Can Type 1 Diabetes Be Prevented?

Type 1 diabetes¹ is one of the most prevalent chronic autoimmune diseases affecting children, but people of all ages can develop the condition.

Scientists haven’t found a way to prevent or cure type 1 diabetes, but the condition is manageable, and most people with type 1 diabetes are able to lead happy, fulfilled lives.

What is type 1 diabetes?

Type 1 diabetes is an autoimmune disease in which the body attacks the beta cells in the pancreas. 

Pancreatic beta cells produce insulin which is needed to move sugar from the blood into cells, where it’s used for energy. In people with type 1 diabetes, the pancreas cannot produce enough insulin to effectively transport the sugar from the blood into the cells, leading to a buildup of sugar in the blood. 

Unlike type 2 diabetes, which can result from being overweight or inactive, type 1 diabetes is genetic and isn’t caused by these lifestyle factors. 

Type 1 diabetes is less common than type 2 diabetes, and only 5 to 10% of people with diabetes have type 1 diabetes. 

Symptoms of type 1 diabetes

Some signs of type 1 diabetes can appear in anyone, regardless of age and sex, while others relate to the functioning and health of the sex organs and only affect reproductively mature people. 

General symptoms 

The general symptoms of type 1 diabetes can be experienced by both children and adults, male or female. These symptoms include:

• Dry skin

• Blurred vision

• Increased thirst

• Increased urination

• Unexplained weight loss

• Fatigue

• Increased hunger

• Numbness or tingling in the hands and feet

• Sores that don’t heal

Additional symptoms only present in men

Men with diabetes are more likely to develop erectile dysfunction (ED) than men who don’t. Men with diabetes are also more likely to experience ED at a younger age than those without.

Different studies² have yielded different results, but it’s estimated that between 20% and 85% of men with diabetes experience ED, with many studies landing at 60% to 80%. The estimated prevalence in the general population is between 16% and 25%.

Erectile dysfunction may be caused by nerve damage or circulation problems resulting from diabetes. Proper management of diabetes may help prevent and treat ED. 

Diabetes may trigger retrograde ejaculation in men. Semen should move through the urethra and out of the penis during ejaculation. However, in men that experience retrograde ejaculation, some or all of the semen moves backward into the bladder.

By itself, retrograde ejaculation is typically not dangerous, but retrograde ejaculation may cause infertility. 

Type 1 diabetes may also cause low levels of testosterone in men. Testosterone levels naturally drop with age; however, men with diabetes may experience a further reduction in testosterone. Low testosterone can cause symptoms such as a low sex drive, depression, and weakened bones and muscles.

Additional symptoms only present in women

Type 1 diabetes increases the risk of bladder and yeast infections in women. The yeast that typically exists at healthy levels within the body grows more freely when blood sugar levels are high.

An overgrowth of yeast causes the common symptoms of yeast infections, including burning and swelling around the vagina and pain during urination or sex. 

Diabetes may also cause sexual and reproductive issues in women. For example, increased blood sugar can harm a baby during the first few weeks of pregnancy. Often, women do not even know they are pregnant during this period.

Beyond that, women with diabetes may face challenges with a low sex drive and reduced sexual response.

• Polycystic ovarian syndrome (PCOS) has also been linked to diabetes and can also make conceiving difficult. 

Causes of type 1 diabetes

Type 1 diabetes is an autoimmune condition in which the body attacks and destroys the beta cells in the pancreas. 

Pancreatic beta cells are responsible for insulin production. Insulin helps transport sugars from the blood into the cells to be stored and used for energy. 

Without sufficient insulin to transport the sugars, people with type 1 diabetes may have high sugar levels in their blood. High blood sugar levels can be dangerous. 

Type 1 diabetes is genetic, which means that genetic predisposition (or a higher risk of developing type 1 diabetes) runs in families. However, not everyone with a genetic predisposition for type 1 diabetes will develop the condition. 

Researchers³ suspect that some environmental triggers, such as certain viral infections, may play a role in the development of type 1 diabetes. Unlike type 2 diabetes, type 1 diabetes is not caused by an unhealthy lifestyle.

Risk factors for type 1 diabetes

Age

Type 1 diabetes most commonly develops in children, teenagers, and young adults. However, the condition may develop at any age. 

Family history

People with a family history of type 1 diabetes face a higher risk of developing the condition.

Not everyone with a family history of type 1 diabetes will develop it. However, it’s important to stay vigilant, especially if you have symptoms of diabetes.

Viral infections 

Some viral infections are associated with the onset of type 1 diabetes, including:

• Enteroviruses 

• Mumps virus 

• Rotavirus 

• Cytomegalovirus 

Diagnosing type 1 diabetes 

Diabetes is diagnosed using a simple blood test. There are several blood tests for diabetes, but they all assess blood sugar.

Your doctor may perform an A1C test⁴ to measure your average blood sugar levels over the past three months.

The results are reported as percentages (representing the proportion of blood proteins coated with sugar) or in milligrams per decilitre — mg/dL (representing the estimated average glucose per decilitre of blood). A result of 6.5% or 140mg/dL and above indicates diabetes. 

You’ll need to fast overnight for some tests (fasting blood sugar and glucose tolerance). If your result is 126mg/dL or higher on a fasting blood sugar test, or 200mg/dL on a glucose tolerance test, your levels align with a diabetes diagnosis. 

A random blood sugar test can be carried out at any time of the day, regardless of when you last ate. If your blood sugar levels in a random blood test are over 200mg/dL, you’re within the range for diabetes. 

If your blood sugar indicates diabetes, your doctor will check for autoantibodies. Autoantibodies are antibodies that attack the body and indicate autoimmune diseases, like type 1 diabetes. Autoantibodies are not present in type 2 diabetes.

Further, they may test a urine sample for ketones, which are produced when the body is burning fat for energy. Ketones can also be present in people with type 2 diabetes, but at the diagnosis stage, they’re more commonly found in people with type 1 diabetes.

In more advanced or poorly-managed cases of diabetes, ketones can indicate a serious condition called diabetic ketoacidosis.

Who can get type 1 diabetes?

Type 1 diabetes can develop at any age, but it’s usually diagnosed in younger people.

Development in children

Type 1 diabetes usually develops in children or young adults. Children are also more likely to have a serious complication called diabetic ketoacidosis⁵ (DKA) — excessive production of ketones — at the onset of type 1 diabetes than adults. 

You can read more about diabetic ketoacidosis in the “complications” section.

Development in adults 

Although type 1 diabetes most commonly develops in children, it can also develop in adults. 

Adult-onset type 1 diabetes is sometimes misdiagnosed and improperly treated as it’s mistaken for type 2 diabetes. An adult with undiagnosed type 1 diabetes may only get a diagnosis after interventions like exercise, a healthy diet, and oral medications fail to reduce blood sugar levels within a normal range.  

Latent autoimmune diabetes in adults⁶ (LADA), sometimes called type 1.5 diabetes, accounts for 2 to 12% of type 1 diabetes diagnoses in adults and is characterized by a lack of need for insulin (like some patients with type 2 diabetes) alongside the autoantibody markers found only in type 1 diabetes. 

Can type 1 diabetes be prevented?

Scientists don’t know how to prevent type 1 diabetes, but they’re working on it.

In the pursuit of prevention methods, three strategies may prove useful: primary prevention, secondary prevention, and tertiary prevention. 

Primary prevention

Primary prevention focuses on those at a high risk of developing type 1 diabetes, including people with a family history of the condition. 

Primary prevention aims to prevent the onset of autoimmunity against beta cells. Primary prevention needs to start early because type 1 diabetes progresses more rapidly once beta cell autoimmunity starts.

One clinical trial⁷ is presently investigating whether administering oral insulin daily to high-risk infants from four to seven months until three years of age may train the immune system to tolerate beta-cell autoantigens to combat the autoimmunity associated with type 1 diabetes. 

This study is ongoing, so the results are not yet available. However, in a study⁸ focusing on relatives of people with type 1 diabetes, another team of researchers found that oral insulin did not prevent or delay the onset of type 1 diabetes. 

Other studies⁹ have proposed possible connections between type 1 diabetes development and cow’s milk, gluten, vitamin D, and omega-3s, but more research is needed to determine if these dietary components can be manipulated in the primary prevention of type 1 diabetes.

Research¹⁰ into vaccines against viral infections associated with type 1 diabetes onset also shows promise for type 1 diabetes prevention. Additionally, some researchers are examining the possibility of a vaccine to induce immune tolerance to beta cells in those at a high risk of developing type 1 diabetes. 

Secondary prevention

Secondary prevention is for those who have at least two islet autoantibodies. Secondary prevention aims to stop the development of autoimmunity and potentially prevent the onset of clinical diabetes. 

In their review of secondary prevention studies, one group found that antigen-specific therapy was deemed the “holy grail” of type 1 diabetes prevention. In this therapy, autoantigens are strategically introduced into the body to initiate a protective autoimmune response instead of a destructive one.

They discuss several antigen-specific therapies, including immunomodulation (modification of the immune response) with cyclosporine, glutamic acid decarboxylase, proinsulin peptides, and insulin.

Tertiary prevention

Tertiary prevention is for those who meet the clinical criteria for type 1 diabetes. Tertiary prevention aims to reduce complications, prolong remission, and preserve beta cell mass. 

There’s evidence¹¹ that vitamin D receptor gene variations may be linked to type 1 diabetes. Therefore, vitamin D may prove useful in helping people with type 1 diabetes manage their condition. However, research is limited and more information is needed.

As discussed above, vitamin D supplementation is also a topic of interest for researchers studying the primary prevention¹² of type 1 diabetes. 

Treatments for type 1 diabetes

Insulin treatment 

Type 1 diabetes requires insulin treatment. 

As type 1 diabetes is characterized by low levels of insulin causing high blood sugar levels, insulin treatments are necessary to help transport sugar from the blood into cells. Insulin treatments can be in the form of a pen, pump, or syringe. 

Insulin pens and syringes are forms of insulin injections. While insulin pens may provide better blood glucose control and are convenient, they can also be more expensive.

While some insulin pens are meant to be reloaded and reused, you should never reuse a needle from a pen. Likewise, an insulin syringe should only be used once.

To use an insulin pen or syringe, you must inject the insulin below the skin. Discuss with your doctor if you think an insulin pen or syringe may be right for you. 

Insulin pumps are small devices that mimic the function of a healthy pancreas to provide doses of insulin continuously. If you use an insulin pump to treat type 1 diabetes, you must use it constantly, day and night. However, you can choose to alternate between a pump and injections. 

Pramlintide 

Your doctor may recommend pramlintide if you need additional help controlling blood sugar levels after meals. Notably, pramlintide injections increase the risk of hypoglycemia (low blood sugar), so it’s vital to be aware of the signs of low blood sugar if you take pramlintide for type 1 diabetes.

Artificial pancreas

An artificial pancreas is a continuous glucose monitor that automatically administers the required amount of insulin throughout the day. 

An artificial pancreas differs from an insulin pump as the latter delivers a constant supply of insulin throughout the day, whereas the former automatically adjusts the levels of insulin administered based on blood glucose readings. 

The FDA approved¹³ the first artificial pancreas in 2016. 

Managing type 1 diabetes

If you have been diagnosed with type 1 diabetes, you can take steps to effectively manage your condition.

Insulin treatments

Depending on the type of insulin therapy you choose, you may need to remember to take your insulin treatment several times per day. Insulin pens and syringes require routine injections, while insulin pumps are worn day and night and administer insulin as needed throughout the day. 

Discuss the different treatment options with your doctor to determine which is right for you. 

Maintaining a healthy lifestyle

To effectively manage your diabetes, it is crucial to living a healthy lifestyle. This includes eating well, exercising regularly, and maintaining a healthy weight. Although type 1 diabetes is not caused by poor diet or being overweight, these factors may increase the risk of developing complications associated with type 1 diabetes. 

Managing blood sugar levels 

Testing your blood sugar with a glucometer or continuous glucose monitor (CGM) will help ensure you’re aware and can take the necessary actions if your blood sugar spikes or dips.

Your doctor may advise you to check your blood sugar when you first wake up, before a meal, two hours after a meal, or at bedtime.

If you test your blood sugar before a meal, your reading should be between 80 and 130mg/dL. If you test two hours after the start of a meal, it should be less than 180mg/dL. 

Whether your blood sugar is too high or too low, it’s essential you take the necessary steps to reduce or increase it to within a normal range, as anything outside the normal range can lead to severe complications. 

Support and resources

Diabetes self-management education and support (DSMES) services can help you build a diabetes management plan and will provide ongoing support for living with your condition. 

DSMES services can help you learn the skills you need to safely manage your diabetes, including:

• How to check your blood sugar

• How to take your medications

• Coping with the emotional aspect of diabetes

• Minimizing the risk of complications

• Dealing with life changes that can affect your diabetes, such as changes to your insurance, doctors, or living situation

If you wish to avail of these services, ask your doctor to refer you or check out diabetes education programs near you.  

Regular medical checkups 

Visiting a doctor regularly is essential for people with chronic conditions, such as type 1 diabetes. Complications are a major cause of illness and death in people with type 1 diabetes. With your doctor’s guidance, you can reduce your risk of serious complications.

Complications of type 1 diabetes

There are several complications that can occur as a result of type 1 diabetes. Two potential complications of diabetes are hypoglycemia and diabetic ketoacidosis. 

Hypoglycemia

Hypoglycemia¹⁴, or low blood sugar, is a problem that can occur with type 1 diabetes. Blood sugar levels lower than 70mg/dL are considered too low and may result from type 1 diabetes treatment. 

If your blood sugar levels are between 55 and 69mg/dL, you may use the 15–15 rule. Simply eat 15g of carbohydrates and then recheck your blood sugar after 15 minutes. 

If your blood sugar levels are still below 70mg/dL, you may repeat this rule. Young children will require less than 15g of carbs. Note that this method is necessarily appropriate for children. Ask your doctor about modifying the 15–15 rule to suit your child’s needs. 

Foods ideal for the 15–15 rule include: 

• 3 or 4 glucose tablets (follow the instructions)

• Jelly beans (check the label for how many jelly beans you’ll need to eat to reach 15g of carbs)

• ½cup or 4oz of soda or juice

Severely low blood sugar levels are lower than 55mg/dL. Your doctor may prescribe injectable glucagon if you’re susceptible to severely low blood sugar levels. 

If your blood sugar levels are extremely low, contact your doctor for emergency treatment regardless of whether you use injectable glucagon. If it’s after-hours or you can’t reach your doctor, call 911.

Diabetic ketoacidosis 

Diabetic ketoacidosis is a life-threatening condition in which the liver breaks down fats for fuel, causing a buildup of ketones in the body. This can occur in type 1 diabetic patients when insufficient insulin levels result in insufficient sugar transport.

Symptoms of diabetic ketoacidosis include:

• Increased thirst

• Increased urination

• Rapid breathing

• Dry mouth and skin

• Headache

• Fruity breath

• Vomiting

• Stomach pain

• Muscle aches

• Flushed face

Diabetic ketoacidosis is treated by replacing fluids, electrolytes, and insulin. However, if you experience these symptoms, you should contact your doctor. You can reduce your risk of developing diabetic ketoacidosis by checking your blood sugar often (especially if you’re sick), keeping your blood sugar under control, keeping up with prescribed medications, and speaking to your doctor about adjusting your insulin if your needs change.

Additional complications

Additional complications associated with type 1 diabetes include: 

• Heart disease

• Stroke

• Dental health problems

• Kidney disease

• Foot problems that may become severe

• Eye problems

• Depression

• Nerve damage

When to visit a doctor

Early diagnosis is helpful in managing type 1 diabetes and preventing complications. If you have symptoms of type 1 diabetes, you should visit your doctor for assessment. Let your doctor know if you have a family history of type 1 diabetes so they can perform the appropriate tests.

The lowdown

Type 1 diabetes is an autoimmune condition with a genetic link. The body attacks cells in the pancreas, which results in insufficient insulin production and high blood sugar levels. Type 1 diabetes can affect people of any age.

Researchers haven’t found a way to prevent type 1 diabetes, but many studies are trying to find primary, secondary, and tertiary prevention methods. Type 1 diabetes is treatable but not curable. However, with proper treatment and healthy lifestyle habits, most people with type 1 diabetes are able to live happily, fulfilled lives.