What is type 1 diabetes?

Type 1 diabetes is a condition that causes high blood sugar because the pancreas makes too little insulin or doesn’t make any insulin at all. It accounts for 5 to 10 percent of diabetes cases.

When someone has this condition, they may experience symptoms like feeling hungry, thirsty and tired.  They may also pee more often, have unexplained weight loss and blurry eyesight. This condition isn’t preventable, and it doesn’t have a cure, yet. However, treatment can help people manage their symptoms.

Read on to learn more about type 1 diabetes, its causes and symptoms, getting a diagnosis, and managing the condition.

In this article:

What is type 1 diabetes?

Type 1 diabetes is an autoimmune condition where the immune system mistakenly attacks and damages insulin-producing cells in the pancreas. This makes the pancreas unable to produce insulin. Insulin is a hormone that helps direct sugar to organs and helps sugar enter cells so they can use it for energy.

“Without insulin, sugar remains in the blood at high levels. Virtually every organ in the body can be negatively affected by elevated blood sugar over time,” explains Jennie Stanford, MD, dual board certified in family medicine and obesity medicine. High blood sugar harms organs like the eyes, gums, heart, kidneys, liver, nerves and teeth when it is left unmanaged.

Type 1 diabetes used to be called juvenile diabetes or insulin-dependent diabetes. It is typically diagnosed in children and young adults, but it can show up in anyone at any age. Up to half of cases occur in adults.

Type 1 diabetes is not the same as type 2 diabetes, which is the most common type of diabetes. Type 2 diabetes is a condition that can sometimes be prevented or delayed. While it previously was only seen in adults, the rise of obesity and poor nutrition in children has led to increasing numbers of type 2 diabetes cases occurring in children and adolescents.

Type 2 diabetes occurs when the body doesn't make or use insulin properly. This condition is likely to occur due to factors like not being physically active, unhealthy eating, lifestyle habits, insulin resistance and genetics.

Causes of type 1 diabetes

No one knows for sure what causes type 1 diabetes, but experts believe that it’s due to a combination of an autoimmune response, environmental factors and genes.

Autoimmune response

Type 1 diabetes occurs when the immune system mistakenly attacks and destroys the beta cells in the pancreas that make insulin. This autoimmune response can happen for months to years until the beta cells stop making insulin and someone starts having symptoms. Nonetheless, recent studies suggest that type 1 diabetes can be delayed, and health care providers can identify early stages before symptoms appear.

Environmental triggers

Sometimes, things in the environment, like viruses or stressors, can contribute to someone developing type 1 diabetes by triggering the body to attack its insulin-making cells.

Genes

Specific genes, such as the human leukocyte antigen (HLA) genes, may make a person prone to type 1 diabetes, especially when they are young. Studies have found that if one twin has type 1 diabetes, the other twin has up to a 70 percent chance of also developing it. The risk for other siblings is around 8 to 10 percent.

Just having these genes doesn't mean someone will develop type 1 diabetes, though. Many people with type 1 diabetes don't have a family history of diabetes. Neither do they have the gene that carries the highest risk for the condition.

Symptoms of type 1 diabetes

Type 1 diabetes symptoms often appear suddenly. They include the following:

• Blurry vision
• Breath that smells fruity
• Dehydration
• Feeling hungry and thirsty often
• Muscle pain and stiffness
• Nausea and vomiting
• Peeing often
• Stomach pain
• Tiredness
• Unexplained weight loss

Diagnosing type 1 diabetes

A health care provider may evaluate for type 1 diabetes by first asking about the person’s health history, family history and medications they may be taking.

The health care provider may then do a blood test to check blood sugar levels. These are tests that may be used:

• The A1C test, which measures the average blood sugar level over the last two or three months.
• The fasting blood sugar test, which measures blood sugar levels after the person has stayed without food throughout the night.
• The glucose tolerance test, which involves measuring a person's blood sugar before and after drinking glucose (sugar).
• A random blood sugar test, which measures blood sugar at the time the test is taken

The health care provider may also recommend other blood tests, like those that check for antibodies that attack someone’s own cells and urine tests for ketones. The body makes ketones when it breaks down fat for energy. Ketones in the urine could mean the person has type 1 diabetes.

If a person has type 1 diabetes, the health care provider may recommend screening their family members as well.

Treatment options for type 1 diabetes

After a type 1 diabetes diagnosis, the health care provider will create a management plan that involves dietary management, insulin therapy and monitoring blood sugar levels.

• Dietary management: The health care provider may refer the person to a dietitian or nutritionist who will work with them to create a healthy eating plan. This plan could involve balancing how many carbohydrates a person has with their insulin dose or sticking with a consistent carbohydrate intake.
• Insulin therapy: Treating type 1 diabetes involves multiple insulin injections throughout the day, including after eating and drinking, to help manage blood sugar levels. The insulin is usually administered by a pen, pump or syringe.
• Monitoring blood sugar levels: Part of a complete type 1 diabetes management plan involves monitoring blood sugar levels with a continuous glucose monitor or blood sugar meter (called a glucometer). The monitor will track fluctuations caused by drinks, foods, medications and certain activities, helping ensure blood sugar levels stay in a healthy range.

Managing type 1 diabetes

Adding healthy habits to an everyday routine can help people live confidently while managing type 1 diabetes.

Daily routine adjustments

People with type 1 diabetes may need to adjust their daily routine to include getting enough sleep, having healthier meals and tracking food intake. These changes, no matter how small, can build up to improve their diabetes management and well-being. People will likely need to take the time to cook and focus on the foods and ingredients they eat.

Consistent, good-quality sleep is also essential in managing diabetes, because it helps regulate insulin levels and other stress and hunger hormones. People can improve their sleep by staying active during the day and establishing a regular sleep schedule that includes aiming for at least seven hours of sleep per night, following a bedtime routine, reducing screen time before bed and implementing other sleep hygiene practices.

Additionally, setting reminders to take insulin helps ensure someone is taking the correct dose at the right time.

Exercise and physical activity

Exercising and staying physically active provides many health benefits for people with type 1 diabetes. Benefits include helping the body use insulin better, keeping the heart healthy, improving cholesterol levels, maintaining bone strength and reducing the risk of early death.

Small lifestyle changes — for example, taking the stairs instead of an elevator — can help make people more physically active.

However, managing blood sugar levels can be tricky when someone exercises. It’s important for people to speak with a health care provider about what types of exercise they should do and how long they should be active during the day. They should also discuss how to modify their food intake and insulin doses when they exercise to prevent blood sugar levels from dropping too low or going too high.

Coping with stress and emotional challenges

Having type 1 diabetes can bring moments of stress and emotional challenges. The stressors can make it difficult to manage the condition well.

People can manage their stress levels and reduce emotional distress by engaging in hobbies, exercising, following a healthy sleep routine, journaling, meditating, prioritizing rest, reducing caffeine intake, seeking professional help in therapy, spending time with loved ones and taking walks.

Complications associated with type 1 diabetes

Having type 1 diabetes can cause more severe health problems if left untreated or poorly managed.

“As glucose builds up in the bloodstream, it can lead to serious complications in both large and small blood vessels,” says Dr. Stanford. “For example, heart disease can result from high blood sugar in the large arteries of the heart, and blindness can result from ongoing high blood sugar levels in the small arteries of the eyes.”

Health complications associated with type 1 diabetes include the following:

• Bladder problems
• Blood vessel problems
• Diabetic ketoacidosis (DKA)
• Eye damage
• Gum disease
• Heart disease
• Increased infections
• Kidney damage
• Liver disease
• Nervous system damage
• Sexual dysfunction
• Skin problems
• Stroke

Advances in type 1 diabetes research

Innovative treatment methods

Having type 1 diabetes means someone has to take insulin for life. Still, innovative treatment methods for improving blood sugar control, such as continuous glucose monitors and automated insulin delivery systems like the artificial pancreas, have made managing it easier.

A continuous glucose monitor checks blood sugar levels day and night. The artificial pancreas consists of a continuous glucose monitor that automatically checks blood sugar levels 24/7, an insulin pump that delivers insulin to the body when needed and an app that tracks blood sugar levels.

Vaccines and immune therapies

Researchers are looking to develop therapies that use the body’s immune system to protect insulin-producing beta cells, keep them working for longer, and slow down or even prevent their destruction in type 1 diabetes. So far, teplizumab is the first and only immunotherapy approved for delaying the progression of type 1 diabetes in adults and children ages 8 years and older with early-stage disease.

Other promising new treatments are being studied and developed. However, some challenges remain, like ensuring the treatments work for everyone and ensuring they are effective in the long term.

Living with type 1 diabetes

Living with type 1 diabetes means having to undergo insulin therapy for life, because there currently isn’t currently a cure for the condition. However, it's possible for people to lead a comfortable and active life with type 1 diabetes by making small but consistent changes to their daily eating, exercising and sleep routines.

People living with type 1 diabetes should work with a health care provider to determine the most appropriate management plan for their case. It’s important to follow a prescribed insulin schedule as much as possible and tell a health care provider about any worrying side effects. This will help to prevent or delay long-term complications associated with uncontrolled type 1 diabetes.

Frequently asked questions

What is the difference between type 1 and type 2 diabetes?

In type 1 diabetes, the immune system mistakenly attacks and damages the cells in the pancreas that produce insulin (called beta cells), causing them to make little or no insulin. On the other hand, type 2 diabetes occurs when the body's cells don't respond to insulin as well as they should, causing sugar to remain in the blood, rather than be used by cells in the body for energy.

Type 1 diabetes is not preventable, while type 2 diabetes can be. Type 2 diabetes represents around 90 percent of diabetes cases, whereas type 1 diabetes accounts for 5 to 10 percent of cases.

What causes type 1 diabetes?

An autoimmune reaction, genes, and environmental triggers, like stress or viral infections, are factors that can contribute to the development of type 1 diabetes.

Is type 1 diabetes curable?

No, type 1 diabetes isn’t curable. People with type 1 diabetes have to take insulin to treat it.

This content is for informational purposes only and is not medical advice. Consult your health care provider before taking any vitamins or supplements and prior to beginning or changing any health care practices.