Type 1 diabetes is a chronic (life-long) autoimmune disease that prevents your pancreas from making insulin. Insulin is an important hormone that regulates the amount of glucose (sugar) in your blood. Under normal circumstances, insulin functions in the following steps:
If you don’t have enough insulin, too much sugar builds up in your blood, causing hyperglycemia (high blood sugar), and your body can’t use the food you eat for energy. This can lead to serious health problems.Type 1 diabetes was previously known as juvenile diabetes and insulin-dependent diabetes.
Type 1 diabetes (T1D) can develop at any age, but it’s most commonly diagnosed between ages 4-6 and 10-14. and it occurs almost equally in males and females. While family history isn’t required, having a first-degree relative (parent or sibling) with T1D
increases the risk.
Type 1 diabetes (T1D) is less common than Type 2 diabetes, accounting for about 5-10% of all diabetes cases. Globally, around 1.1 million children and adolescents under 20 are estimated to with T1D. The incidence of T1D is increasing, particularly in younger populations.
Type 1 diabetes develops when the immune system mistakenly attacks and destroys insulin-producing cells in the pancreas, leading to a total insulin deficiency.
The exact cause is not fully understood, but genetics play a significant role. Without a family history, the risk is about 0.4%. If your mother has Type 1 diabetes, your risk is 1% to 4%, and if your father has it, the risk is 3% to 8%. If both parents have Type 1 diabetes, the risk can rise to 30%.
Certain factors, such as viruses or environmental toxins, may trigger the immune attack in individuals with a genetic predisposition.
Symptoms of Type 1 diabetes usually start mild and worsen over time as insulin production decreases. Common symptoms include:
If you or your child exhibit these symptoms, it’s crucial to see a healthcare provider and get tested for Type 1 diabetes as soon as possible.
Early diagnosis and treatment are essential for managing the condition effectively.
Type 1 diabetes is diagnosed through several tests:
Blood Glucose Test: Measures the amount of sugar in the blood. It can be a random test (no fasting required) or a fasting test (no food or drink for at least 8 hours). Very high blood sugar
levels typically indicate Type 1 diabetes
Glycosylated Hemoglobin Test (A1c):
If blood glucose tests suggest diabetes, this test measures average blood sugar levels over the past three months.
Antibody Test: Checks for autoantibodies that attack insulin-producing cells. The presence of certain
autoantibodies confirms Type 1 diabetes, as they are not typically found in Type 2 diabetes.
o Rapid-Acting Insulin: Begins to work within 15 minutes and lasts for a few hours. Used for meal times and to cover high blood sugar.
o Short-Acting Insulin: Starts working within 30 minutes and lasts 3-6 hours. Also used around meal times.
o Intermediate-Acting Insulin:
Takes 1-2 hours to start working and lasts up to 18 hours. Often used to provide basal coverage.
o Long-Acting Insulin: Starts working within 1-2 hours and lasts up to 24 hours or more. Provides a steady level of insulin throughout the day
o Multiple Daily Injections (MDI):
Involves using a vial and syringe or pre-filled insulin pens to inject insulin into the fatty tissue of the belly, upper arm, thigh, or buttocks. This method is usually less expensive but requires frequent injections.
o Insulin Pump: A small device that continuously delivers insulin through a catheter inserted under the skin. The pump allows for more precise insulin delivery and can be programmed to
adjust insulin rates based on blood sugar levels.
o Rapid-Acting Inhaled Insulin:
An alternative to injections, this type of insulin is inhaled through the mouth, similar to using an asthma inhaler. It works quickly but is less commonly used due to availability and cost.
Blood Glucose Meter: Requires a finger prick to obtain a small blood sample, which is placed on a test strip inserted into the meter. Results appear within seconds and provide a snapshot of blood sugar levels at that moment. This method is the most common and affordable home testing option.
Continuous Glucose Monitoring (CGM): a small sensor is placed over the arm . The sensor continuously measures glucose levels in the interstitial fluid and sends data to a receiver or smartphone app. CGMs provide real-time data, trends, and alerts for high or low blood sugar, reducing the need for frequent finger sticks.
Purpose: To match insulin doses with the amount of carbohydrates consumed, as carbs significantly impact blood sugar levels. This involves counting grams of carbs in meals and snacks.
Insulin-to-Carb Ratio: A personalized ratio used to determine how much insulin is needed for a specific amount of carbohydrates. This ratio can vary based on factors like time of day, activity level, and current blood sugar levels. Your endocrinologist will help establish and adjust this ratio as needed.
Current Status: There is no cure, but research is ongoing. Studies like TrialNet aim to understand and potentially prevent the onset of Type 1 diabetes.
Experimental Treatments:
Pancreatic Islet Transplantation:
Involves transplanting insulin-producing cells from a donor pancreas into the recipient. This is still experimental and typically available through clinical trials.
Genetic Predisposition: There is no known way to prevent Type 1 diabetes. Family members of those with Type 1 diabetes can be tested for autoantibodies, which may indicate a higher risk of developing the disease.
Management: Effective management can lead to a good quality of life. However, poorly controlled diabetes can lead to serious complications. Complications may include:
Daily Management:
Mental Health: Address emotional challenges and seek support if needed.
Support Network: Engage with diabetes communities and educate those around you.
Care Responsibilities:
Emergency: If experiencing symptoms of diabetic ketoacidosis (DKA), such as high blood sugar, nausea, vomiting, and rapid breathing, seek emergency care immediately.
Hypoglycemia (Low Blood Sugar): Occurs when insulin levels are too high relative to food intake or physical activity, leading to blood sugar levels below 70 mg/dL. Symptoms include:
Treatment: Follow the “15-15 rule”:
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