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Type 1 diabetes: An introduction

This form of diabetes occurs when the body's immune system attacks the pancreas, resulting in a lack of insulin and too much sugar in the blood. Though it can't be prevented, treatment can help control the disease.

Diabetes is a group of diseases that occur when the body can't produce insulin or process it properly. As a result, too much sugar stays in the blood. Over time, this can lead to a variety of serious complications including heart disease, kidney failure and blindness.

Type 1 and type 2 diabetes account for nearly all cases of this disease. But according to the Centers for Disease Control and Prevention (CDC), only about 5% of the people with diabetes have type 1.

Type 1 diabetes: A lack of insulin

Type 1 diabetes happens when the body produces no or very little insulin—a hormone that transports glucose (sugar) from the blood to the cells where it is used for fuel. As a result, unused glucose builds up in the blood.

This shortage or complete absence of insulin happens because the pancreas, which produces insulin, is attacked by the body's own immune system. The immune system destroys the specific cells in the pancreas that produce insulin.

The exact cause of type 1 diabetes isn't known, according to CDC. Certain genes confer an increased risk of developing the disease, and it's also thought that exposure to unidentified environmental triggers, such as viruses, causes the body to attack itself.

Type 1 diabetes usually develops in children and young adults, but it can occur at any age, according to CDC. It's more common among whites than other racial groups. There is no known way to prevent type 1 diabetes.

Quick onset of symptoms

Type 1 diabetes doesn't always cause symptoms. According to CDC and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), symptoms of type 1 diabetes may include:

  • Excessive thirst.
  • Frequent urination.
  • Extreme hunger.
  • Weight loss.
  • Blurred vision.
  • Extreme fatigue.

Nausea, vomiting or stomach pain may accompany these symptoms.

If you have symptoms of diabetes, see your doctor. A blood test can check for the disease.

Complications

According to the NIDDK, the complications of diabetes can affect many parts of the body.

These complications include:

  • Cardiovascular problems, including heart disease, heart attack and stroke.
  • Loss of vision and blindness.
  • Kidney failure.
  • Nerve damage, which can cause pain or numbness in your feet, hands and limbs.
  • Impaired circulation to the feet, which can cause wounds to heal slowly or become infected. In severe cases, a foot wound that doesn't heal may end up leading to amputation.

Blood sugar that's too high can lead to a condition called diabetic ketoacidosis (DKA). This is a life-threatening situation. The signs include vomiting, nausea, shortness of breath and a fruity smell on the breath. If untreated, DKA can lead to a coma or death.

Blood sugar that's too low can also be dangerous and cause unconsciousness.

Controlling the disease

People with type 1 diabetes must take insulin each day in order to live, according to CDC. Insulin can be delivered by injection or with an insulin pump.

The amount of insulin you use is determined by how much food you eat and how active you are. You'll need to check your blood sugar frequently to make sure you're getting the right balance.

According to the NIDDK, treatment for type 1 diabetes also includes:

  • Following a healthy meal plan.
  • Being physically active.
  • Controlling blood pressure and cholesterol.

Work closely with your healthcare team. You'll need regular checkups to measure your average blood glucose, your blood pressure, your cholesterol and the health of your eyes, among other things.

Some people with type 1 diabetes benefit from what is called tight control. That means keeping blood glucose as close to normal as possible by checking blood sugar and adjusting insulin more frequently. According to the American Diabetes Association, tight control helps prevent or slow some complications. However, tight control isn't for everyone, and it should be done only with a doctor's supervision.

What the future holds

Scientists are working on possible cures for type 1 diabetes. One is a pancreas transplant, and another is to transplant islet cells—the cells in the pancreas that make insulin. These procedures are promising, but each has drawbacks. A pancreas transplant is a major surgery and usually is performed with a kidney transplant in people with serious complications from diabetes.

Islet cell transplant is a much simpler surgery, but more research is needed to find out how long the cells will survive. In both cases, the person must take anti-rejection medicine for the rest of his or her life.

Another major focus of research, this one in the area of managing type 1 diabetes, has been in developing a fully automated system called an artificial pancreas. Acting like a real pancreas, the system has three main components: a sensor to read blood glucose levels and send data to a computer; an insulin pump or other delivery mechanism; and the computer that runs the show. The goal is to relieve individuals of having to carry out these steps manually several times a day. 

Learn more

For more information, visit the Diabetes health topic center.

reviewed 7/18/2019

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