Type 1 diabetes is an autoimmune disease that occurs when insulin-producing beta cells within the pancreas are gradually destroyed and eventually fail to produce insulin. Insulin is a hormone that helps the body’s cells use glucose for energy. Blood glucose (or blood sugar) is manufactured from the food we eat (primarily carbohydrates) and by the liver. If glucose can’t be absorbed by the cells, it builds up in the bloodstream instead. Untreated, the high blood sugar levels that result can be toxic to every system of the body, causing serious complications.
Type 1 accounts for 5 to 10 percent of all diagnosed diabetes in the United States. Although type 1 diabetes develops most often in children and young adults, the disease can be diagnosed at any age. Of the 1.25 million Americans living with type 1 diabetes, about 200,000 are younger than twenty years old. Unlike type 2 diabetes, type 1 diabetes is more common in Caucasians than in those of Latino, African American, or other non-Caucasian backgrounds. The rate of type 1 diabetes has been increasing by roughly 2 to 5 percent each year, globally.
Type 1 Diabetes Causes
Researchers have identified several genes associated with the development of type 1 diabetes. While the causes are complex and not completely understood, the prevailing belief about the etiology, or cause, of type 1 diabetes is that while someone may have a genetic predisposition for developing the disease, it takes an environmental trigger or series of triggers (e.g., virus, toxin, drug) to set off the autoimmune process that destroys insulin-producing beta cells of the pancreas.
Risk factors for developing type 1 diabetes may include:
A child with an immediate relative with type 1 diabetes has a risk of developing type 1 diabetes ten to twenty times higher than the general population. The risk varies depending upon which relative it is.
The presence of other autoimmune disorders, such as thyroid disease and celiac disease, raises the risk of type 1 diabetes.
Early cessation of breastfeeding and/or exposure to cow’s milk
Some clinical research indicates that breastfeeding for at least three months decreases the risk of type 1 diabetes. Other studies suggest that exposure to cow’s milk or cow’s milk-based formula before one year of age may increase diabetes risk, although other studies have not borne out this link.
In America, Caucasians have a greater risk of type 1 diabetes than African Americans, Native Americans, Asian Americans, and Latinos. Worldwide, Finland and Sweden have the highest incidence of type 1 diabetes.
History of childhood viruses
Viruses that have been associated with type 1 diabetes as environmental triggers include Coxsackie B, enteroviruses, adenovirus, rubella, cytomegalovirus, and Epstein-Barr virus.
Type 1 Diabetes Symptoms
Symptoms of type 1 diabetes usually develop quickly over a short period. If not diagnosed and treated with insulin, a person with type 1 diabetes can lapse into diabetic ketoacidosis (DKA), which can lead to coma if left untreated. DKA is life-threatening, so it’s important to contact your healthcare provider immediately if you are experiencing symptoms. Type 1 diabetes symptoms include:
- Excessive thirst
- Frequent urination
- Extreme hunger
- Unexplained weight loss
- Fatigue, or a feeling of being “run down” and tired
- Tingling or burning pain in the feet, legs, hands, or other parts of the body
- Blurry vision
- Stomach pain
- Breath that smells sweet, or has a fruit or wine odor to it
- Dry, itchy skin
- Frequent or recurring infections, such as urinary tract infections, yeast infections, and skin infections
- Slow healing of cuts and bruises
- Irritability, depression
Type 1 Diabetes Treatment
People with type 1 diabetes must have insulin injections to supplement the failing insulin production of their pancreas. Insulin is injected with a syringe or pen injector, or through an infusion device called an insulin pump. There are many types of insulin and insulin administration, classified by how long they take to work and how long they last in the body. Talk to your doctor about the options that may be best for you.
There are also adjunct, or companion, treatments for type 1 diabetes that may be prescribed along with insulin. For example, the injectable hormone pramlintide (Symlin) is taken with mealtime insulin to help avoid after-meal blood sugar spikes.
Blood Glucose Monitoring
Checking and tracking your blood glucose levels will help you know if you are meeting the treatment goals set by you and your doctor. These trends will help you understand how your body reacts to food, exercise, medication, illness, and more. Talk to your doctor about when and how to check your blood glucose levels. There are blood glucose monitors used for individual tests, and continuous glucose-monitoring devices used to map out trends—and even alert you if your blood glucose levels are dangerously high or low.
Eating Well and Exercising
Good nutrition, particularly careful monitoring of carbohydrate intake, and regular physical activity are also important “treatments” for controlling type 1 diabetes and preventing long-term complications.
The food you eat directly impacts your blood glucose levels and diabetes management. Working with a certified diabetes educator or registered dietitian-nutritionist and/or taking an active role in medical nutrition therapy (MNT) can help you get and stay on the right track if healthy eating is something you struggle with.
Exercise makes it easier for your body to use insulin, and can help prevent long-term complications. Talk to your doctor before beginning a new exercise routine, and be sure to check your blood glucose levels before, during, and/or after to prevent dangerously low levels.
Updated by Julia Telfer, MPH, 10/16.
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