What You Need To Know About Type 1 Diabetes

• Type 1 diabetes is less common than its counterpart, type 2 diabetes. Around 5–10% of people who have diabetes are diagnosed with type 1.

• Nearly 1.5 million Americans¹ live with type 1 diabetes, and approximately 64,000 people are diagnosed annually.

• Fewer than one in three Americans consistently achieve their target blood sugar levels.

• 16 to 20 in every 100 people will develop severely low blood sugar yearly. Between two and eight people will lose consciousness or have a seizure.

Signs and symptoms of type 1 diabetes can vary based on how effectively the condition is managed. Early signs of the condition may appear mild and progress in severity as the disease evolves. They can also come on suddenly and, if undiagnosed or left untreated, can lead to severe complications.

Common signs of type 1 diabetes include:

• Blurred vision

• Unexplained weight loss

• Increased hunger or thirst

• Fatigue

• Frequent urination

• Sores that don’t heal  

Symptoms are similar in children and adults; however, adults may have more difficulty getting an accurate diagnosis.

How is type 1 diabetes diagnosed?

There are several methods for diagnosing type 1 diabetes. The most common methods include: 

• Blood tests: Diagnosing type 1 diabetes requires a simple blood test. There are different blood tests for diabetes, but they all assess blood sugar levels. Some types require fasting, while others don’t. One blood test, the A1C test, shows your average blood sugar levels over the past two to three months and can help a doctor determine if you have prediabetes or diabetes. If your blood sugar is high and your doctor believes you have type 1 diabetes, they may use a different blood test to check for antibodies that distinguish between type 1 and type 2.

• Urine tests: A urine test is another tool that helps doctors distinguish between type 1 and type 2 diabetes. The presence of ketones in your urine means that your body is burning fat to create energy, which is more common in type 1 diabetes.

It’s not entirely clear what causes type 1 diabetes. However, we know it stems from a problem with the immune system, which causes the body to attack the pancreatic cells responsible for insulin production.

There’s no specific gene that causes type 1 diabetes, but there is a genetic link that makes some people more at-risk. Relatives of people with type 1 diabetes are more likely to develop the condition than others. However, having a relative with this condition doesn’t mean you’ll develop type 1 diabetes.

The risk of developing type 1 diabetes is 0.4% in the general population. The risk is substantially higher if your mother (1.3–4%), father (6–9%), or sibling (6–7%) has it. That said, those numbers indicate that more than nine times out of ten, a person with a family history of type 1 diabetes will not go on to develop the condition.

So, why do some people with genetic predisposition develop diabetes while others don’t?

Environmental factors, such as enteroviral infection, could heighten a person’s risk of developing the condition. Further, there’s evidence that some environmental toxins could trigger an autoimmune response or cause direct damage to pancreatic cells.

There’s no known way to prevent type 1 diabetes. If your risk is higher because of genetic predisposition, be aware of the signs and symptoms of the condition and see your doctor as soon as you notice just one symptom. The best way to get ahead of the condition is to know what early signs and symptoms to look out for.

If you have a family history of type 1 diabetes, it also helps to check for symptoms of the disorder regularly.

Unfortunately, there is no known cure for type 1 diabetes. However, the condition can be effectively managed with proper treatment and a healthy lifestyle. Treatment for type 1 diabetes focuses on insulin replacement. This is typically achieved through injections (several times daily) or an insulin pump (continuously). Your doctor will work with you to determine how much insulin you need and how often.

Insulin 

There are several types of insulin, and your doctor might prescribe more than one type. Some types can’t be mixed, so never combine different types of insulin without checking with your doctor first. Insulin can be administered in different ways.

Your age, lifestyle, and other factors will help determine which types of insulin and delivery methods are best for you. A diabetes educator will train you on the method (or methods) you choose. Insulin delivery methods include: 

• Syringes: Syringe injections are typically less costly than pens and pumps. You can inject insulin into your arm, thigh, abdomen, or buttocks, but it is delivered fastest when injected into the abdomen.

• Pens: Like syringes, a pen delivers insulin into the body by injection. They’re more portable and discreet than syringes, but they cost more. Some types of insulin aren’t compatible with pens, so check with your doctor or pharmacist before investing in one.

• Pumps: Insulin pumps deliver insulin through a thin tube that typically goes to the stomach area or back of the upper arm. They deliver insulin more accurately, but they’re more expensive than injections, and there’s a learning curve.

• Inhalers: Insulin inhalers are fast-acting and are used alongside long-acting injections. The device is small and easy to use, but dosing is somewhat imprecise.

Healthy lifestyle habits

Type 1 diabetes is a unique condition requiring a lot of at-home management. An essential part of that is proactively monitoring blood sugar levels.

How to monitor your blood sugar

If you’ve recently been diagnosed with type 1 diabetes, your doctors have likely already stressed the importance of consistently monitoring your blood sugar. You’ll need to track your blood sugar at home to ensure your levels don’t fall below or above the normal range.

Unhealthy blood sugar levels can make you feel lousy and increase your risk of developing severe complications. You can monitor your blood sugar using a blood sugar meter (glucometer) or a continuous glucose monitor (CGM). 

A glucometer is the most straightforward tool for monitoring your blood sugar at home. The meters come with test strips that require a pinprick of blood for analysis at specific times. In contrast, a CGM uses a small sensor under the skin to check sugar levels every few minutes.

If you use a CGM, you’ll need to confirm its accuracy daily using a glucometer.

Beyond testing, there are many things you can do at home to keep your blood sugar in check:

• Minimize stress: High-stress levels can make living with a chronic condition much more difficult. Stress hormones can also have unpredictable effects on your blood sugar levels. Getting enough sleep and meditation can help you manage your stress.

• Exercise: Getting enough regular physical activity can help you manage your diabetes more effectively. Exercising can help you better control your blood sugar levels.

• Eat well: Maintaining healthy nutrition is important for everyone, but it's crucial for people with type 1 diabetes. Foods that are high in fiber and low in added sugar are better options for people with diabetes. Keep track of carbs, which can boost your blood sugar. You may find it helpful to work with a dietician.

• See your healthcare providers regularly: Even if you think you have diabetes under control, it’s a good idea to check in with your doctor regularly. They’ll be in the best position to determine if your treatment is working well for you or if your insulin dose should be adjusted. Don’t neglect seemingly unrelated health concerns. Some diabetes complications affect vision, hearing, mental health, and oral health.

• Take extra care of your feet: People with type 1 diabetes are more likely to develop serious foot problems than those without the condition. Check your feet daily, even if they look and feel fine. You might not notice minor cuts and scrapes until they’ve become infected or are so severe that they won’t heal.

Supporting a child with type 1 diabetes

If you’re a parent of a child with type 1 diabetes, you’re likely very much involved with their diabetes management. This includes ensuring that they stay on top of their treatment plan. An exceptionally challenging part of diabetes care is administering insulin.

Speak to a diabetes educator who can help you learn efficient injection techniques, develop a healthy diet plan for your child, and teach you about the signs of unhealthy sugar levels or complications. Taking care of a child with diabetes can seem overwhelming, but it doesn’t need to be. Ask your child’s doctor or diabetes educator about support groups and resources available in your area.

Surgery

Type 1 diabetes can typically be managed with insulin replacement and lifestyle changes. However, surgery may be necessary in exceptional cases. Specifically, some people with diabetes need pancreas transplant surgery — where a malfunctioning pancreas is replaced with a healthy one from a donor.

People who undergo surgery must take medication to prevent their bodies from rejecting the new pancreas. Because of the risks (including the risk of rejection), pancreas transplant surgery is rarely recommended for type 1 diabetes.

While not routinely offered, an experimental procedure called “pancreatic islet transplantation¹” shows promise. The surgery, which is typically well-suited for people who struggle to manage their blood sugar levels, involves removing islet cells from a healthy donor pancreas and infusing them (through a catheter) into the receiver’s liver, where they’ll begin making insulin and releasing it into the bloodstream.

For patients with type 1 diabetes who need a kidney transplant, islet transplantation may be offered in conjunction. Ongoing research indicates that this procedure may become a standard treatment option.

Complications of type 1 diabetes

Type 1 diabetes can lead to serious medical complications, such as:

Diabetic ketoacidosis (DKA)

Diabetic ketoacidosis (DKA)² is a potentially life-threatening complication of type 1 diabetes. In DKA, the body burns fat excessively (instead of glucose)  to produce energy. Symptoms include flushed cheeks, stomach pain, rapid breathing, and excessive thirst. Contact your doctor immediately if you have type 1 diabetes and exhibit signs of DKA. If your doctor is unavailable, call 911. DKA is a medical emergency.

Hypoglycemia (low blood sugar)

Hypoglycemia³, or low blood sugar, has many triggers. Ironically, hypoglycemia may be caused by insulin taken to manage diabetes. Alcohol, puberty, hot weather, and poor eating habits can also cause low blood sugar.

Symptoms include dizziness, shaking, sweating, fatigue, and anxiety. If you experience symptoms of low blood sugar, the CDC recommends that you follow the 15–15 rule:

• Eat or drink anything that contains 15g of carbohydrates

• Check your blood sugar after 15 minutes to see if it has been raised

• Repeat if your blood sugar is still below 70mg/dL

Note that the 15–15 rule is no substitute for medical care. If your blood sugar levels are extremely low (below 55mg/dL), seek medical attention. 

Other complications that could arise from type 1 diabetes include:

• Eye disease

• Kidney disease 

• Heart disease 

• Stroke

• Nerve damage, especially in the feet 

• Tooth decay and gum disease 

• Hearing loss

The American Diabetes Association¹ provides a wealth of resources and links to services for people living with diabetes in the US. Beyond that, your healthcare provider or diabetes educator may be able to connect you with a support group in your area. 

When to see a doctor

You should see a doctor if you experience symptoms of type 1 diabetes, especially if you have a family history of the condition. Once you’re diagnosed, a team of healthcare providers, including your primary doctor, a diabetes nurse, a nutritionist, pharmacists, diabetes educators, and specialist doctors, will be involved in your care. 

An endocrinologist² is a doctor who specializes in treating conditions that are linked to hormones, including diabetes. Some endocrinologists further specialize in diabetes care and become diabetologists. 

Diabetes management is a team effort, and regular visits to your healthcare providers’ offices will be part of your routine forever. Type 1 diabetes is a condition that can change quickly or gradually, and you’ll need consistent reassessment. 

If you’re experiencing symptoms of a complication, such as nausea, vomiting, and rapid breathing, don’t wait until your scheduled checkup to seek medical care. Complications like diabetic ketoacidosis are serious and time-sensitive.