What is Type 1 Diabetes
Key Takeaways
In people with type 1 diabetes, the body doesn’t produce enough of the hormone insulin.
Insulin helps sugar pass from the blood into the cells in order to provide them with energy. Without insulin, the blood sugar can rise very high, because cells are not able to take up sugar from the blood.
Type 1 diabetes is treated with insulin therapy. Insulin can be given by injections multiple times per day, or through an insulin pump.
Other medications, such as GLP-1 RAs (like semaglutide and liraglutide), may also be used in some cases.
Lifestyle management is crucial for type 1 diabetes management, including eating a healthy diet that’s low in refined carbohydrates (sugars and starches).
It’s important for people with type 1 diabetes to monitor their blood sugar regularly to keep it from rising too high or dropping too low. This can be done with finger stick testing or with a continuous glucose monitor (CGM).
Careful management of type 1 diabetes helps to avoid complications like kidney disease and vision loss.
Diabetes is a general term which means that the body has trouble controlling blood sugar. There are a few different types of diabetes. Type 1 diabetes means that the body doesn’t produce enough insulin. Although it’s sometimes known as “juvenile diabetes,” type 1 diabetes can develop at any age.
There’s currently no way to definitively cure type 1 diabetes and restore the body’s production of insulin. However, people with type 1 diabetes can live long and healthy lives with the use of insulin therapy. New types of technology, including continuous glucose monitors (CGMs) and insulin pumps, help make it easier and more convenient for people with type 1 diabetes to manage their condition. However, if it’s not managed properly, type 1 diabetes can cause both short-term and long-term health complications.
Causes and Risk Factors for Type 1 Diabetes
Type 1 diabetes is an autoimmune condition, which means that it’s caused by the immune system mistakenly attacking the body’s own tissues. The immune system destroys the cells in the pancreas that make insulin.
It’s not yet known what causes this to happen in some people. Unlike with type 2 diabetes, diet and other aspects of lifestyle do not seem to play a role in determining a person’s risk of developing type 1 diabetes.
Genetics is believed to have an impact, because people who have close relatives with type 1 diabetes are more likely to develop it themselves. However, type 1 diabetes can also develop in people with no family history of this condition. It’s believed that exposure to viruses or environmental factors may play a part in triggering type 1 diabetes, but it’s still not clear what causes some people to develop this condition.
Is Type 1 Diabetes the same as Juvenile Diabetes?
In the past, type 1 diabetes was sometimes referred to as “juvenile diabetes.” This is because it’s the most common type of diabetes in children. The most common age of diagnosis is between 5 and 14 years old. However, people of any age can potentially develop type 1 diabetes. In fact, about 40% of cases of type 1 diabetes are diagnosed in people over the age of 30.
Although many parents are understandably worried when their child is diagnosed with type 1 diabetes, it’s important to know that this condition can be managed. In fact, the life expectancy for people with type 1 diabetes has been improving rapidly over the past years, due to advances in technology that help people with this condition to manage their blood sugar. Although it certainly does require some effort to manage it well, people with type 1 diabetes can live long and healthy lives.
Symptoms of Type 1 Diabetes
Some of the symptoms of type 1 diabetes may include:
Feeling very thirsty and/or hungry
Frequent urination (children may suddenly begin to experience bedwetting at night)
Headaches
Losing weight without trying
Feeling very tired
The onset of these symptoms can be quite rapid, often within a period of a few weeks to months. However, it’s believed that the destruction of cells in the pancreas by the immune system actually begins long before symptoms appear. At first, the remaining cells are able to produce enough insulin to compensate. When there are too few cells left to make enough insulin for the body to function, then symptoms begin to appear.
Complications – Things to Watch Out For
In the past, before the discovery of insulin, people with type 1 diabetes typically lived for only a short time after diagnosis. Fortunately, now that we have insulin therapy, things have changed quite a bit. People with type 1 diabetes can live long lives, as long as they receive the proper treatment.
Still, there are some potential complications that are important to watch out for. These include:
Diabetic ketoacidosis (DKA)
When the body has very little to no insulin, then a condition called diabetic ketoacidosis, or DKA, can develop. Insulin normally allows glucose from the blood to enter into cells and provide them with energy. Without insulin, glucose builds up in the blood, leading to very high blood sugar. In addition, because the cells don’t have access to energy from glucose, the body begins to break down fats for energy. This process creates substances known as ketones. Because ketones are acidic, having too many of them makes the blood too acidic. This interferes with the function of various body systems, and can lead to dangerous fluid shifts within the body.
Early signs of DKA are similar to those of high blood sugar, such as excessive thirst and frequent urination. However, as it progresses, it causes more symptoms, which may include:
Nausea and vomiting
Abdominal pain
Confusion
Rapid breathing
A “fruity” smell to the breath
If left untreated, DKA can be fatal. If you have type 1 diabetes, and you develop signs of DKA, it’s important to get treatment immediately. Insulin (given by injection or an insulin pump) can reverse DKA.
DKA can be caused by missing insulin doses. An insulin pump can make it less likely that you’ll miss an insulin dose, although it’s important to check the pump regularly to make sure that it’s functioning properly. Another potential cause is an increase in the body’s need for insulin. Stresses on the body, such as an illness, infection, or surgery, cause the body to make high levels of a stress hormone called cortisol. Cortisol blocks the actions of insulin, so you need more insulin when the body is under stress. If the levels of insulin are not adjusted, this can lead to DKA.
Hypoglycemia
Although it’s dangerous to get too little insulin, it can also be dangerous to get too much. Taking too much insulin can cause the blood sugar level to drop too low. This is medically known as hypoglycemia, and it causes symptoms like:
Shakiness
Confusion
Sweating
Rapid heartbeat
Dizziness
Extreme hunger
When blood sugar is extremely low, this can cause symptoms like seizures and a loss of consciousness. If not treated, it can be fatal. If you believe that your blood sugar may be low, test it as soon as possible. If it’s low, taking about 10 to 15 grams of sugar (such as by drinking some fruit juice) will help to correct this.
People with type 1 diabetes sometimes experience hypoglycemia when they skip meals, exercise at a time that’s not usual for them, or eat less than they expected to. All of these factors can lower your blood sugar, and if the amount of insulin is not adjusted to account for this, then blood sugar can drop too low.
To avoid hypoglycemia, it’s important to adjust your insulin dose to account for factors like what and when you eat and how much exercise you do. If you change your usual habits, you may need to adjust your insulin to compensate. A continuous glucose monitor (CGM) can alert you when your blood sugar is beginning to drop, so you can take action to avoid hypoglycemia.
Long-term complications
Over time, high blood sugar causes damage to tissues throughout the body. This can lead to a variety of complications, including:
Heart disease
Kidney disease
Vision loss
Nerve damage
Infections
To reduce the risk of these complications, it’s important to keep blood sugar within a healthy range as often as possible. The goal is to prevent glucose levels from rising too high, without causing them to fall too low. In general, the goal for people with diabetes is to keep fasting glucose between 80 and 130 mg/dL (4.4 to 7.2 mmol/L) and blood glucose two hours after a meal lower than 180 mg/dL (10.0 mmol/L). Aiming for lower targets than this could increase the risk of hypoglycemia, but allowing blood glucose to rise higher increases the risk of long-term complications.
Frequent testing of your glucose levels helps to ensure that you’re keeping it in range as often as possible. A continuous glucose monitor (CGM) is often very helpful for this, because it can alert you to trends in your glucose levels so that you can take action before it goes too high or too low.
Testing for Type 1 Diabetes
If you’ve begun experiencing symptoms that could indicate that you have diabetes, then it’s important to get tested. If your child is experiencing these symptoms, seek testing for them as soon as possible.
In general, there are a few different tests that can be used to diagnose diabetes. Testing at GP or specialist clinics in Singapore usually costs about $15 to $25. The tests that may be used include:
Random blood sugar test
This test checks your blood glucose level at any time of day. In most cases, people have not been fasting before this test. Because your blood glucose level is strongly influenced by how recently you ate and what type of food it was, there can be a lot of variation in the results of this test. However, if a random blood glucose level is quite high – 200 mg/dL (11.1 mmol/L) or higher – this could indicate diabetes. This will generally be confirmed with a fasting blood sugar test.
Fasting blood sugar test
A more reliable way to test blood glucose is to do the test when you’ve been fasting for several hours. The blood sample is most commonly taken early in the morning, before you’ve eaten breakfast. A fasting blood glucose of 126 mg/dL (7.0 mmol/L) or higher generally indicates diabetes. To be sure of the diagnosis, the test will generally be repeated on a different day to confirm the result.
HbA1c Test
This test checks a person’s average blood sugar over the past three months, by looking for an altered form of hemoglobin that’s created when blood sugar levels are high. This test may miss some cases of type 1 diabetes, because this condition can come on quickly and lead to a rapid rise in blood sugar levels. Because the HbA1c test is looking at average levels over a three-month period, this short period of high sugar levels may not affect HbA1c levels enough to be detected on the test.
However, the HbA1c test is very useful for tracking whether a person’s treatment plan is working well to help keep their glucose levels from rising too high. People with type 1 diabetes will usually receive this test two to four times per year, so that their treatment plan can be adjusted if needed to help keep their blood sugar under control.
How to tell Type 1 from Type 2 diabetes
Tests of blood glucose or HbA1c can indicate that you have diabetes, but they don’t indicate which specific type.
The symptoms of both types are similar, but the symptoms of type 1 tend to come on more quickly, while they generally develop more gradually for type 2. However, adults who develop type 1 diabetes may take longer to notice symptoms than children do, so this isn’t always a reliable way to tell the difference.
In addition, people with type 2 diabetes often have other conditions that tend to go along with it, such as high cholesterol, high blood pressure, and being overweight. Someone who doesn’t have these conditions may be more likely to have type 1 diabetes, while those who have these conditions are more likely to have type 2 diabetes. This is not a perfect way to tell the difference, but can help to differentiate the two types.
There are also tests that can help to indicate which type you have. Testing insulin levels is often useful – people with type 1 diabetes will have low insulin levels, while those with type 2 diabetes often have high insulin levels. Testing C-peptide, a protein that’s produced when the body makes insulin, can also help to determine whether insulin is being produced. However, insulin levels will go down after a person has had type 2 diabetes for many years, so it’s important to take the timeline into consideration.
In addition, the blood can also be tested for specific antibodies. Because type 1 diabetes is caused by the immune system attacking cells in the pancreas that make insulin, the blood can be tested for specific antibodies, which are proteins made by the immune system when it’s activated. If certain antibodies that target proteins on pancreatic cells are present, this indicates type 1 diabetes. This is a very reliable way to distinguish type 1 from type 2 diabetes.
Finally, assessing a patient’s response to treatment can be useful. If diabetes doesn’t respond well to oral medications that increase insulin sensitivity, then the person may have type 1 diabetes rather than type 2. This is because insulin sensitivity is generally normal in people with type 1 diabetes – it’s the amount of insulin that’s low.
Managing Type 1 Diabetes
There is currently no cure for type 1 diabetes, meaning that we don’t yet have a way to restore the ability of the pancreas to make insulin. However, we can replace it by giving insulin through injections or an insulin pump. This requires careful attention and management, but is highly effective at treating type 1 diabetes. Along with learning how to use insulin to manage your condition, you will also need to pay attention to your dietary and exercise habits.
It’s very important to have support from a medical professional in order to manage diabetes. If tests have shown that you have diabetes, then you should definitely consult with a doctor about your next steps. You can go to your GP, or you can choose a diabetes specialist.
Here at NOVI Health, our physicians specialize in diabetes care. Our holistic NOVI Magnum program also includes support from other health professionals, including nutritionists and health coaches. This helps people with type 1 diabetes to optimize all aspects of their lifestyle to help them stay as healthy as possible.
Medication and monitoring
Treatment for type 1 diabetes generally requires insulin. Because the body is no longer able to make enough insulin, taking insulin helps to replace what is missing. Insulin can be taken via injections or an insulin pump.
The amount of insulin needs to be adjusted based on blood sugar levels. If not enough insulin is used, then the blood sugar will be too high, which can cause DKA and also greatly increases the risk of long-term complications. However, taking too much insulin can cause the blood sugar to drop too low. It’s important to use the right amount of insulin for your current blood glucose level.
For people with type 1 diabetes, monitoring glucose levels is crucial. Some people with type 1 diabetes monitor their blood sugar several times a day using a finger prick test, while others choose a continuous glucose monitor (CGM), which is implanted under the skin and reports glucose levels to your smartphone every few minutes.
Besides insulin, some people with type 1 diabetes may benefit from taking a class of medications known as GLP-1 RAs. This group includes medications like semaglutide, liraglutide, and dulaglutide. Small studies have recently shown that people with type 1 diabetes may be able to reduce their need for insulin by taking these medications. More research is needed to confirm these results, but patients with type 1 diabetes may want to consider trying GLP-1 RAs in order to help control their blood sugar.
Diet and Exercise
Many people with diabetes are looking for the right “diabetes diet.” Managing your food intake is one way to help maintain a healthy blood sugar level. This involves keeping track of how many grams of carbohydrates you’re eating at any given time – this is known as “counting carbs.” You need to match the amount of insulin that you take with the amount of carbohydrates that you’ve eaten.
In general, people with type 1 diabetes should focus on eating a balanced diet, including all three major nutrient groups – protein, fats, and carbohydrates. Try to minimize refined carbohydrates, such as sugars and starches. These will cause a quick spike in blood sugar, because they’re rapidly absorbed by the body.
Include as much fiber as possible. Because fiber slows down your digestive process, it helps to slow your body’s absorption of carbohydrates. Instead of a quick spike in blood sugar, you’ll experience a more gradual rise, with a lower peak. Fiber is found in fruits, vegetables, and whole grains. Protein can also help to slow down the absorption of carbohydrates, so eating protein along with carbs can also be helpful.
Exercise is crucial for everyone’s health. People with diabetes sometimes experience a drop in blood sugar during or after physical activity. When you exercise, you may need to take extra carbs and/or adjust your insulin dose in order to prevent hypoglycemia.
There’s a learning curve to managing type 1 diabetes. It helps to have a team of professionals supporting you as you learn how to navigate testing your glucose levels, using your insulin pump or giving yourself insulin injections, and adjusting your lifestyle to help keep your blood sugar under control.
Our NOVI Health team of doctors, nutritionists, and health coaches can help you learn all of the skills that you need to stay healthy and live a fulfilling life with type 1 diabetes.
Learn more about NOVI Magnum, our holistic diabetes treatment program.
