Type 1 Diabetes
Guide For Insulin Dependent Diabetics

Type 1 Diabetes

Contents

• What Is Type 1 Diabetes?
• What Causes Type 1 Diabetes?
• What Are The Symptoms?
• How Is It Diagnosed?
• How Is It Treated?
• Preventing Complications
• Can Type 1 Diabetes Be Prevented?

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What Is Type 1 Diabetes?

Terminology: It was originally called juvenile diabetes or insulin-dependent diabetes.

It is a type of diabetes which usually starts in childhood or early adulthood. It is characterized by high levels of sugar (glucose) in the blood caused by failure of the pancreas to produce insulin (a hormone that removes glucose from the blood). Type 1 diabetes is a serious condition and if left untreated will quickly lead to severe complications, coma and even death. Type 1 diabetics account for about 10 percent of all people who receive a diabetes diagnosis. While there is no cure for the disease, patients can manage their symptoms with daily injections of insulin (on average 4 or 5 injections a day). Insulin can only be taken in injection form, although the delivery of injections has become much more convenient with the introduction of insulin pens. Type 2 diabetes on the other hand tends to develop later in life (which is why it was traditionally called adult onset diabetes) and is linked to obesity and other lifestyle risk factors. It tends to produce milder symptoms than type 1 diabetes (usually because the body still produces some insulin), and can usually be managed with diet and exercise and/or oral medications. If it worsens, the patient may need to take a few shots of insulin (typically 1 or 2 daily).

What Causes Type 1 Diabetes?

The immediate cause of type 1 diabetes is the failure of the pancreas (a small organ located behind the stomach) to produce insulin. Wherever insulin travels in the body it opens up cells so that they accept glucose from the blood which is immediately used for energy or stored as fat for later use. Without insulin, glucose remains sloshing around in the blood where it eventually triggers symptoms of diabetes.

The Body Attacks Itself
The exact causes of diabetes is not known - in other words, why the pancreas fails to produce insulin. It is thought to be an autoimmune response whereby the body's defense system attacks the pancreas (mistaking it for a hostile entity) destroying its ability to make insulin. The disease often occurs in young people who have other autoimmune diseases such as asthma, lupus and thyroid disease.

Exposure To A Virus
So what exactly triggers the autoimmune response? Doctors think the trigger might have an environmental cause, something like exposure to a virus. Scientists have identified a few possible culprits - possibly the same viruses that cause the common cold. While some doctors don't think you can catch this virus like a cold (by someone sneezing on you), others believe you can - but only if you already have a genetic predisposition. Studies show that many people with type 1 diabetes have certain genetic chromosomes that are not present in people without the disease. So what does the virus do? It may be that the virus directly attacks your pancreas, reducing its ability to make insulin. Or it may be the virus contains the same substance that is naturally present in the pancreas. When the body's defense system kicks in and starts killing the virus, it kills cells in the pancreas too because it can't tell the difference.

Cow's Milk
Some doctors believe that certain chemicals in cow’s milk might trigger diabetes in people already genetically predisposed. Researchers found that babies who were breastfed were less likely to develop the disease than those who were fed cow’s milk.

What Are The Symptoms?

Type 1 diabetes tends to develop very quickly (type 2 on the other hand can takes years), so that by the time a patient is diagnosed, they are often very ill. Common signs include:

Need to urinate frequently
Increased thirst
Feeling extra hungry
Losing weight, despite eating more
Feeling very tired and fatigued
Blurred eyesight
It may cause irregular periods or delay a first period in young girls (menarche).

Other warning signs indicate blood sugar levels have rocketed:

Rapid breathing
Flushed face
Dry skin and mouth
Breath that smells fruity
Nausea or vomiting
Stomach cramps

Statistically the disease is more likely to start in winter when temperatures are lower. This is probably because viruses are more common in winter and children tend to play indoors. This closer proximity makes it easier for viruses to spread.

How Is It Diagnosed?

Your doctor will order several blood glucose tests. These tests are described in detail in our article, diabetes diagnosis. The tests will measure the levels of glucose in your blood. If the results are consistently high, across all the tests, a diagnosis will be made. See also, are there any home tests for diabetes?

How Is It Treated?

As most patients are quite sick by the time they are diagnosed, an initial hospital stay may be necessary. There is no cure for any type of diabetes; instead the goal of diabetes treatment is to reduce the symptoms of the disease by stabilizing blood sugar levels. Initially you will be seen by your doctor once a week, until you have your blood sugar levels under control. Your healthcare team should consist of your primary care doctor, an endocrinologist (diabetes consultant), a dietician and a diabetes educator. Together this team will:

1. Prescribe insulin in the correct dosages.
2. Show how and where in the body to take insulin shots (image).
3. Teach you how to check your blood glucose levels at home.
4. Choose a suitable eating plan and tell you how much and when to eat.
5. Provide advice on exercise, how long and how often to exercise.
6. Tell you how to recognize the signs of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia).
7. Explain about the other types of diabetes tests you will need on a regular basis to prevent complications.

Insulin
Everyone with type 1 diabetes must take multiple daily insulin injections. Insulin does not come in pill form, it needs to be injected directly into the bloodstream. While some use a traditional syringe and vial, others use insulin pens (more popular with kids, image), insulin pumps (image) or insulin jet injectors (image). Most patients need to take anywhere between 1 and 5 shots a day, and occasionally in the middle of the night. They will be taught how to perform blood glucose monitoring before and after every meal using a handheld blood glucose monitor. If you need to buy a monitor, check our article: Guide to buying glucose monitors.

Diet And Exercise
People with this disease are advised to eat the same sorts of foods at the same time, everyday. This helps to prevent sugar spikes. The American Dietetic Association has a diabetes diet plan which is worth checking out. Regular exercise is also recommended, but your diabetes educator will discuss a personal plan with you.

Preventing Complications

Your doctor will talk to you about potential diabetes complications. By managing to keep your glucose levels as normal as possible, you should be able to delay the onset of (or even prevent) complications such as kidney disease, eyes problems and foot disorders (for specific details take a quick look at our article on diabetes facts). It is also worth reading our articles on:
Heart attack prevention.
Stroke prevention.
Coronary heart disease prevention.

Can Type 1 Diabetes Be Prevented?

Currently, there are no proven methods to prevent the onset of type 1 diabetes (see also diabetes prevention). However, scientists are working hard to find a way. In the not too distant future children with a family history of type 1 diabetes may be offered genetic testing for the chromosome most associated with the disease. At this stage, there is no point in identifying who is at risk because we still don't have a way to stop them developing the disease. Scientists still need to pinpoint the exact virus which triggers diabetes. But once they do, they will produce a vaccination to hopefully prevent the onset of the disease in children who genetically test positive. Doctors in Finland (where the disease is most common) have tried various vaccines, but none have worked so far. In the meantime, other trials are looking at ways to stop the body's immune system from destroying the entire pancreas in people already diagnosed with the disease. This includes the use of steroid drugs, cytotoxic drugs and nicotinamide (a type of B vitamin). Finally, until proven otherwise, if you are having children, do consider breastfeeding rather than giving them cow’s milk. If you're looking for more information check out our list of websites under diabetes resources.

Related Articles on Type 1 Diabetics

For more questions on diabetes, see the following:

• Gestational Diabetes
• What to do in case of diabetic coma
• Are there blood glucose monitors that don't require strips?
• What is a normal blood sugar count?

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