What You Should Know About Late-Onset Type 1 Diabetes

Many think type 1 diabetes happens early in life, and type 2 happens when people get older. This common misconception results in some confusion for adults when they develop type 1 diabetes.

In this article, we'll discuss type 1 diabetes and its onset later in life. You'll learn how to identify the symptoms and manage your condition.

What is late-onset type 1 diabetes?

Let's start with a generic description of diabetes. Healthy people produce a hormone called insulin when the body builds up too much sugar in the blood. Insulin moves glucose out of the bloodstream and into the cells, which use it for energy. 

People with diabetes have an insulin problem that significantly interferes with their ability to manage glucose levels. Exactly how that happens depends on the type of diabetes.

Type 1 diabetes vs. type 2 diabetes

The main feature that determines the diabetes type is the cause of the body's inability to use insulin. People with type 1 diabetes simply do not produce enough insulin on their own to properly uptake their blood sugar.

Type 2 is different. The body produces insulin but cannot efficiently process it. This is called insulin resistance. Although the mechanisms at play are different, the result is the same: Blood sugar levels remain too high. 

Type 1 diabetes in adults

Type 1 diabetes is usually associated with children or young adults. But there's no age limit to when someone can develop this condition. Generally, type 1 diabetes is less frequent, affecting only 5-10% of those who have diabetes.

Studies¹ have shown that new cases of type 1 diabetes are slightly more likely in the adult population. When the condition develops in an adult, doctors refer to it as late-onset or adult-onset type 1 diabetes.

What are the signs and symptoms? 

The primary symptoms of type 1 diabetes are similar to those of other forms of diabetes:

• Increased urination

• Increased thirst

• Unintentional weight loss

• Increased appetite

• Blurred vision

• Numb or tingly hands and feet

• Fatigue

• Dry skin

Some symptoms are specific to type 1 diabetes, such as nausea, vomiting, and stomach pain.

What causes it?

Type 1 diabetes is an autoimmune reaction. Your immune system is supposed to protect your health by attacking dangerous invaders like bacteria. However, sometimes your immune system mistakes parts of your body for an attack. 

This type of reaction can affect nearly every part of the body. Type 1 diabetes affects the pancreas, which produces insulin. When your immune system attacks your pancreas, it can no longer produce enough insulin for your body to function correctly. 

How is it diagnosed?

Doctors use simple blood tests to diagnose diabetes. They can check your overall blood sugar level during rest or after drinking a glucose drink. All of these tests determine how your body uses blood sugar. They will show whether you have diabetes, but the type of diabetes.

An additional test to check for autoantibodies in your blood can confirm a diagnosis of type 1 diabetes. People with type 2 do not have these.

Type 1 diabetes is less frequent and not associated as closely with adulthood. So it isn't uncommon for doctors to initially misdiagnose you with type 2 diabetes. 

Treatment for late-onset type 1 diabetes

Treatment options are more limited for type 1 diabetes. When you have type 1 diabetes, you need to make lifestyle changes, rely on insulin injections, and visit your doctor regularly. All these things ensure that you're keeping your blood sugar levels under control. 

Doctor visits

When you have diabetes, it's crucial to maintain regular appointments with your doctor. Often, people with diabetes have a diabetic care team that can help with various aspects of the condition. 

This team may include a dietician to ensure that you're consuming the right amount of carbohydrates at the right time. You may have other doctors specializing in typical complications associated with diabetes. 

Your primary care provider will tell you which other specialists to see at diagnosis and each appointment. Each doctor will recommend how frequently you should visit them. 

Insulin

People with type 2 diabetes produce insulin but can't process it efficiently. Still, they might not need insulin injections as medications can improve insulin sensitivity. This isn't an option with type 1 diabetes.

Because your body isn't making enough insulin, increasing cells' sensitivity to insulin using medications might help but can't replace insulin injections. For that reason, everyone with type 1 diabetes must use insulin.

Insulin delivery methods

People with type 1 diabetes have several options for insulin delivery. Your doctor will help you decide which of these methods is best for your lifestyle and the severity of your condition. 

Here's a brief overview of the options:

Syringes and pens 

Using this method, you'll have to inject yourself or find someone you trust to do it. Because you'll need regular insulin injections, it's not practical to go to a doctor's office to receive them. Both methods use a needle to deliver the injection, though pens are easier to use and more convenient. 

Insulin pumps

Insulin pumps do not require shots. Instead, they automatically deliver a precise insulin dose through a tube inserted into your body. The tube is usually inserted into your stomach or the back of your upper arm and connects to the cell phone-sized pump that carries the insulin.

Insulin inhaler 

An insulin inhaler cannot replace the other two methods, but it can support them when you need a quick insulin dose before a meal.

The types of insulin

In addition to the delivery method, different types of insulin are available. The types differ in how quickly they begin to work, how long it takes them to reach peak strength, and how long they stay active in your body. 

The right type for you will depend on many aspects. Some of these factors are beyond your control, such as how quickly your body processes blood sugar. Factors you can control include your eating pattern and lifestyle.

Your doctor will work with you to find the right type of insulin. Just as you may use an insulin inhaler with one of the other delivery methods, your doctor may decide that an insulin combination is the best treatment. If so, they'll take the time to explain which circumstances require which type of insulin so you're always getting an appropriate dose.

Management of late-onset type 1 diabetes

We've mentioned the need to make changes to your lifestyle in addition to insulin and doctor visits. Having diabetes isn't as simple as taking your medication in the morning and forgetting about it. You'll need to monitor your blood sugar and how many carbohydrates you eat. 

Other changes, such as losing weight and exercising, can better control your diabetes.

Diet

Your body cannot process blood sugar adequately, so you must be careful about how many carbs you eat. Understanding the distinction between a serving size and a portion is essential. Many prepackaged foods have more than one serving in them.

When looking at the nutritional label, be sure to go by the number of servings when counting carbs.

An accurate way to manage your consumption is to manually multiply the carbs in servings by the number of servings in the meals and track every carb you eat. There are mobile apps and other tools that can help you with this. 

The plate method is an easier but less reliable way. You start with an empty 9-inch dinner plate, placing non-starchy vegetables on one half. Divide the other half evenly between carbs and protein, with each taking a quarter of the plate.

Controlling your blood sugar 

As your blood sugar remains at high levels with diabetes, you need to be careful about how many carbohydrates you consume. However, because of this careful diet and your insulin, your blood sugar can also be too low. Managing diabetes is a constant battle of balancing your blood sugar. 

When your blood sugar is too low, doctors recommend the 15/15 rule. This is simple: Eat 15g of carbohydrates and wait 15 minutes before checking your blood sugar. Repeat as necessary. 

Weight loss

Type 1 diabetes isn't as closely associated with obesity like type 2 diabetes. However, it's still important to control your weight. Type 1 diabetes can cause type 2 diabetes clinical signs such as obesity. When this happens, doctors call it double diabetes. 

Maintaining a healthy weight can reduce your risk of developing type 2 diabetes signs. There are many other comorbidities between diabetes and obesity: Managing your weight also avoids them. 

Exercise

The more sensitive your body is to insulin, the less of it you'll need to keep your blood sugar under control. When you're active, your body lowers its insulin resistance, so it uses insulin better. The CDC recommends that everyone with diabetes gets at least 150 minutes of moderate exercise per week.

This doesn't mean you need to train for a marathon. Simple activities such as dancing or doing chores around the house can be enough to get your heart rate up. Your diabetic care team can ease you into an exercise program so you won't feel overwhelmed and quit. 

The lowdown

Type 1 diabetes can happen to anyone at any stage of life. Sometimes, you may receive a misdiagnosis of type 2 diabetes as type 1 is rarer and usually associated with earlier onset. If you have type 1 diabetes, you rely on insulin to replace what your body isn't making.

However, like type 2 diabetes, type 1 is manageable by combining diet and lifestyle changes in addition to insulin.