What is Type 1 Diabetes?

Type 1 diabetes is a lifelong condition where the pancreas stops producing insulin, a hormone that helps to control blood sugar. Without insulin, sugar stays in the blood, causing high blood sugar (hyperglycemia), which can further lead to serious health issues. People with type 1 diabetes generally require daily synthetic insulin to survive. 

Unlike type 2 diabetes, which is linked to insulin resistance and lifestyle factors, type 1 is mainly caused by an autoimmune reaction. Although type 1 diabetes usually begins in children, it can develop in individuals of any age. Keep reading to get an in-depth understanding of type 1 diabetes.

Causes and Risk Factors of Type 1 Diabetes

The main cause of type 1 diabetes is still unknown. In general, the immune system defends the body against harmful viruses and bacteria. In type 1 diabetes, the immune system wrongly attacks and destroys the insulin-producing cells in the pancreas.

Numerous risk factors can be the cause of type 1 diabetes, which mainly include:

• Genetics

• Exposure to environmental factors and viruses

How Type 1 Diabetes Affects the Body?

Type 1 diabetes develops when the immune system attacks or destroys cells in the pancreas that produce insulin.

• This leads to a lack of insulin production while disrupting the body's ability to regulate blood sugar.

• The deficiency significantly impacts metabolism as the body cannot use glucose for energy effectively. 

Symptoms and Diagnosis of Type 1 Diabetes

The symptoms of type 1 diabetes generally include:

• Urinating more often

• Feeling more thirsty than usual

• Feeling extremely hungry

• Bed-wetting in children who have not wet the bed previously

• Mood swings or irritability

• Unintended weight loss

• Blurry vision

• Feeling weak or tired

Diagnosing type 1 diabetes is relatively simple. A healthcare provider may ask for the following tests in case a person has symptoms of type 1 diabetes:

• Glycosylated hemoglobin test (A1c)

• Blood glucose test

• Antibody test

Management and Treatment for Type 1 Diabetes

People with type 1 diabetes generally require synthetic insulin per day or multiple times a day to live and stay healthy. They also need to try to keep their blood sugar levels within a healthy range.

Since numerous factors affect blood sugar levels, type 1 diabetes management is highly individualised and complex. Some of the main components of type 1 diabetes management include:

• Insulin therapy: There are various types of insulin therapies that can aid in the lifelong management of type 1 diabetes, based on the healthcare provider’s recommendation. These include short-acting, rapid-acting, intermediate-acting, and long-and-ultra-acting insulin.

• Monitoring blood glucose levels: One needs to check the blood glucose levels at least 4 times a day, but this depends on the type of insulin therapy being administered.

• Lifestyle adjustments: In general, several lifestyle adjustments are to be made and implemented on a daily basis. This includes scheduling yearly physical exams and routine eye check-ups, wearing a tag that says one is diagnosed with diabetes, staying up to date with vaccinations, keeping cholesterol and blood pressure under control, etc.

Long-term Complications of Type 1 Diabetes

Diabetes complications can cause several disabilities and may even be life-threatening. Over time, the complications of type 1 diabetes can affect major organs in the body, which generally include:

• Diabetes highly increases the risk of heart and blood vessel diseases. These mainly include heart attacks, coronary artery disease with chest pain (angina), narrowing of the arteries (atherosclerosis), high blood pressure, and stroke.

• High blood sugar levels can damage the walls of small blood vessels (capillaries) that supply the nerves. This can particularly affect the legs and can cause numbness, tingling, pain, or burning.

• Over time, poorly controlled blood sugar may also be the cause of loss of sensation in the affected limbs.

Living with Type 1 Diabetes

Type 1 diabetes is a difficult condition that highly requires effort, planning, and daily management. Some essential tips that can help manage diabetes involve:

• Counting carbohydrates helps to manage blood sugar by matching insulin to the food. It even allows more flexibility in what a person eats. An individual can learn this through courses like DAFNE (Dose Adjustment for Normal Eating) or by simply consulting a healthcare provider.

• Regular exercise or any physical activity can also be beneficial in controlling blood sugar levels and maintaining overall health during diabetes.

• Monitoring blood sugar with a CGM (Continuous Glucose Monitor) or a glucometer is important for managing diabetes and avoiding complications. An individual must monitor their blood sugar before and after meals, as well as before bed, to address high blood sugar quickly.

• One must follow the doctor’s instructions for taking insulin and other medications if required.

• Regular visits to the endocrinologist are essential to ensure that the diabetes management plan is working. 

• One must consult other healthcare providers regularly, especially the eye specialist, as type 1 diabetes majorly affects the eyes.

• Individuals can ask an endocrinologist how to manage diabetes when they are sick since illness can cause diabetes-related DKA (ketoacidosis). Therefore, it is important to always be ready.

Upcoming Research and Advances

Currently, there is no cure for Type 1 diabetes, but scientists are researching different ways to slow down or prevent the progression of the condition, which mainly involve:

• Replacing lost beta cells in Type 1 diabetes could restore blood sugar control, but immune attacks often destroy them again. Dr. Song's new immunotherapy prevents these attacks and reduces inflammation without requiring immunosuppressive drugs. This therapy offers personalised treatment and long-lasting effects and may even improve islet transplant success.

• Scientists are also researching pancreatic islet transplantation, which is an experimental treatment for Type 1 diabetes. It helps to replace damaged islets with donor cells that produce insulin and is currently available only through research studies.

Support and Resources for Type 1 Diabetes

Many diabetes support groups offer ongoing assistance to people with diabetes. This helps to reinforce and maintain the skills, knowledge, and lifestyle changes gained from DSMES (Recognised Diabetes Self-Management Education and Support) services.

Diabetes support groups are also an excellent way for patients to easily connect with online resources and applications in their community. Here are some of the resources that may be useful for the patients:

• AACE (American Association of Clinical Endocrinologists) 

• Academy of Nutrition and Dietetics

• ADA (American Diabetes Association)

Conclusion

There’s no way to prevent type 1 diabetes yet, but researchers are working on ways to protect islet cells in newly diagnosed patients. The patient can ask their doctor about clinical trials and consider the risks and benefits carefully.

While type 1 diabetes is lifelong and can feel overwhelming, individuals can manage it by learning to control their blood sugar levels and making healthy lifestyle choices.