Type 1 diabetes, also known as juvenile diabetes, is a congenital disease that represents about 5 percent of all diabetes cases. Specifically, the disease affects blood glucose (sugar) levels, raising them to higher than normal levels.
High glucose levels occur because the pancreas is producing little or no insulin. Ultimately, when the pancreas doesn’t produce enough insulin or does not properly use insulin, glucose begins to build in the bloodstream; and, the cells start to starve for energy.
Glucose buildup in the blood is called hyperglycemia. Diabetes type I diabetes is also termed insulin-dependent diabetes as insulin is the best treatment for the disease. (1)
Type 1 diabetes is often thought to be a childhood disease. However, it can occur at every age of life. It is a chronic autoimmune disease. With the disease, the body does not produce insulin. It’s a hormone that is required for the body to carry glucose from the bloodstream into the body’s cells.
Furthermore, cells that produce insulin within the pancreatic islets are destroyed, basically through starvation as they are not receiving energy. Without insulin therapy, the cells die.
Insulin therapy and other treatments are effective with type 1 diabetes. The primary role of insulin in the body is to help move certain nutrients, especially sugar, also called glucose, into cell tissues in the body.
Cells depend on sugars and nutrients from the diet as a source of energy for the cells. This allows them to perform processes the body relies on for function, health, and wellbeing. With type 1 diabetes, the pancreas does not produce glucose, so no glucose is moved into the cells.
Ultimately, glucose then builds up in the bloodstream, and high blood glucose (sugar) levels result. As a result, patients can experience dehydration, weight loss, diabetic ketoacidosis, and damage to the body.
While all factors that lead to type 1 diabetes are unknown, the disease can be inherited. It could be caused by a toxin or a virus, and occur with other autoimmune diseases. Often, type 1 diabetes results from the body’s immune system and its inability to fight harmful bacteria and viruses.
Unfortunately, the pancreas does not produce insulin, which destroys cells due to the cells starving for energy.
According to a new study published in the Journal of Experimental Medicine, distinctive metabolic changes that precede the development of type 1 diabetes identify a metabolic phenotype linked to susceptibility to type 1 diabetes. (2) (3)
Typically, type 1 diabetes symptoms are not severe. However, subtle or severe, patients can experience a variety of symptoms that include:
- Increased thirst
- Dry mouth
- Increased appetite
- Abdominal pain
- Nausea and occasionally vomiting
- Unexplained weight loss
- Frequent urination
- Blurred vision
- Recurrent infections of the skin or urinary tract
- Heavy, labored breathing
The following type 1 diabetes symptoms are emergency signs:
- Rapid breathing
- Shaking and confusion
- Fruity smell to the breath
- Loss of consciousness
- Abdominal pain
Diagnostic tests are administered to determine the presence of type 1 diabetes.
Types of diagnostic tests include:
A1C Glycated hemoglobin test
The A1C test is administered to measure the patient’s average blood sugar level, measuring levels over a timeframe of the past two to three months. Red blood cells contain an oxygen-carrying protein with blood sugar attached.
The AC1 test measures the sugar levels of the proteins in the red blood cells. Consequently, the more sugar attached to the oxygen-carrying protein, the higher the blood glucose levels. A diabetes diagnosis is dependent on a 6.5 percent or higher reading of blood sugar levels. Multiple AC1 tests will be administered.
Most importantly, two separate tests have a 6.5 percent or higher reading of blood sugar level, type 1 diabetes is diagnosed.
Moreover, patients suffering from other conditions or are pregnant are administered different tests:
The tests used may include:
Random blood sugar test
The random blood sugar test is merely taking a blood sample at a random time. It is not dependent on any specific time of day, or an empty stomach.
Moreover, repeat testing may be required to confirm the results. The random blood sugar test measures blood sugar levels in millimoles per liter or milligrams per deciliter. Blood sugar levels of 200 mg/dL or higher suggest diabetes.
Fasting blood sugar test
Fasting blood sugar test requires patients to fast overnight. Ultimately, the test measures the blood sugar levels of the fasting patient in milligrams per deciliter. Blood sugar levels less than 100 mg/dL is normal.
A prediabetes diagnosis is determined when a patient’s blood levels read from 100 to 125 mg/dL; and, 126 mg/dL or higher on two separate tests indicates diabetes.
If a type 1 diabetes diagnosis results, doctors may run additional blood tests to check for autoantibodies that are common in type 1 diabetes. The tests are to distinguish between type 1 and type 2 diabetes.
With type 1 diabetes, insulin therapy is required to control blood sugar levels. Also, patients will be required to count carbohydrate, fat, and protein in their diets. They should also eat healthy foods, frequently monitor blood sugar levels, and engage in regular exercise, as well as to maintain a healthy weight.
Typically, daytime blood sugar levels before meals should be between 80 and 130 mg/dL. Two hours after meals numbers should be no higher than 180 mg/dL.
Type 1 diabetes patients will require type 1 diabetes insulin therapy for their entire lives. Types of insulin include:
- Short-acting (regular) insulin
- Rapid-acting insulin
- Intermediate-acting (NPH) insulin
- Long-acting insulin
Insulin is administered via an insulin pump or injections.
Other medications prescribed to type 1 diabetes patients may include:
- High blood pressure medications
- Cholesterol-lowering drugs
With type 1 diabetes, patients are required to monitor their blood sugar levels up to four times a day. According to the American Diabetes Association, blood sugar levels should be tested before meals and snacks. Also before bed, when exercising or driving, and if the patient feels their glucose levels are low.
Various factors like food, activity, stress, medications, illness, hormonal changes, and alcohol influence glucose levels. Moreover, monitoring glucose levels help to ensure patients are in their mg/dL blood sugar levels range throughout the day.
Patients are recommended to follow a healthy lifestyle and diet. However, there is no diabetes diet. Doctors will recommend a lifestyle change to healthy eating and exercising.
Patients should build their diets from nutritious, low fat, high fiber foods like:
- Whole grains
Type 1 diabetes patients should eat fewer animal products and refined carbohydrates like sweets and white bread. Carbohydrate counting is essential as the body will require insulin to metabolize the carbohydrates.
Type 1 diabetes and alcohol
Patients should restrict alcohol from their diet since type 1 diabetes and alcohol do not mix. Alcohol can cause blood glucose levels to rise, while excess alcohol can lower the glucose level, dropping it to dangerous levels.
Furthermore, alcohol is also considered a depressant and stimulates the appetite. Type 1 diabetes and alcohol can interfere with the positive effects of medicines and insulin, increase blood pressure, and increase the heart rate.
Patients must consult with their doctors regarding an exercise plan. Exercise is essential and should be part of their daily routine. Most doctors will recommend patients to engage in 150 minutes of weekly aerobic exercise, with no more than two days without exercise.
Hence, exercise lowers glucose sugar levels. Patients engaging in any new activity should monitor their glucose levels more often. Increased activity may require an adjustment to the meal plan or insulin doses.
There are times that type 1 diabetes patients need to be particularly careful:
Blood sugar levels should be checked before driving. Critically, if the patients’ glucose level is below 70 mg/dL, driving will need to be postponed as hypoglycemia can occur. A snack containing 15 grams of carbohydrates is needed, and retesting in 15 minutes to ensure blood sugar levels are at a safe level for safe driving.
Type 1 diabetes patients can have challenges in the workplace. Most importantly, if the job requires an activity, hypoglycemia is a severe risk, and accommodations may be necessary. Also, the patient may require additional breaks for blood sugar testing and food and drink.
A type 1 diabetes patient should not attempt to become pregnant until A1C readings are 6.5 percent. Women with type 1 diabetes have an increased risk of delivering children with congenital disabilities, mainly if their disease is poorly managed.
Elderly that is prone to sickness or frail or has cognitive defects, typically do not have the same stringent diabetes management. For the elderly, often an A1C goal of less than 8 percent is adequate.
Serious health risks are associated with type 1 diabetes. Treatment, management, and monitoring of the disease are crucial.
Health risks include:
- Diabetic ketoacidosis
- Heart disease and stroke
- Retinopathy and blindness
- Kidney disease
Type 1 diabetes consequences of uncontrolled diabetes
When type 1 diabetes is not well-controlled, patients are vulnerable to life-threatening problems:
- Kidney damage
- Poor blood circulation
This disease can be an emotionally draining disease. Patients are required to follow a strict diet, planning each meal and snack. Furthermore, tracking blood sugar levels and insulin therapy is crucial. Ultimately, the treatment and management of diabetes type 1 is a lot to deal with, and patients can feel emotionally and physically exhausted.
Besides, it is essential that type 1 diabetes patients reach out for support during bouts of depression. Diabetes management includes maintaining mental and emotional health.
Signs of depression include:
- Loss of interest in activities
- Changes in sleep patterns
- Depressed mood or irritability
- Trouble concentrating
- Lack of energy
- Feelings of guilt or despair
- Changes in appetite
- Difficulty concentrating
- Suicidal thoughts
Type 1 diabetes patients can suffer chronic complications with the disease. Serious complications include end-stage kidney disease, stroke, and blindness. Besides, several factors contribute to chronic complications. For instance, poor glycemic control, obesity, and fear of hypoglycemia are associated factors with chronic complications.
Living with type 1 diabetes is challenging. Patients must receive proper care and engage in a healthy lifestyle that helps to manage their disease. They must balance nutrition, exercise, and proper blood glucose management techniques for their entire life. However, it is possible, and the better controlled, the higher the quality of life of the patient. (4)
The emotional support of patients is crucial for mental health. For this reason, patients are encouraged to connect with other people living with diabetes. The regimen of a patient is grueling with carbohydrate counting, blood glucose testing multiple times a day, diet, and injections. Type 1 diabetes patients can feel physically and mentally draining.
Support is necessary for patients and their families. Also, families of patients should also have support as they play an essential role in the lives of the ones they love with diabetes.