Type 1 Diabetes
An autoimmune condition that stops the body making insulin
Quick Facts
- Type: Autoimmune / endocrine condition
- Cause: Immune attack on insulin-making cells
- Treatment: Lifelong insulin
- Emergency: Diabetic ketoacidosis (DKA)
Overview
Type 1 diabetes is a chronic condition in which the pancreas makes little or no insulin. Insulin is the hormone that allows sugar (glucose) from food to enter the body's cells for energy. Without enough insulin, glucose builds up in the blood while cells go hungry.
Type 1 diabetes is an autoimmune disease: the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. It is different from type 2 diabetes, which involves the body becoming resistant to insulin. Type 1 most often appears in children and young adults but can develop at any age. People with type 1 diabetes need insulin every day to live, and with modern treatment they can lead full, active lives.
Symptoms
Symptoms often develop over a few weeks and can come on quickly, especially in children. They include:
- Increased thirst and frequent urination
- Extreme hunger
- Unintended weight loss
- Tiredness and weakness
- Blurred vision
- Irritability or mood changes
- Bedwetting in a child who was previously dry at night
Seek emergency care for signs of diabetic ketoacidosis (DKA): nausea and vomiting, abdominal pain, deep or rapid breathing, fruity-smelling breath, confusion, or drowsiness. DKA is a life-threatening emergency.
Causes
Type 1 diabetes is caused by an autoimmune process in which the immune system destroys the insulin-producing cells of the pancreas. The exact trigger is not fully understood, but it is thought to involve a combination of:
- Genetic susceptibility, certain inherited genes raise the risk
- Environmental triggers, such as certain viral infections, that may set off the immune attack in susceptible people
Importantly, type 1 diabetes is not caused by eating sugar, being overweight, or anything a person did. It cannot currently be prevented.
Risk Factors
- A family history of type 1 diabetes
- Certain genes that increase susceptibility
- Younger age (childhood and adolescence), though it can occur at any age
- The presence of certain other autoimmune conditions
Diagnosis
Type 1 diabetes is diagnosed with blood tests that show high blood sugar, including:
- Random or fasting blood glucose tests
- A1C test, which reflects average blood sugar over the past few months
- Autoantibody tests, which can confirm the autoimmune nature and help distinguish type 1 from type 2
- Tests for ketones in blood or urine, especially if DKA is suspected
Because symptoms can appear suddenly and progress to DKA, prompt testing is important when type 1 diabetes is suspected.
Treatment
Treatment centers on replacing insulin and keeping blood sugar in a healthy range. Key elements include:
- Insulin: Given by injection or an insulin pump, in regimens matched to meals and activity. Insulin is essential and lifelong.
- Blood sugar monitoring: Finger-stick checks or continuous glucose monitoring to guide insulin doses.
- Carbohydrate awareness: Matching insulin to the carbohydrate in meals.
- Physical activity: Beneficial, with adjustments to insulin and food to avoid low blood sugar.
- Managing highs and lows: Recognizing and treating low blood sugar (hypoglycemia) and high blood sugar, and preventing DKA.
Regular care helps prevent long-term complications affecting the eyes, kidneys, nerves, heart, and blood vessels.
Prevention
Type 1 diabetes cannot currently be prevented because it results from an autoimmune process. However, complications can be reduced by:
- Keeping blood sugar in the target range
- Attending regular check-ups, including eye, kidney, and foot exams
- Managing blood pressure and cholesterol
- Not smoking
- Learning to recognize and quickly treat low and high blood sugar
When to See a Doctor
See a doctor promptly for symptoms such as excessive thirst, frequent urination, unexplained weight loss, and fatigue. Seek emergency care immediately for signs of diabetic ketoacidosis:
- Nausea, vomiting, or abdominal pain
- Deep, rapid breathing or fruity-smelling breath
- Confusion, drowsiness, or difficulty staying awake
Also seek urgent help for severe low blood sugar with confusion, seizures, or loss of consciousness, which needs immediate treatment.
Frequently Asked Questions
What is the difference between type 1 and type 2 diabetes?
Type 1 diabetes is an autoimmune disease in which the pancreas stops making insulin, so insulin is needed for life. Type 2 diabetes mainly involves the body becoming resistant to insulin and is more linked to weight and lifestyle, though both raise blood sugar.
Can type 1 diabetes be prevented or cured?
There is currently no way to prevent or cure type 1 diabetes. It is managed with lifelong insulin, blood sugar monitoring, and healthy habits. Research into prevention and new treatments is ongoing.
Did eating too much sugar cause type 1 diabetes?
No. Type 1 diabetes is caused by an autoimmune attack on the insulin-producing cells, not by diet or lifestyle. Nothing the person or family did caused it, and it could not have been avoided by eating less sugar.
What is diabetic ketoacidosis?
DKA is a dangerous condition that develops when there is not enough insulin, causing the body to break down fat and produce acidic ketones. Symptoms include nausea, vomiting, deep breathing, fruity breath, and confusion. It is a medical emergency requiring immediate care.
Why do people with type 1 diabetes need insulin injections?
Because their pancreas no longer makes insulin, it must be replaced from outside the body, by injection or pump, to move sugar from the blood into cells. Without insulin, blood sugar rises dangerously and DKA can develop.
References
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Type 1 diabetes.
- American Diabetes Association.
- Centers for Disease Control and Prevention (CDC). Diabetes.
- MedlinePlus, U.S. National Library of Medicine. Type 1 diabetes.