Type 1 Diabetes

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Type 1 diabetes is when the body does not make enough insulin. Insulin is a hormone that helps your body convert food into energy. Without insulin, glucose (sugar) from the food you eat cannot enter cells. So glucose builds up in the blood. Your body tissue becomes starved for energy.

Type 1 diabetes usually begins in children and young adults. Over the long-term, if type 1 diabetes is not adequately treated, high blood sugar levels can damage the blood vessels, heart, kidneys, eyes, nerves, and other tissues or organs.

Most cases of type 1 diabetes are caused by the body's immune system attacking and destroying the islet cells that make insulin. These cells are in the pancreas. The current theory is that some people have genes that make them prone to getting type 1 diabetes. For these people, certain things in the environment may trigger an immune system attack on the pancreas. The trigger or triggers have yet to be identified, but may be certain viruses, foods, or chemicals.

Risk factors include:

• Other autoimmune illness, including:
  • Addison's disease (disorder of the adrenal glands)
  • Celiac disease (autoimmune disease of the digestive tract)
  • Graves' disease (thyroid disease)
  • Hashimoto's disease (thyroid disease)
  • Pernicious anemia
  • Vitiligo (disorder that affects the skin cells)
• Age: starts at age 4 with peak at ages 11-13
• Bottle-feeding or short duration of breastfeeding
• Ethnicity: Northern European, Mediterranean, African Americans, Hispanics
• Family history (parent, sibling) of type 1 diabetes
• Obesity during childhood
• Risk increases with increase in birth weight
• Sex: more common in males than females

If you have any of these symptoms, do not assume it is due to type 1 diabetes. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

• Blurry vision
• Extreme thirst
• Fatigue, weakness
• Headaches
• Hunger
• Increased urination
• Irritability
• Weight loss

Destruction of insulin-producing pancreatic cells may occur so quickly that ketoacidosis (commonly known as diabetic coma) is the first sign of a problem. Symptoms of ketoacidosis include:

• Abdominal pain
• Abnormally deep and fast breathing
• Coma
• Dehydration (not enough fluid in the body)
• Drowsiness
• Dry skin and mouth
• Fruity breath odor
• Low blood pressure
• Rapid pulse
• Vomiting and nausea

The doctor will ask about your symptoms, medical history, and family history, and do a physical exam.

Type 1 diabetes is diagnosed based on the results of blood tests and other criteria. These include:

• Blood sugar tests after you have not eaten for eight or more hours (called fasting blood test) revealing blood sugar levels greater than or equal to 126 mg/dL (7.0 mmol/L) on two different days
• Glucose tolerance test measuring blood sugar two hours after you consume glucose with a measurement greater than or equal to 200 mg/dL (11.1 mmol/L)
• HbA1c level of 6.5% or higher, indicating high blood sugar over the past 2-4 months
• Symptoms consistent with diabetes and a random blood test revealing a blood sugar level greater than or equal to 200 mg/dL* (11.1 mmol/L)

*mg/dL = milligrams per deciliter of blood, mmol/L = millimole per liter of blood

Some children may be tested for insulin levels or anti-islet cell antibodies to confirm the diagnosis.

Diabetes treatment aims to maintain blood sugar at levels as close to normal as possible. Regular medical care is important for preventing or delaying complications.

If you are diagnosed with type 1 diabetes, follow your doctor's instructions .

Currently, there is no known way to prevent type 1 diabetes. Researchers are studying immunosuppressive treatments that may benefit high-risk people.