When the body doesn’t produce enough insulin to maintain a healthy glucose level (sugar), it results in Type 1 diabetes. According to the National Institute of Diabetes and Digestive and Kidney Diseases, it is most often diagnosed in children and young adults, although it may occur at any age (NIDDK).
Why Blood Sugar Levels Soar in People With Type 1 Diabetes
For energy, your body uses glucose, an essential sugar, which breaks down in the usual digestive process to digest the food you ingest. According to the American Diabetes Association (ADA), insulin, a hormone generated by the pancreas, helps the liver, muscle, and fat cells absorb sugar.
The pancreas’s insulin-producing beta cells are destroyed by the body’s immune system in type 1 diabetes. Hyperglycemia, or high blood sugar, occurs when the body lacks this hormone.
Endocrinologist Charles Scott Thomas, MD, of Kaiser Permanente Los Angeles Medical Center in Los Angeles, says, “We don’t know precisely what prompts this autoimmune process to commence.” Genetic and environmental factors may play a role in determining a patient’s risk.
Type 1 diabetics must inject insulin every day and check their blood glucose levels periodically throughout the day.
Type 1 vs. Type 2 Diabetes
Blood sugar levels that are excessively high are a symptom of both type 1 and type 2 diabetes. However, their approaches to it are vastly different.
Since type 1 diabetes is an autoimmune illness, it causes the body to generate very little or no insulin. According to the CDC, there is no way to stop it from taking place.
According to the CDC, “insulin resistance” occurs when cells in the body’s fat, muscle, and liver do not react adequately to insulin. Instead of entering the cells effectively, glucose builds up in the circulation.
Glucose levels rise in people with type 2 diabetes, and the pancreas reacts by generating more insulin. If your pancreas stops producing enough insulin regularly, your blood sugar will continue to climb.
The CDC estimates that between 90 and 95 percent of people with diabetes have type 2 diabetes. Changing one’s diet and exercising regularly may often help one avoid or postpone the onset of diabetes.
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Type 1 Diabetes Symptoms and Signs
Sanjoy Dutta, PhD, vice president of research at JDRF, explains that type 1 diabetes symptoms may emerge quickly, particularly in young individuals. The following symptoms are listed by the NIDDK:
- Excessive thirst
- Frequent urination
- Increased hunger
- Fatigue
- Blurry vision
- Unexplained weight loss
According to Dr. Dutta, weight reduction may occur in spurts. It’s possible to lose 10 kilos (22 pounds) in two weeks in certain situations.”
According to Dr. Thomas, the start of type 1 diabetes in very young children might be challenging to identify. Diaper wetting, bedwetting, and an increase in thirst are all symptoms that something is wrong.
The condition is known as diabetic ketoacidosis (DKA)
Diabetes type 1’s other potentially life-threatening condition is ketoacidosis, adds Dr. Dutta, and this is especially true for children and adolescents. Diabetic ketoacidosis (DKA) occurs when insulin declines and the body cannot utilize your growing blood glucose as fuel; instead, it burns fat, leading to a buildup of acids in the bloodstream ketones, which may be fatal. Symptoms of DKA, according to the MedlinePlus handbook from the National Library of Medicine, include:
- Fruity-smelling breath
- Confusion or fatigue
- Difficulty breathing
- Dehydration
- Dry skin and mouth
- Facial flushing
- Increased urination or thirst
- Headache
- Achy or stiff muscles
- Stomach pain, nausea, or vomiting
DKA requires rapid medical assistance, which may need a trip to the hospital. DKA may be detected via a blood or urine test for ketones. Insulin injections and fluid replenishment are part of the treatment plan.
Type 1 diabetes is often discovered due to an episode of diabetic ketoacidosis (DKA), especially in children and adolescents. While this may happen to everyone who has type 1 diabetes at any age, it is more common for people to get the condition in their middle or older years, which means they are more likely to already be under a doctor’s care because of their high blood sugars.
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Type 1 Diabetes: Causes and Risk Factors for the Disease
Researchers believe that a mix of genetic and environmental variables may be responsible for developing type 1 diabetes. For example, MedlinePlus reports that having certain HLA complex gene variations increases your chance of developing type 1 diabetes. Proteins produced by these genes are crucial to the body’s immunological response. (1)
New research suggests that long-term viral infection may raise a child’s chance of acquiring type 1 diabetes, linked to coxsackieviruses and other viruses. (2)
Among the other probable risk factors for type 1 diabetes are as follows:
- The fact of my being a man. According to Thomas, men are 1.5 times more likely than women to be diagnosed with type 1 diabetes.
- The presence of autoantibodies that are linked to an increased danger
- Per the CDC, European ancestry is a risk factor for the disease (although it may affect persons of any race or ethnicity). According to the ADA, HLA-DR3 and HLA-DR4 are the most common gene variations in white persons with the illness.
- Type 1 diabetes is a familial disease that affects a close relative.
One in every 17 men with type 1 diabetes will give birth to a kid with the disease. If a woman has a kid before the age of 25, her risk is one in 25, but if she has a child after 25, the risk reduces to one 100.
According to the JDRF, 80 percent of those diagnosed with type 1 diabetes have no family history of the condition.
How Is Type 1 Diabetes Diagnosed?
Thomas explains that the first step in diagnosing type 1 diabetes is testing for extremely high blood sugar levels. It is essential to find out if the high blood sugar is related to the pancreas losing the capacity to produce enough insulin, and to test the antibody levels that are often seen in type 1 diabetes.”
Tests for Blood Glucose
According to the NIDDK, your healthcare practitioner may order the following tests to identify type 1 diabetes.
Glucose readings at random Taking this blood sugar test do not need fasting before blood collection. Diabetes is diagnosed if your blood sugar level is over 200 milligrams per deciliter (mg/dL). (3)
The hemoglobin A1C test reveals your three-month average blood sugar level. It is not necessary to fast to get a blood sample. Diabetic patients have an A1C level greater than or equal to 6.5.
If you haven’t eaten or drunk anything except water for at least eight hours, a fasting plasma glucose test measures how high your blood sugar is. A blood glucose level of 126 mg/dL or greater indicates diabetes.
Tests for Autoantibodies
According to the University of Rochester Medical Center Health Encyclopedia, your doctor may request a diabetic autoantibody test to discover autoantibodies that target insulin or pancreatic cells involved in its synthesis, as well as specific enzymes.
Other Tests for Diagnosis
Type 1 diabetes may also be diagnosed with the use of the following tests:
- What may measure insulin production byproducts with a c-peptide test, which can reveal how much insulin your body produces in conjunction with a glucose level?
- A blood test for insulin Unlike C-peptide tests, this one measures insulin levels in your bloodstream.
If you’ve been diagnosed with type 1 diabetes, Dutta advises you to seek treatment from an endocrinologist. A primary care physician does not have the expertise to treat type 1 diabetes, which is very different from type 2 diabetes. “I’m not saying that a general practitioner will not be helpful, but a primary care physician does not have the expertise to treat type 1 diabetes, which is very different from type 2 diabetes.”
A Diabetic Patient’s Future Prognosis
A study published in Cardiovascular Endocrinology and Metabolism in June 2020 found that those with type 1 diabetes who reach the age of 43 have a life expectancy of roughly eight years less than those without the disease.
A 2015 Scottish research published in the Journal of the American Medical Association reported an average life expectancy of 78 years (JAMA). At the age of 20, males with type 1 diabetes were 11 years less likely to live than men who did not have the condition in that research. The research published in JAMA indicated a 13-year drop in the life expectancy of women.
Type 1 diabetes can affect your life expectancy, depending on how well you manage it.
People with type 1 diabetes who had rigorous therapy for 6.5 years had a slightly decreased risk of complications and a lower overall risk of early mortality, according to a second JAMA study published in January 2015.
Duration of Type 1 Diabetes
Diabetics with type 1 diabetes must constantly monitor their blood sugar levels throughout their lives. According to Thomas, there is a continual need to consider diabetes for many young individuals. When it comes to living a whole and successful life, type 1 diabetics may tap into an inner force they didn’t know they possessed, even though their path will differ from others who don’t have the disease.
Dutta, on the other hand, has a more upbeat outlook. “Is there a treatment? No. Despite progress in the clinic, no recognized medicine for curing type 1 diabetes has been developed. People with diabetes are becoming better at managing their condition because of glucose monitoring and insulin administration innovations.
Type 1 Diabetes Medication and Treatment Options
“Insulin treatment remains the cornerstone of type 1 diabetic care,” adds Thomas. This is the primary method of maintaining blood sugar at a healthy range throughout the day.
Therapy with Insulin
As the American Diabetes Association (ADA) and the University of California San Francisco’s Diabetes Teaching Center explain, there are two significant forms of Insulin given to keep you going all day: (4, 5)
- Insulin is injected into the body at regular intervals. Even if you don’t eat for a while, this fluid will remain in your body. NPH — Humulin N (isophane), Novolin N, and Lente (Lente) — Detemir (Levemir), Tresiba (deludec), and Basaglar, Lantus, and Toujeo are examples of intermediate- and long-acting insulins that are slowly delivered into the circulation to endure (glargine).
- Insulin bolus or lunchtime insulin is administered to cover the glucose you get from eating. If you have recently eaten a large meal, you will need to inject a smaller bolus insulin dosage. Novolog (insulin aspart), Apidra (insulin glulisine), and Humalog are examples of fast-acting or regular-acting insulins (insulin lispro). They begin functioning within 15 to 30 minutes and continue for many hours after being taken before a meal.
According to the JDRF, insulin treatment entails the use of one of the following injection methods typically:
- A syringe with a needle With a disposable needle and prefilled syringe, Insulin is taken from a vial and injected directly into the subcutaneous fat layer.
- Pen with Insulin in it Insulin is injected into the body using a disposable needle and a pen with a prefilled cartridge of Insulin or pulls Insulin from the cartridge using a disposable syringe.
- Infusion set A computerized device delivers Insulin through a tiny catheter taped beneath the abdomen’s skin. Using information provided by patients, the pump may recommend an insulin dosage based on the number of carbs they expect to consume and their current blood sugar level,” adds Thomas.
As of 2016, the Health Care Cost Institute estimates that only 53% of the 7.4 million Americans who take Insulin inject it using vials and syringes, with the other 46% using prefilled insulin pens. According to the second research published in the Journal of Clinical Medicine, an estimated 350,000 patients in the United States utilize pumps.
Glucose Monitoring
Glucose monitoring is an integral element of type 1 diabetes management. People with diabetes often use one of the following ways to check their blood sugar:
- An instrument for measuring blood sugar. The FDA defines it as a portable gadget that examines a sample of your blood, which you collect by stabbing your finger with a lancet and then depositing the blood drop on a disposable test strip. Once that’s done, the meter is plugged in. Talk to your doctor about which meter is best for you, and check with your insurance company to see if any expenses are reimbursed.
- Wearing a continuous glucose monitor (CGM) all the time allows you to monitor and record your blood sugar levels at any time. It’s possible to test glucose levels in the fluid between fat cells using a 12 inch long, thinner-than-a-needle sensor, which the NIDDK developed. Sensor data is sent to a receiver or app on a smart device through a transmitter attached to the sensor. A few of the most popular CGMs include the Dexcom G6, the Freestyle Libre, and Medtronic Guardian Connect.
According to Thomas in addition to seeing their blood sugar levels in real-time, patients may also identify patterns. Using this information, they may better understand how their lifestyle affects their blood sugar and prevent dangerous fluctuations.
An integrated CGM may provide information about the patient’s present blood sugar level and the overall trend of their blood sugar to the insulin pump.” According to Thomas, this gives the pump the ability to adjust insulin administration to keep blood sugar levels within a safe range. “These gadgets give a helping hand, but the patient must still be actively engaged in his or her diabetes control.”
Treatments for Type 1 Diabetes Besides Insulin Pump Therapy
Type 1 diabetes therapies that aren’t as well known include:
- The pancreas is an artificial organ. According to Dutta, this cutting-edge gadget combines an insulin pump with a continuous glucose monitor (CGM) and a dosage algorithm. Dependent on the CGM measurement and a five-minute moving average, the algorithm tells the pump, “You administer X units of insulin,” and it fluctuates based on your glucose levels. His FDA-approved artificial pancreases include the MiniMed 670G and 770G hybrid closed-loop systems from Medtronic and the Control-IQ closed-loop device from Tandem Diabetes Care. (The FDA recalled MiniMed 670Gs in February 2020 due to a problem that might lead to improper dosing: the retainer rings were damaged or missing.)
- The use of a jet engine According to the Food and Drug Administration, an injector with an insulin cartridge administers insulin under the skin through a jet of air.
- Insulin was inhaled. According to the ADA, rapid-acting inhaled insulin is administered at the start of each meal by inhaling powder via the lips into a device. Afrezza is the brand’s name that sells it (insulin human).
- Pramlintide, The MedlinePlus website, states that this medicine is used in conjunction with mealtime insulin and slows the transit of food through the stomach to prevent blood sugar spikes after meals.
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Type 1 Diabetes Prevention
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says researchers are looking at methods to prevent or at least halt the development of type 1 diabetes.
A study published in August 2019 in the New England Journal of Medicine revealed that persons with type 1 diabetes who had relatives with the condition were given the monoclonal antibody medication teplizumab, which is now in phase 3 clinical trials. (6, 7)
Type 1 Diabetes Complications
Chronically high blood sugar may cause a wide range of health issues, according to the National Institute on Diabetes and Digestive and Kidney Diseases. These are a few examples:
- Heart disease
- Stroke
- Kidney disease
- Low blood sugar, or hypoglycemia
- Nerve damage, or diabetic retinopathy
- Slow-healing wounds
- Foot problems
- Limb amputations
- Eye problems and blindness, or diabetic retinopathy
- Dental disease
- Bladder problems
- Sexual dysfunction
COVID-19, the respiratory illness caused by the new coronavirus, may significantly increase your risk of complications if you have any diabetes. According to Thomas ‘ research, uncontrolled diabetes and COVID-19 infection may cause more severe symptoms, substantial lung involvement, and death in individuals. According to the CDC, about 40% of COVID-19 fatalities in the United States have occurred in patients with diabetes.
Type 1 Diabetes Management: Nutrition and Exercise
According to the JDRF’s UK division, there is no one-size-fits-all diet or activity regimen for those with type 1 diabetes. If you live a healthy lifestyle, your blood sugar levels will remain in a reasonable range. Before beginning any diet or fitness regimen, consult with your doctor to confirm that the adjustments you are making are safe and suitable for you.
Diet
There are some benefits to working with a registered dietitian nutritionist (RDN) certified in diabetes care and education (CDCES), such as helping you identify the meal plan that works best for you. Ask your doctor for a recommendation or look for an RDN in your region in the academy’s directory. (8)
Carb counting (the tracking of your consumption of carbs, which break down into glucose) and a protein, fat, and fiber ratio are all recommended by the JDRF UK as ways to keep blood sugar levels stable.
If you’re taking any medicine or insulin, your healthcare staff can assist you in determining the ideal dosage. According to the Diabetes Teaching Center at the University of California, San Francisco, carbohydrates should account for 45 to 65 percent of total daily calories for most persons with diabetes.
Vegetables and fruits; whole grains; fat-free or low-fat milk products (unless you are a vegetarian; lean meats, poultry, fish; beans; eggs; and nuts and seeds) are all likely to be included in a balanced diet, according to government standards. Saturated fat, cholesterol, salt, and added sugars should be limited in your diet. Take care to avoid trans fats in your diet.
Exercise
As part of diabetes care, the National Institute on Diabetes and Digestive and Kidney Diseases (NIDDK) recommends physical exercise. Make careful to speak with your doctor before starting an exercise program. Exercise regimens may need to be adjusted if diabetic complications such as nerve damage or low blood sugar.
Aim for 150 to 300 minutes of moderate-intensity physical activity per week or 75 to 150 minutes of vigorous-intensity physical activity per week. If you can speak but not sing throughout the action, if you can’t utter more than a few words without stopping to take a breath, it’s a more vigorous-intensity exercise. Again, your healthcare practitioner will assist you in determining the most appropriate kind of exercise for your particular condition.
A Look at the Facts: How Many People Have Type 1 Diabetes?
People of all ages might be affected by Type 1. Type 1 diabetes statistics include the following:
- The Centers for Disease Control and Prevention estimates that at least 1.4 million persons aged 20 and older have been diagnosed with type 1 diabetes or 5.2 percent of all adults with diabetes.
- According to the CDC, type 1 diabetes affects at least 187,000 children under the age of 20.
- As many as 27,000 children and 37,000 adults are newly diagnosed with type 1 diabetes in the United States each year, according to research released last year and published by the medical journal BMC Medicine.
- The cost of treating type 1 diabetes might be prohibitive. According to the Health Care Cost Institute, persons with type 1 diabetes spent an average of $5,705 per year for insulin in 2016.
Type 1 Diabetes and BIPOC
Regarding type 1 diabetes, Hispanics, non-Hispanic Asian and Pacific Islanders, and Black children and teens showed the most significant yearly percentage increases between 2002 and 2015, the Centers for Disease Control and Prevention (CDC) reports.
According to Thomas, youth from BIPOC communities, especially those from lower socioeconomic status groups, have a higher risk of developing DKA. In a 2018 research published in Diabetes Care, the authors (who did not include Thomas) hypothesized that insurance coverage and parental education were primarily responsible for the discrepancy.
Diabetes Type 1: Our Favorite Sites for Learning More
As previously said, type 1 diabetes is a long-term condition that needs constant monitoring. This may be a frightening reality for someone who has recently gotten a diagnosis. Do your best to learn as much as possible, and don’t be afraid to ask for assistance if you need it. “Get to know the disease’s symptoms. He says, “Knowledge is power.”
It’s a socially complex sickness; therefore, don’t be afraid to tell others about it. Remind yourself that “you didn’t acquire it because you did anything wrong or were overeating.” His other recommendation is to join in clinical studies if possible since this would contribute to the discovery of new medicines and, maybe, a cure.
Using the following resources, you may learn more about the condition, seek support, receive assistance obtaining medicine, manage life with type 1 diabetes, and participate in clinical studies.
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