
- Increased thirst
- Urinating often
- Feeling hungry even if you eat
- Significant weight loss in a short period
- Mood changes and irritability
- Cuts and bruises that don't heal
- Blurry vision
- Mouth thrush that keeps coming back
These symptoms may occur suddenly. Not everyone with type 1 diabetes has them, so it's important to get yourself or your child checked if you suspect you may suffer from this condition.
Having undiagnosed type 1 diabetes can lead in some cases to ketoacidosis, a serious complication that leads to the formation of ketones in the body. Ketones are acidic substances that occur when your blood glucose levels are very high.
Symptoms of diabetic ketoacidosis include:
- Flushed face
- Rapid breathing
- Dry skin and mouth
- Stomach pain
Ketoacidosis calls for immediate medical attention.
Signs of Type 1 Diabetes in Small Children
Diagnosing type 1 diabetes is easy through a blood test. However, when the patient is a small child, it may be difficult to recognize the condition and get him or her tested.
Signs of type 1 diabetes in a small child include:
- Bedwetting in a child who is potty trained
- Becoming more tired and not wanting to play or join in activities he or she otherwise enjoys
- Constantly asking for something to drink
- Losing weight rapidly despite eating normally
- Diaper rash caused by excessive yeast
- Unusual behavior such as irritability, moodiness, or restlessness coupled with other diabetes type 1 symptoms
Type 1 Diabetes Vs Type 2 Diabetes
Type 1 diabetes shares many symptoms with type 2 diabetes, which are the result of the body's inability to process glucose normally. However, while both conditions are chronic, they differ through their cause, onset of symptoms, and treatment.
In type 1 diabetes, the body doesn't produce insulin or produces very little of it. In type 2 diabetes, by contrast, the body develops insulin resistance but continues to make the hormone in most cases.
Type 1 diabetes symptoms develop rapidly and are difficult not to notice. Type 2 diabetes symptoms tend to be more gradual. Some people don't realize they have type 2 diabetes until a routine blood test shows elevated blood sugar levels or they develop complications.
Unlike type 1 diabetes which appears predominantly in children and young adults, type 2 diabetes peaks after the age of 45. That said, it may occur in adolescents and young adults as well.
The risk factors for the two conditions also differ. Family history and weight are shared contributing factors, but type 1 diabetes is thought to be largely a genetic condition with environmental factors. Type 2 diabetes, meanwhile, has more controllable risk factors such as diet, activity level, and lifestyle choices.
Despite the differences between the two conditions, recent research shows that type 2 diabetes may also be an autoimmune disease. As research in this area continues, more similarities between the two may be discovered.
Causes and Risk Factors
The causes behind type 1 diabetes are thought to be genetics and environmental factors, such as exposure to certain viruses.
However, similar to other autoimmune diseases, the exact cause of the condition has not been determined. What is clear is that people with type 1 diabetes have damaged insulin-producing cells in the pancreas that cannot make sufficient insulin to allow glucose to enter cells.
Greater insulin demand caused by a diet rich in foods with a high glycemic index can be a risk factor. However, type 1 diabetes owes more to genetics and environmental factors than type 2 diabetes and may be more difficult to prevent.
The known risk factors for type 1 diabetes are:
- Family history - Having a parent, brother, or sister with type 1 diabetes increases the risk that you may develop the condition.
- Genes - Carrying certain genes further increases the risk. Genes known to trigger type 1 diabetes include variants of the HLA-DRB1 and HLA-DQA1 genes which provide instruction for the production of proteins.
- Age - Type 1 diabetes can occur at any age, but it most commonly occurs between the ages of 4 and 7 and 10 and 14 years.
- Environmental factors - Viral infections with enteroviruses during childhood are also a contributing factor to the development of the condition.
- Vitamin D - Research found that countries away from the Equator, where people are less exposed to the sun, may suffer Vitamin D deficiencies which could contribute to the development of type 1 diabetes.
- Diet - Dietary factors are not as strongly associated with the incidence of type 1 diabetes as with type 1 diabetes. But eating foods that quickly raise the level of blood sugar (high Glycemic index foods) may be associated with the disease when it occurs in conjunction with the increased insulin demand that teenagers experience during their growth phases.
- Breastfeeding - Research indicates that children who are not breastfed are at higher risk.
- Weight - High weight at birth and rapid weight gain during the ages of 12 to 18 months may also be risk factors.
- Race - Similar to other types of diabetes, type 1 occurs more often in African Americans, Hispanics, Asian Americans, and Indian Americans.
Diagnosis and Treatment
Detecting diabetes early is crucial to address the condition before complications develop. The diagnosis criteria and tests used are the same as those for type 2 diabetes:
- A1C Hemoglobin Test - 6.5% or higher on two separate tests.
- Random Blood Sugar Test - Over 200 mg/dL along with symptoms of the condition.
- Fasting Blood Sugar - Over 126 mg/dL on two separate tests.
Many of those with undiagnosed type 1 diabetes present symptoms before their blood test. When diabetic ketoacidosis occurs, the symptoms are so severe that doctors immediately order blood tests.
It's important to note that type 1 diabetes may be initially misdiagnosed as type 2 diabetes. This happens especially in adults, who are less likely to develop the first condition.
Your doctor may not realize you have type 1 diabetes until your diabetes treatment begins and the treatment proves ineffective, or complications arise.
Having type 1 diabetes means you need insulin so that your body can use glucose more effectively and prevent its accumulation in the blood. Additional medication may also be needed.
Insulin must be injected every day. Insulin pens allow for the self-injection of insulin while minimizing pain at the site of the injection. Insulin is commonly injected into the fat layer under the skin using a short needle.
Good to know: It's best to rotate the injection site to ensure optimal absorption. Common injection sites include the abdomen, thigh, arm, and buttocks.
You can also take insulin through an insulin pump, which delivers it continuously at preset amounts. Similar to a miniature computer, this tiny device consists of a reservoir, cannula, and control buttons. You can wear the insulin pump all the time, but you have to alternate the insertion site to avoid infection.
The amount of insulin you must take depends on your blood sugar levels and other factors. Different types of insulin begin working at different intervals and the duration of their effects varies.
While rapid-acting insulin starts working as quickly as 15 minutes after injection, it lasts only up to 4 hours. By comparison, long-acting insulin takes up to two hours to work but its effects may last 24 hours or longer.
Because some people with type 1 diabetes may become resistant to insulin, doctors sometimes also prescribe metformin to reduce the production of sugar in the liver.
Other medication that your doctor may prescribe includes drugs for lowering cholesterol and high blood pressure, and aspirin.
Oral medication for diabetes is currently in development or awaiting FDA approval and may be available before long.
Lifestyle changes are a crucial part of the standard treatment for type 1 diabetes. They focus on healthy eating and exercise.
Dietary changes are often necessary to help maintain blood sugar concentrations within their normal range. Here are some essential type 1 diabetes diet tips:
- Eat fewer refined carbs such as white bread.
- Avoid processed foods, sugary drinks, and other foods with a high glycemic index.
- Eat fewer animal and high-fat products.
- Eat more whole grains, fruits, and vegetables.
- Add more low-fat, high-fiber foods to your diet.
- Don't skip meals.
- Eat balanced meals at regular hours.
- Watch portion sizes.
- Count your carbs.
Following a type 1 diabetes eating plan can be more challenging for children and adolescents. A personalized plan can prove useful, allowing for the addition of favorite foods while balancing carbs, protein, and fat.
For adults with type 1 diabetes, at least 150 minutes of aerobic exercise every week can help manage blood sugar levels while improving overall health. This can include brisk walking, jogging, cycling, swimming, and other activities.
Children should get at least 60 minutes of activity every day. Going from sedentary to active with type 1 diabetes may require you to adjust insulin doses or meal plans.
Other Lifestyle Changes
Other lifestyle changes can make managing type 1 diabetes easier and possibly prevent some complications. These include quitting smoking, drinking alcohol in moderation, and managing stress more effectively through meditation and other techniques. Some people with type 1 diabetes can also benefit from losing weight.
There is no established way to prevent type 1 diabetes. But the lifestyle changes used to manage type 1 diabetes can help boost your overall health and make the condition easier to manage.
As research on type 1 diabetes causes continues, some of these lifestyle factors may prove to help ward off the disease. Also crucial is screening for type 1 diabetes if you experience symptoms or have a family history of the disease.
10 Things to Remember
In the end, here are the takeaways:
- Type 1 diabetes is an autoimmune disease caused by damage to insulin-secreting cells. It's as yet incurable but manageable.
- Type 1 diabetes usually appears in childhood or adolescence but may appear at any age.
- The causes of type 1 diabetes are genetic or environmental, unlike those of type 2 diabetes, which tend to be more controllable.
- It shares many symptoms with type 2 diabetes, but these have a quicker onset and can be more severe.
- People with type 1 diabetes need to take insulin every day, which can be self-administered through an insulin pen or delivered through a small pump.
- Insulin can be fast-acting, slow-acting, or intermediate in its effects-the best insulin type for you depends on your blood results and doctor's recommendation.
- Eating healthy, exercising regularly, and making other dietary changes are part of the treatment for type 1 diabetes.
- Type 1 diabetes is diagnosed through blood tests: an A1C hemoglobin test result of >6.5% or a random blood sugar test >200 mg/dL along with symptoms indicates the condition.
- No scientifically proven method for preventing type 1 diabetes exists but healthy eating, regular exercises, and other lifestyle changes coupled with regular screening can help you keep it under control.
- There is no type 1 diabetes diet, but a personalized type 1 diabetes meal plan coupled with an activity plan enables you to better manage the condition while improving your quality of life.
While type 1 diabetes is a serious condition that currently cannot be reversed, there are many things you can do to live a healthy and fruitful life despite having it.