What is Type 1 Diabetes?

Diabetes mellitus is a chronic health condition in which your body is unable to produce or use the insulin hormone effectively.

Insulin is a hormone produced by the β (beta) cells in your pancreas. It helps regulate the amount of glucose (sugar) present in your blood. Your body digests the food you eat and breaks it down into glucose (sugar). This glucose gets absorbed into your bloodstream and is transported to your cells, which convert the glucose into energy. Insulin acts like a key to let glucose enter your cells.

In diabetes mellitus, the body is unable to produce or use insulin effectively, leading to the glucose being unable to enter your cells and resulting in high blood glucose levels.

Type 1 Diabetes mellitus, known simply as Type 1 Diabetes, is an autoimmune disorder, where your immune system mistakenly attacks and destroys the insulin-producing β-cells in your pancreas. This results in little to no insulin production in your body.

Type 1 Diabetes is less common when compared to Type 2 Diabetes. The International Diabetes Federation (IDF) reports that around 5 to 10% of all cases of diabetes mellitus worldwide are of Type 1 Diabetes.

Type 1 Diabetes is also known as insulin-dependent diabetes, as insulin administration is the only way to manage it.

Type 1 Diabetes was previously also referred to as juvenile diabetes, as it mainly affects children, adolescents and young adults. However, it can also be diagnosed in older adults.

Type 1 Diabetes: Causes

Type 1 Diabetes is an autoimmune disorder with the exact cause still not known. However, people with Type 1 Diabetes may have been born with a genetic susceptibility toward autoimmune conditions. The condition may then be triggered due to certain immunological or environmental factors like exposure to chemicals, viruses, etc. which may destroy your β-cells. In rare cases, Type 1 Diabetes can also be caused by an injury to your pancreas.

Unlike Type 2 Diabetes, poor diet and other lifestyle habits do not play a role in the development of Type 1 Diabetes.

Type 1 Diabetes: Risk Factors

Just like its exact cause, the risk factors for Type 1 Diabetes are not very clear. However, some factors that can raise your risk for Type 1 Diabetes include:

• Family History: People with a family history of Type 1 Diabetes (having a parent or sibling with the condition) are more likely to develop it.
• Genetics: Having certain genes can also play a role in developing Type 1 Diabetes.
• Age: Your age may also be a risk factor as Type 1 Diabetes usually develops in children, teens, or young adults.

Type 1 Diabetes: Symptoms

• Increased thirst (polydipsia)
• Frequent urination (polyuria)
• Increased hunger and frequent eating (polyphagia)
• Unintended weight loss
• Irritability and other mood changes
• Fatigue and extreme tiredness
• Blurred vision
• Slow-healing wounds and sores
• Frequent and recurring infections

In Type 1 Diabetes, the symptoms may move from mild to severe and develop over a period of weeks or even months. 

Type 1 Diabetes: Diagnosis

Type 1 Diabetes is diagnosed on the basis of blood tests to check your blood glucose levels, the same way that Type 2 Diabetes is.

Diabetes is diagnosed if:

• Fasting blood glucose is greater than 126 mg/dL on two separate tests.
• Random blood glucose is greater than 200 mg/dL, along with symptoms of diabetes.
• Glycated Haemoglobin A1c is greater than 6.5 on two separate tests.

The diagnosis of Type 1 Diabetes is confirmed by performing the following tests:

• Islet Autoantibodies Test: Islet autoantibodies are positive in Type 1 Diabetes and negative in Type 2 Diabetes.
• C-Peptide Test: C-peptide is a substance made in the pancreas along with insulin. In Type 1 Diabetes, your pancreas makes little to no insulin or C-peptide.
• Ketone Test: The presence of ketones in your urine also suggests that you have Type 1 Diabetes.

Type 1 Diabetes: Prevention

Unfortunately, there is no way to prevent Type 1 Diabetes at present, as the cause of the condition is still unknown. However, research is ongoing on the ways to identify individuals who are at a risk for developing Type 1 Diabetes and preventing it before the beta cells in the pancreas are destroyed. 

Meanwhile, Type 1 Diabetes can be managed with insulin injections and the appropriate lifestyle changes.

Type 1 Diabetes: Treatment and Management

Can Type 1 Diabetes be cured? Unfortunately, not yet. Type 1 Diabetes is a condition that requires lifelong care and treatment. Insulin therapy, a balanced diet, regular exercise, and healthy lifestyle habits can help you manage the condition effectively.

1. Insulin

At the moment, insulin is the only medication available to treat Type 1 Diabetes. It is available in the form of an injection and has to be taken every day for effective blood glucose control. There are many types of insulin available in the market. Your doctor will prescribe the best type and the course of insulin treatment, based on the severity of your condition and your physiological needs. 

2. Balanced Diet

Including foods from all the major categories like vegetables, fruits, whole grains, legumes, dairy, lean meat, etc. in your diet in the right amounts can help you receive all the essential nutrients that your body needs and better control your blood sugar levels

It is also important to note the glycaemic index of the food that you are consuming. It refers to a score, ranging from 1 to 100, which is assigned to a food based on the effect it has on your blood glucose levels.

3. Exercise

When you exercise, you are enabling your body’s muscles to use up the glucose present in your bloodstream. This helps lower your blood sugar levels and can also reduce your daily dose of insulin. Exercising regularly can help you avoid several health complications like obesity, heart disease, stroke, etc.

Exercising when you have Type 1 Diabetes can directly affect your blood sugar levels. Hence, it is very important to carefully plan the time and duration of your workouts in order to avoid a spike or dip in your blood glucose levels.

4. Regular Blood Sugar Monitoring

The goal of Type 1 Diabetes management is to bring your blood glucose levels back down to a relatively normal range, where it does not cause any complications. Hence, monitoring your blood glucose levels becomes necessary so that your doctor can devise a treatment plan as per your body’s needs.

Monitoring your blood glucose levels can today be done from the comfort of your home using multiple ways. These ways include using a glucometer, flash glucose monitoring (FGM) system, and continuous glucose monitoring (CGM) system.

Type 1 Diabetes: Complications

The complications of Type 1 Diabetes are caused by untreated high blood glucose levels. Over time, high blood glucose levels can lead to the following health complications based on the short-term and long-term effects they have on your body.

1. Short-Term Complications

• Hypoglycaemia: It is a condition that occurs when your blood glucose levels drop below the normal range due to skipped meals, eating too little, taking too much insulin, overexertion and sickness.

The symptoms of hypoglycaemia can be managed immediately by drinking juice, chewing on hard candy or taking glucose tablets. 

• Diabetic Ketoacidosis: It is a life-threatening complication of Type 1 Diabetes. When the body cannot produce enough insulin and is unable to use the glucose in your blood to generate energy, it starts breaking down fat to use it as fuel. Your liver processes these fats and turns them into ketones.

The presence of too many ketones in your blood can turn it acidic and cause symptoms like fruity-scented breath, vomiting, dry skin or mouth, flushing, headache, muscle stiffness, fatigue, etc.

2. Long-Term Complications

• Cardiovascular Disease: Persistently high blood glucose levels can damage the arteries that supply blood to your heart and other major organs. When cholesterol from your diet accumulates in the damaged artery walls, it can lead to the clogging, narrowing and stiffening of your blood vessels, which can reduce or cut off the blood and oxygen supply to your heart. This can damage your heart tissue and cause various cardiac problems.
• Ischemic Stroke: When the arteries that supply blood to your brain are damaged, it can cause a temporary reduction or loss of blood and oxygen supply to your brain tissue. This is called an ischemic stroke and can cause varying degrees of brain damage.
• Diabetic Nephropathy: When the small and delicate blood vessels in and around your kidneys are damaged, it can hamper your kidney function or cause kidney infections, leading to kidney failure.
• Diabetic Neuropathy: High blood glucose levels can damage your nerves, especially of the limbs and hands. Nerve damage can cause tingling, numbness, or pain in your limbs, with the symptoms gradually progressing to partial or complete loss of sensation.
• Diabetic Retinopathy: High blood glucose levels can cause damage to the tiny blood vessels in your eyes, resulting in leaking of fluid, weakening and breaking of old blood vessels, and development of new, fragile blood vessels. You may experience blurred vision, dark spots, or even develop partial or complete loss of eyesight.

What are the Major Differences Between Type 1 and Type 2 Diabetes?

The following table summarises the key differences between Type 1 and Type 2 Diabetes.