Understanding Type 1 Diabetes


Type 1 diabetes is an autoimmune disorder that destroys the beta cells from your pancreas, leaving you without insulin.

There is also secondary diabetes, which can be caused by an illness or injury that wipes out your beta cells, rather than your own immune system.

The Role of Insulin in Your Body

Insulin is what cells use to fuel themselves. It’s the hormone that helps to move glucose (sugar) into the tissues.

Because the beta cells are damaged, there is no insulin to move glucose into the body’s tissues, which causes a buildup of sugar in your blood, leaving your cells to starve.

High blood sugar can lead to a host of issues:

  • Dehydration – The body gets rid of extra sugar in the blood through urine. The more sugar you have in your blood, the more you pee, the more water you lose.
  • Weight Loss – Glucose takes calories with it when you urinate. Dehydration can also contribute to weight loss through loss of water weight.
  • Diabetic ketoacidosis (DKA) – When your body cannot get enough sugar, it breaks down fat instead, releasing chemicals called ketones. Sugar is also released to help out, but since there is no insulin, everything builds up in the blood, and can be life-threatening if not treated immediately.
  • Body damage – High glucose levels can cause harm to nerves and small blood vessels, affecting the heart, eyes, and kidneys. Arteries may also harden, increasing your chances of having a heart attack or stroke.

Who Is Affected?

Roughly 1 in 20 people with diabetes have type 1, and it is more common among white people than African-Americans. It usually starts before age 20, which is why it is also known as juvenile diabetes.

The Causes

Researchers are unaware of all of the causes of type 1 diabetes, but genetics is a factor.

Type 1 diabetes can occur with autoimmune disorders or can be the result of a virus or other illness that causes the immune system to attack the pancreas. Autoantibodies are present in these cases.

The Symptoms

Symptoms can be subtle, or severe, but are usually:

  • Dry mouth
  • Extreme thirst
  • Increased hunger
  • Stomach pains
  • Nausea and vomiting
  • Urinating often
  • Fatigue
  • Blurry vision
  • Heavy breathing
  • Unexplained weight loss
  • Frequent inflections of the urinary tract, vagina, or skin

If any of the following occur, go to your nearest emergency provider:

  • Stomach pain
  • Breath that smells fruity
  • Rapid breathing
  • Shaking and confusion
  • Loss of consciousness

The Diagnosis Process

A blood sugar test or urinalysis is performed by a doctor to determine the body’s glucose levels.

There is no prevention.

The Treatment

Keeping your blood sugar at levels your doctor recommends is the key to living a long, healthy life.

Type 1 diabetics must use insulin injections to keep their blood sugar in check.

Doctors will mention three things when speaking with you about insulin:

  1. Onset – the length of time before insulin reaches your bloodstream and lowers your blood sugar
  2. Peak time – the point at which insulin is doing the most work to lower blood sugar
  3. Duration – how long the insulin will work after the peak time

There are four types of insulin currently available:

Type Onset Peak Duration
Rapid-acting 15 minutes 1 hour 2-4 hours
Short-acting (regular) 30 minutes 2-3 hours 3-6 hours
Intermediate-acting 2-4 hours 4-12 hours 12-18 hours
Long-acting several hours ~5 hours 24 hours

Your healthcare provider may start you with two different types of insulin and two shots a day, but that can go up to three or four shots a day.

There are a few different ways to get your insulin: through a vial and needle, a prefilled pen, an inhaler, or an insulin pump. The pump is attached to your body and delivers the insulin through a small tube. Talk to your doctor about which option is best for you.

Change in Lifestyle

Maintaining an active life is important in treating type 1 diabetes, but needs to be balanced with your insulin dosage and what foods you are eating.

Continually checking your blood sugar around and during activities will help you to monitor how different activities affect you. If your test is too low, have a snack. If it is too high, check for ketones. If that test is negative, go ahead with your planned activity.

Understand the roles that macronutrients (carbs, proteins, and fats) play in your diet, and then design a meal plan that keeps your blood sugar levels where they should be.

Why Do I Need Treatment?

Without treatment, serious or life-threatening problems occur, such as:

  • Retinopathy – An eye problem that affects about 4 in 5 adults who have had type 1 diabetes for more than 15 years.
  • Kidney damage – A condition called nephropathy, present in 20 to 30 percent of people with type 1 diabetes, shows up around 15 to 25 years after diabetes onset.
  • Poor blood circulation and nerve damage – Hardened arteries and damaged nerves can lead to a loss of sensation, especially in the feet, which raises your chances of injury and prolong some injuries, such as wounds. You could even end up losing a limb.

For the most up to date and most accurate information we highly recommend you consult your healthcare provider.

Reviewed by Dr. Zuraima Corona Rodriguez

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