Formerly known as juvenile diabetes or insulin-dependent diabetes, Type 1 diabetes (T1D) is a chronic, incurable autoimmune condition in which the pancreas produces little or no insulin. T1D is not a lifestyle disease. It accounts for roughly 10% of the more than 420 million cases of diabetes globally.
Type 1 is different than Type 1 diabetes in that a person living with Type 2 diabetes can still produce insulin, but their bodies cannot properly use that insulin. This is also known as “insulin resistance” and can often be treated through diet, exercise and medication.
What is insulin anyway?
Insulin is a hormone that helps regulate glucose levels in the blood. When we eat, our bodies immediately start working to process glucose. The pancreas plays a huge role in this, as it makes insulin and enzymes needed to break down our food.
Glucose comes from foods that contain carbohydrates. Once we eat a carb (even just one!), insulin tells our cells to take the glucose from that carb out of our blood and into our cells. This allows us to use glucose for energy.
I’ve heard it being compared to a key that unlocks the body’s cells, allowing glucose to enter and be absorbed.
I want to stress that carbs do not only come from cakes and cookies. A banana, for example, has approximately 30 grams of carbs, the same amount as a typical cupcake. People get glucose from bread, fruits, vegetables, and dairy products. Fat and glucose are actually two of the body’s preferred sources of fuel. As we know, food gives us energy and energy keeps us alive.
When we eat, our body tips the pancreas off that it needs to release insulin to deal with the rising blood sugar level.
Without insulin, our bodies cannot use glucose for energy, which causes it to build up in the blood stream and cause high blood glucose levels, or “high blood sugar.” The clinical term for this is hyperglycemia. When this happens, our bodies are forced to use other sources of energy to keep us going. The liver helps by turning fat into a type of acid called ketones, which it then sends to our bloodstreams as an alternative source of energy. However, high levels of ketones can lead to ketoacidosis – and for people with diabetes this is a dangerous condition called diabetic ketoacidosis, or DKA.
Those of us living with Type 1 depend on injecting insulin manually since our bodies don’t make insulin anymore.
Symptoms
Recognizing the symptoms of type 1 diabetes is critical. As the body’s insulin production decreases, blood sugar levels can become dangerously high. Symptoms may develop rapidly and can be mistaken for other illnesses such as the flu. Some common symptoms include:
- frequent, unquenchable thirst
- extreme hunger
- frequent urination
- irritability or other mood changes
- unexplained bedwetting
- unwanted or unexplained weight loss
- decreased energy, fatigue or weakness
- fruity smelling breath
- blurry vision
- stomach pain
- nausea or vomiting
- loss of consciousness
- rapid, heavy breathing
Delayed diagnosis can have serious, life-threatening consequences. Please consult your doctor immediately if you are experiencing the above-mentioned symptoms.
Cause
Doctors and researchers are still trying to understand the exact cause of T1D. However, studies suggest that various factors may be at play including genetic predisposition, environmental triggers, and viruses. While Type 1 typically presents during childhood or adolescence, it can also develop in adults – like me! I was diagnosed at age 32.
Treatment + cure
Despite active research, there is currently no cure for Type 1 diabetes. Treatment focuses on managing blood sugar levels with insulin, diet and lifestyle to prevent complications.
Those of us living with T1D are dependent on lifelong insulin injections in order to survive. It’s a full-time balancing act requiring constant attention to avoid acute, life-threatening low blood sugar, or hypoglycemia, or the long-term damage done by hyperglycemia (high blood sugar).
It’s crucial that we monitor our blood sugar levels with finger pricks or a continuous glucose monitor (cgm). If our blood sugar levels are too high or too low, we must take insulin or consume carbs to get more glucose. Carbs in these situations are seen as medicine, or low treatment, in order to keep us alive.
Insulin doses must be carefully calculated based on activity and stress levels, food intake, illness and additional factors, as all these can impact how the insulin works and how much is needed. These calculations are rarely perfect and can result in a tremendous emotional and mental burden for those of us living with diabetes, and caregivers. This is just one small example to support the need for emotional support while living with diabetes.
Impact
If not treated properly, people with T1D are vulnerable to health issues ranging from minor to severe. If blood glucose levels spend too much time outside the recommended healthy range, this can lead to potentially deadly episodes of hyperglycemia or hypoglycemia. Chronic hyperglycemia often causes devastating health complications later in life, including blindness, kidney failure, heart disease and nerve damage.