Understanding Type 1 Diabetes

Insulin is the hormone that regulates glucose in our body. The carbohydrates (glucose) in our food are the body’s main energy source. Once the carbohydrates are absorbed, glucose levels in the blood rise, signalling the pancreas to release insulin. Insulin is responsible for allowing glucose in our blood to enter muscle, fat, and liver cells so they can use it for energy or store it for later use.
Type 1 Diabetes, which used to be known as insulin-dependent diabetes, is an autoimmune condition in which the pancreas produces little or no insulin, a hormone required for sugar (glucose) to enter cells to produce energy. Unlike Type 2 diabetes, which is characterised by insulin resistance and typically associated with older age and obesity, Type 1 diabetes predominantly develops where the pancreas produces little or no insulin, a hormone required for sugar (glucose) to enter cells to produce energy. Unlike Type 2 diabetes, which is characterised by insulin resistance and typically associated with older age and obesity, Type 1 diabetes predominantly develops at a young age. Type 1 diabetes is often diagnosed at an early age and makes patients entirely Insulin-dependent.
The exact cause of Type 1 diabetes is not entirely understood yet. Still, it mainly involves the immune system causing irreversible damage to insulin-producing β cells of islets of Langerhans in the pancreas. Genetic factors and possibly viral infections might contribute to developing this autoimmune response.
There is no known way to prevent or slow down the onset of Type 1 diabetes. Specialised care and insulin therapy can help patients with Type 1 diabetes manage their condition effectively.
Signs and Symptoms of Type 1 Diabetes
Recognising the signs and symptoms of Type 1 diabetes is critical for early diagnosis and management. The most common symptoms include:
- Increased thirst and frequent urination: Excess sugar buildup in your bloodstream pulls fluid from tissues, causing dehydration. This leads to drinking more than usual and more frequent urination. In certain patients, it causes extreme cravings for cold beverages.
- Unexplained weight loss: Despite eating more than usual to relieve hunger, rapid weight loss is often seen due to the inability to metabolise glucose and use it for energy, leading the body to break down muscle and fat.
- Fatigue: When cells lack glucose, the body becomes energy-deprived, causing severe tiredness.
- Blurred vision: High blood sugar levels can draw fluid from the lenses of your eyes, affecting the ability to focus.
- Mood Swings: Diabetes can affect your mood causing irritability or other mood changes.
Less prevalent symptoms may include nausea, vomiting, and a sweet smell on the breath, often described as fruity. These are signs of possible diabetic ketoacidosis, a life-threatening condition that needs immediate medical attention.
Individuals with Type 1 Diabetes should see a specialist endocrinologist
- Complex Diabetes Management: If managing your Type 1 Diabetes becomes complex, involving frequent hypoglycemia (low blood sugar) episodes or difficulty in maintaining stable glucose levels, an Endocrinologist can provide specialised care.
- Presence of Complications: An endocrinologist’s involvement is crucial for comprehensive care when managing complications related to diabetes, such as diabetic retinopathy, nephropathy, or neuropathy.
- Initiation of Insulin Therapy: Since Type 1 Diabetes requires insulin therapy upon initial diagnosis, consulting an Endocrinologist can ensure that the insulin regimen is appropriately tailored to your needs.
- Changes in Treatment Plan: If the treatment regimen needs to be adjusted or intensified, an Endocrinologist can provide expert guidance on advanced treatment options like insulin pumps or continuous glucose monitors (CGMs).
Pregnancy or Planning for Pregnancy: Managing diabetes during pregnancy requires meticulous control, and Endocrinologists can help adjust your management plan to support a healthy pregnancy.
Seeing an Endocrinologist specialising in diabetology ensures that those with Type 1 Diabetes receive specialised and up-to-date care, aiming to maintain healthy blood sugar control and prevent complications.
At Harmony Thyroid, Endocrinology and Diabetes Centre, our experienced Endocrinologist will typically employ one or more of the following tests:
- Blood sugar tests: Patients may undergo the Glycated haemoglobin (A1C) test, which indicates the average blood sugar level for the past two to three months. A percentage of 6.5% or higher on two separate tests indicates diabetes.
- Autoantibody tests: These tests look for autoantibodies, destructive immune system cells that mistakenly attack your body’s tissue. The presence of specific autoantibodies could be a sign of Type 1 diabetes.
- Fasting blood sugar test: A blood sample will be drawn after an overnight fast. Blood sugar levels are tested, with levels higher than 126 mg/dL on two separate tests typically indicating diabetes.
Endocrinologists may use additional tests to confirm the diagnosis and differentiate between Type 1 and Type 2 diabetes, which require different management strategies.
Type 1 diabetes is a chronic condition. Therefore, it requires lifelong management that may include the following components:
- Insulin therapy: Everyone with Type 1 diabetes needs insulin therapy to survive. Insulin must be injected through the skin into the fatty tissue below. Insulin regimens are highly individualised.
- Blood sugar monitoring: Patients must frequently check their blood sugar levels to adjust their insulin doses accordingly. They can opt for continuous glucose monitoring systems that provide real-time data on blood sugar levels at any time of the day.
- Diet and exercise: A healthy diet combined with consistent physical activity significantly aids in controlling blood glucose levels. Carbohydrate counting is essential in adjusting insulin doses.
- Regular check-ups: Routine visits with Endocrinologists are essential for monitoring and adjusting diabetes management plans.
While Type 1 diabetes is a complex and demanding condition, advancements in treatment and management strategies allow individuals to lead whole, active lives. Recognising symptoms early, seeking timely diagnosis, and adhering strictly to management plans are vital for maintaining health and preventing complications.
If you experience symptoms of Type 1 diabetes, book an appointment with Dr Vikram Sonawane, the Medical Director of Harmony Thyroid Endocrinology and Diabetes Centre and an experienced Endocrinologist.
Dr Vikram is well-versed in the treatment and management of prediabetes, diabetes and complex diabetic cases such as peripheral vascular disease, diabetic foot ulcers, diabetic neuropathy and diabetic kidney disease. His expertise ensures comprehensive care tailored to each patient’s unique needs, from early intervention to managing advanced complications.
References:
- Mayo Clinic. Type 1 Diabetes – Symptoms and Causes. Published September 15, 2023. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011
- Cleveland Clinic. Type 1 Diabetes: Causes, symptoms, complications & treatment. Published March 9, 2022. https://my.clevelandclinic.org/health/diseases/21500-type-1-diabetes