- What is Type 1 diabetes?
- What are symptoms of Type 1 diabetes?
- How does Type 1 diabetes affect the body?
- What causes Type 1 diabetes?
- How do you manage Type 1 diabetes?
- There are two main types of diabetes:
- An Overview of Type 1 Diabetes
- Type 1 Diabetes | NIDDK
- Who is more ly to develop type 1 diabetes?
- What are the symptoms of type 1 diabetes?
- What causes type 1 diabetes?
- How do health care professionals diagnose type 1 diabetes?
- What medicines do I need to treat my type 1 diabetes?
- How else can I manage type 1 diabetes?
- Do I have other treatment options for my type 1 diabetes?
- What health problems can people with type 1 diabetes develop?
- Can I lower my chance of developing type 1 diabetes?
- Type 1 Diabetes Mellitus: Practice Essentials, Background, Pathophysiology
- Type 1 Diabetes
- For Parents
- Symptoms & Risk Factors
- Getting Tested
- Connect with Others
- Type 1 Diabetes: What Is It?
- What Happens in Diabetes?
- What Is Type 1 Diabetes?
- Who Gets Type 1 Diabetes?
- What Are the Signs & Symptoms of Type 1 Diabetes?
- How Is Type 1 Diabetes Diagnosed?
- How Is Type 1 Diabetes Treated?
- What Problems Can Happen With Type 1 Diabetes?
- What's New in the Treatment of Type 1 Diabetes?
- How Can I Help My Child?
What is Type 1 diabetes?
Note: This article is part of our library of resources for Forms of Diabetes.
Type 1 diabetes, which was formerly known as juvenile diabetes, is a chronic autoimmune condition that makes the body unable to produce insulin, which is the hormone that regulates blood sugar. Without insulin, our bodies cannot use the sugar in our bloodstream as energy, causing people to experience Diabetic ketoacidosis (DKA).
What are symptoms of Type 1 diabetes?
There are many signs or symptoms that can be present when someone has undiagnosed or untreated diabetes. Here are a few of those symptoms:
- Unquenchable thirst
- Frequent urination
- Unexplained bedwetting
- Unwanted or unexplained weight loss
- Less energy
- Fruity smelling breath
- Blurry vision
- Stomach pain
- Nausea or vomiting
- Loss of conciousness
- Rapid, heavy breathing
Learn about the warning signs of T1D.
How does Type 1 diabetes affect the body?
Type 1 diabetes is an autoimmune condition, which means that the body’s immune system attacks itself, much celiac disease. In the case of Type 1 diabetes, the body attacks the insulin-producing beta cells. These are the cells in the body that produce insulin.
Over time, people with Type 1 diabetes are left with none of these beta cells, also known as islet cells, and therefore cannot produce their own insulin. Insulin is the hormone that allows the body to use the glucose (sugar) in the bloodstream as energy – it kind of acts as a key that unlocks the body’s cells, allowing glucose to enter and be absorbed.
Converting blood glucose is the body’s main way that it gets energy, so without insulin, it has to resort to breaking down bodily tissue such as muscle and fat stores. Another, potentially fatal, consequence for people with Type 1 diabetes who aren’t on insulin therapy is Diabetic ketoacidosis, or DKA.
DKA occurs when there is an overload of glucose in the bloodstream because there is no regulating insulin. For more information on DKA click here.
What causes Type 1 diabetes?
T1D is neither preventable nor curable and while its cause is unknown, studies suggest that T1D results from a genetic predisposition, typically combined with an environmental trigger.
How do you manage Type 1 diabetes?
Living with T1D is a full-time balancing act requiring constant attention to avoid acute, life-threatening hypoglycemia (low blood sugar) or the long-term damage done by hyperglycemia (high blood sugar).
Blood sugar levels must be monitored either with finger pricks or a continuous glucose monitor. Insulin doses must then be carefully calculated based upon activity and stress levels, food intake, illness and additional factors.
These calculations are rarely perfect resulting in a tremendous emotional and mental burden for both patient and caregivers.
There are two main types of diabetes:
- Type 1 diabetes (T1D) is an incurable, autoimmune disease, not a lifestyle disease. T1D accounts for roughly 10% of the more than 420 million global cases of diabetes, and people with Type 1 are insulin-dependent for life.
- Type 2 diabetes occurs when the body cannot properly use insulin, also known as “insulin-resistance,” and can often be treated through diet, exercise and medication.
Learn about Type 2 diabetes here and other forms of diabetes here.
Find out more about Beyond Type 1 and how to get involved!
An Overview of Type 1 Diabetes
Type 1 diabetes is a condition in which your immune system destroys insulin-making cells in your pancreas. These are called beta cells. The condition is usually diagnosed in children and young people, so it used to be called juvenile diabetes.
A condition called secondary diabetes is type 1, but your beta cells are wiped out by something else, a disease or an injury to your pancreas, rather than by your immune system.
Both of these are different from type 2 diabetes, in which your body doesn’t respond to insulin the way it should.
Signs are often subtle, but they can become severe. They include:
Signs of an emergency with type 1 diabetes include:
- Shaking and confusion
- Rapid breathing
- Fruity smell to your breath
- Belly pain
- Loss of consciousness (rare)
Insulin is a hormone that helps move sugar, or glucose, into your body's tissues. Your cells use it as fuel.
Damage to beta cells from type 1 diabetes throws the process off. Glucose doesn’t move into your cells because insulin isn’t there to do the job. Instead, it builds up in your blood, and your cells starve. This causes high blood sugar, which can lead to:
- Dehydration. When there’s extra sugar in your blood, you pee more. That’s your body’s way of getting rid of it. A large amount of water goes out with that urine, causing your body to dry out.
- Weight loss. The glucose that goes out when you pee takes calories with it. That’s why many people with high blood sugar lose weight. Dehydration also plays a part.
- Diabetic ketoacidosis (DKA). If your body can't get enough glucose for fuel, it breaks down fat cells instead. This creates chemicals called ketones. Your liver releases the sugar it stores to help out. But your body can’t use it without insulin, so it builds up in your blood, along with the acidic ketones. This mix of extra glucose, dehydration, and acid buildup is known as ketoacidosis and can be life-threatening if not treated right away.
- Damage to your body. Over time, high glucose levels in your blood can harm the nerves and small blood vessels in your eyes, kidneys, and heart. They can also make you more ly to get hardened arteries, or atherosclerosis, which can lead to heart attacks and strokes.
There’s no way to prevent type 1 diabetes. Doctors don't know all the things that cause it. But they know that your genes play a role.
They also know that you can get type 1 diabetes when something around you, a virus, tells your immune system to go after your pancreas. Most people with type 1 diabetes have signs of this attack, called autoantibodies. They’re there in almost everyone who has the condition when their blood sugar is high.
Type 1 diabetes can happen along with other autoimmune diseases, Graves’ disease or vitiligo.
Only about 5% of people with diabetes have type 1. It affects males and females equally. You’re at higher risk of getting it if you:
- Are younger than 20
- Are white
- Have a parent or sibling with type 1
If your doctor thinks you have type 1 diabetes, they’ll check your blood sugar levels. They may test your urine for glucose or chemicals your body makes when you don’t have enough insulin.
People who have type 1 diabetes can live long, healthy lives. You’ll need to keep a close eye on your blood sugar levels. Your doctor will give you a range that the numbers should stay within. Adjust your insulin, food, and activities as necessary.
Everyone with type 1 diabetes needs to use insulin shots to control their blood sugar.
When your doctor talks about insulin, they’ll mention three main things:
- “Onset” is how long it takes to reach your bloodstream and begin lowering your blood sugar.
- “Peak time” is when insulin is doing the most work in terms of lowering your blood sugar.
- “Duration” is how long it keeps working after onset.
Several types of insulin are available.
- Rapid-acting starts to work in about 15 minutes. It peaks about 1 hour after you take it and continues to work for 2 to 4 hours.
- Regular or short-acting gets to work in about 30 minutes. It peaks between 2 and 3 hours and keeps working for 3 to 6 hours.
- Intermediate-acting won’t get into your bloodstream for 2 to 4 hours after your shot. It peaks from 4 to 12 hours and works for 12 to 18 hours.
- Long-acting takes several hours to get into your system and lasts about 24 hours.
Your doctor may start you out with two injections a day of two types of insulin. Later, you might need more shots.
Most insulin comes in a small glass bottle called a vial. You draw it out with a syringe that has a needle on the end and give yourself the shot. Some kinds come in a prefilled pen. Another kind is inhaled. You can also get it from a pump, a device you wear that sends it into your body through a small tube. Your doctor will help you pick the type and the delivery method that’s best for you.
Exercise is an important part of treating type 1. But it isn’t as simple as going for a run. Exercise affects your blood sugar levels. So you have to balance your insulin dose and the food you eat with any activity, even simple tasks around the house or yard.
Knowledge is power. Check your blood sugar before, during, and after an activity to find out how it affects you. Some things will make your levels go up; others won't. You can lower your insulin or have a snack with carbs to keep it from dropping too low.
If your blood sugar is high — above 240 mg/dL — test for ketones, the acids that can result from high sugar levels. If they’re OK, you should be good to go. If they’re high, skip the workout.
You’ll also need to understand how food affects your blood sugar. Once you know the roles that carbs, fats, and protein play, you can build a healthy eating plan that helps keep your levels where they should be. A diabetes educator or registered dietitian can help you get started.
Type 1 diabetes can lead to other problems, especially if it isn’t well-controlled. Complications include:
- Cardiovascular disease. Diabetes can put you at higher risk of blood clots, as well as high blood pressure and cholesterol. These can lead to chest pain, heart attack, stroke, or heart failure.
- Skin problems. People with diabetes are more ly to get bacterial or fungal infections. Diabetes can also cause blisters or rashes.
- Gum disease. A lack of saliva, too much plaque, and poor blood flow can cause mouth problems.
- Pregnancy problems. Women with type 1 diabetes have a higher risk of early delivery, birth defects, stillbirth, and preeclampsia.
- Retinopathy. This eye problem happens in about 80% of adults who have had type 1 diabetes for more than 15 years. It’s rare before puberty, no matter how long you’ve had the disease. To prevent it — and keep your eyesight — keep good control of blood sugar, blood pressure, cholesterol, and triglycerides.
- Kidney damage. About 20% to 30% of people with type 1 diabetes get a condition called nephropathy. The chances go up over time. It’s most ly to show up 15 to 25 years after the onset of diabetes. It can lead to other serious problems kidney failure and heart disease.
- Poor blood flow and nerve damage. Damaged nerves and hardened arteries lead to a loss of feeling in and a lack of blood supply to your feet. This raises your chances of injury and makes it harder for open sores and wounds to heal. When that happens, you could lose a limb. Nerve damage can also cause digestive problems nausea, vomiting, and diarrhea.
American Diabetes Association. Diabetes Care, January 2004.
Juvenile Diabetes Research Foundation: “Fact Sheets: Type 1 Diabetes Facts.”
American Diabetes Association: “Diabetes Basics: Type 1;” “Exercise and Type 1 Diabetes;” “Insulin Routines;” “Insulin Basics;” and “Insulin Pumps.”
Joslin Diabetes Center: “The Truth About the So-Called Diabetes Diet.”
Mayo Clinic: “Type 1 diabetes.”
Nemours/KidsHealth: “Type 1 Diabetes: What Is It?” “Long-term Complications of Diabetes.”
International Diabetes Federation: “Diabetes and cardiovascular disease.”
American Diabetes Association: “Skin Complications,” “DKA (Ketoacidosis) & Ketones.”
Reviews in Obstetrics and Gynecology: “Type 1 Diabetes Mellitus and Pregnancy.”
© 2019 WebMD, LLC. All rights reserved. Genetics and Type 1 Diabetes
Type 1 Diabetes | NIDDK
Diabetes occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes mainly from the food you eat. Insulin, a hormone made by the pancreas, helps the glucose in your blood get into your cells to be used for energy. Another hormone, glucagon, works with insulin to control blood glucose levels.
In most people with type 1 diabetes, the body’s immune system, which normally fights infection, attacks and destroys the cells in the pancreas that make insulin. As a result, your pancreas stops making insulin. Without insulin, glucose can’t get into your cells and your blood glucose rises above normal. People with type 1 diabetes need to take insulin every day to stay alive.
People with type 1 diabetes need to take insulin every day.
Who is more ly to develop type 1 diabetes?
Type 1 diabetes typically occurs in children and young adults, although it can appear at any age. Having a parent or sibling with the disease may increase your chance of developing type 1 diabetes. In the United States, about 5 percent of people with diabetes have type 1.1
What are the symptoms of type 1 diabetes?
Symptoms of type 1 diabetes are serious and usually happen quickly, over a few days to weeks. Symptoms can include
- increased thirst and urination
- increased hunger
- blurred vision
- unexplained weight loss
Sometimes the first symptoms of type 1 diabetes are signs of a life-threatening condition called diabetic ketoacidosis (DKA). Some symptoms of DKA include
- breath that smells fruity
- dry or flushed skin
- nausea or vomiting
- stomach pain
- trouble breathing
- trouble paying attention or feeling confused
DKA is serious and dangerous. If you or your child have symptoms of DKA, contact your health care professional right away, or go to the nearest hospital emergency room.
What causes type 1 diabetes?
Experts think type 1 diabetes is caused by genes and factors in the environment, such as viruses, that might trigger the disease. Researchers are working to pinpoint the causes of type 1 diabetes through studies such as TrialNet.
How do health care professionals diagnose type 1 diabetes?
Health care professionals usually test people for type 1 diabetes if they have clear-cut diabetes symptoms.
Health care professionals most often use the random plasma glucose (RPG) test to diagnose type 1 diabetes. This blood test measures your blood glucose level at a single point in time.
Sometimes health professionals also use the A1C blood test to find out how long someone has had high blood glucose.
Even though these tests can confirm that you have diabetes, they can’t identify what type you have. Treatment depends on the type of diabetes, so knowing whether you have type 1 or type 2 is important.
To find out if your diabetes is type 1, your health care professional may test your blood for certain autoantibodies. Autoantibodies are antibodies that attack your healthy tissues and cells by mistake. The presence of certain types of autoantibodies is common in type 1 but not in type 2 diabetes.
Because type 1 diabetes can run in families, your health care professional can test your family members for autoantibodies. Type 1 diabetes TrialNet, an international research network, also offers autoantibody testing to family members of people diagnosed with the disease.
The presence of autoantibodies, even without diabetes symptoms, means the family member is more ly to develop type 1 diabetes. If you have a brother or sister, child, or parent with type 1 diabetes, you may want to get an autoantibody test.
People age 20 or younger who have a cousin, aunt, uncle, niece, nephew, grandparent, or half-sibling with type 1 diabetes also may want to get tested.
What medicines do I need to treat my type 1 diabetes?
If you have type 1 diabetes, you must take insulin because your body no longer makes this hormone. Different types of insulin start to work at different speeds, and the effects of each last a different length of time. You may need to use more than one type. You can take insulin a number of ways. Common options include a needle and syringe, insulin pen, or insulin pump.
Some people who have trouble reaching their blood glucose targets with insulin alone also might need to take another type of diabetes medicine that works with insulin, such as pramlintide. Pramlintide, given by injection, helps keep blood glucose levels from going too high after eating. Few people with type 1 diabetes take pramlintide, however.
The NIH has recently funded a large research study to test use of pramlintide along with insulin and glucagon in people with type 1 diabetes. Another diabetes medicine, metformin, may help decrease the amount of insulin you need to take, but more studies are needed to confirm this.
Reseachers are also studying other diabetes pills that people with type 1 diabetes might take along with insulin.
Hypoglycemia, or low blood sugar, can occur if you take insulin but don’t match your dose with your food or physical activity. Severe hypoglycemia can be dangerous and needs to be treated right away. Learn more about hypoglycemia and how to prevent or treat it.
How else can I manage type 1 diabetes?
Along with insulin and any other medicines you use, you can manage your diabetes by taking care of yourself each day.
Following your diabetes meal plan, being physically active, and checking your blood glucose often are some of the ways you can take care of yourself. Work with your health care team to come up with a diabetes care plan that works for you.
If you are planning a pregnancy with diabetes, try to get your blood glucose levels in your target range before you get pregnant.
Do I have other treatment options for my type 1 diabetes?
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has played an important role in developing “artificial pancreas” technology.
An artificial pancreas replaces manual blood glucose testing and the use of insulin shots. A single system monitors blood glucose levels around the clock and provides insulin or a combination of insulin and glucagon automatically.
The system can also be monitored remotely, for example by parents or medical staff.
In 2016, the U.S. Food and Drug Administration approved a type of artificial pancreas system called a hybrid closed-loop system.
This system tests your glucose level every 5 minutes throughout the day and night through a continuous glucose monitor, and automatically gives you the right amount of basal insulin, a long-acting insulin, through a separate insulin pump.
You still need to manually adjust the amount of insulin the pump delivers at mealtimes and when you need a correction dose. You also will need to test your blood with a glucose meter several times a day. Talk with your health care provider about whether this system might be right for you.
The illustration below shows the parts of a type of artificial pancreas system.
An artificial pancreas system uses a continuous glucose monitor, an insulin pump, and a control algorithm to give you the right amount of basal insulin.
The continuous glucose monitor sends information through a software program called a control algorithm. your glucose level, the algorithm tells the insulin pump how much insulin to deliver. The software program could be installed on the pump or another device such as a cell phone or computer.
Starting in late 2016 and early 2017, the NIDDK has funded several important studies on different types of artificial pancreas devices to better help people with type 1 diabetes manage their disease. The devices may also help people with type 2 diabetes and gestational diabetes.
NIDDK is also supporting research into pancreatic islet transplantation—an experimental treatment for hard-to-control type 1 diabetes. Pancreatic islets are clusters of cells in the pancreas that make insulin. Type 1 diabetes attacks these cells.
A pancreatic islet transplant replaces destroyed islets with new ones that make and release insulin. This procedure takes islets from the pancreas of an organ donor and transfers them to a person with type 1 diabetes.
Because researchers are still studying pancreatic islet transplantation, the procedure is only available to people enrolled in a study. Learn more about islet transplantation studies.
What health problems can people with type 1 diabetes develop?
Over time, high blood glucose leads to problems such as
- heart disease
- kidney disease
- eye problems
- dental disease
- nerve damage
- foot problems
- sleep apnea
If you have type 1 diabetes, you can help prevent or delay the health problems of diabetes by managing your blood glucose, blood pressure, and cholesterol, and following your self-care plan.
Can I lower my chance of developing type 1 diabetes?
At this time, type 1 diabetes can’t be prevented. However, through studies such as TrialNet, researchers are working to identify possible ways to prevent or slow down the disease.
 Centers for Disease Control and Prevention. National diabetes statistics report, 2017. Centers for Disease Control and Prevention website. www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf (PDF, 1.3 MB) . Updated July, 18 2017. Accessed August 1, 2017.
Type 1 Diabetes Mellitus: Practice Essentials, Background, Pathophysiology
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Type 1 Diabetes
Type 1 diabetes (previously called insulin-dependent or juvenile diabetes) is usually diagnosed in children, teens, and young adults, but it can develop at any age.
If you have type 1 diabetes, your pancreas isn’t making insulin or is making very little. Insulin is a hormone that enables blood sugar to enter the cells in your body where it can be used for energy. Without insulin, blood sugar can’t get into cells and builds up in the bloodstream. High blood sugar is damaging to the body and causes many of the symptoms and complications of diabetes.
Type 1 diabetes is less common than type 2—approximately 5-10% of people with diabetes have type 1. Currently, no one knows how to prevent type 1 diabetes, but it can be managed by following your doctor’s recommendations for living a healthy lifestyle, controlling your blood sugar, getting regular health checkups, and getting diabetes self-management education.
Hypoglycemia symptoms can include:
- Nervousness or anxiety
- Sweating, chills, or clamminess
- Irritability or impatience
- Dizziness and difficulty concentrating
- Hunger or nausea
- Blurred vision
- Weakness or fatigue
- Anger, stubbornness, or sadness
If your child has type 1 diabetes, you’ll be involved in diabetes care on a day-to-day basis, from serving healthy foods to giving insulin injections to watching for and treating hypoglycemia (low blood sugar; see below). You’ll also need to stay in close contact with your child’s health care team; they will help you understand the treatment plan and how to help your child stay healthy.
Much of the information that follows applies to children as well as adults, and you can also click here for comprehensive information about managing your child’s type 1 diabetes.external icon
Type 1 diabetes is caused by an autoimmune reaction (the body attacks itself by mistake) that destroys the cells in the pancreas that make insulin, called beta cells. This process can go on for months or years before any symptoms appear.
Some people have certain genes (traits passed on from parent to child) that make them more ly to develop type 1 diabetes, though many won’t go on to have type 1 diabetes even if they have the genes. Being exposed to a trigger in the environment, such as a virus, is also thought to play a part in developing type 1 diabetes. Diet and lifestyle habits don’t cause type 1 diabetes.
Symptoms & Risk Factors
It can take months or years for enough beta cells to be destroyed before symptoms of type 1 diabetes are noticed. Type 1 diabetes symptoms can develop in just a few weeks or months. Once symptoms appear, they can be severe.
Some type 1 diabetes symptoms are similar to symptoms of other health conditions. Don’t guess—if you think you could have type 1 diabetes, see your doctor right away to get your blood sugar tested. Untreated diabetes can lead to very serious—even fatal—health problems.
Risk factors for type 1 diabetes are not as clear as for prediabetes and type 2 diabetes, though family history is known to play a part.
A simple blood test will let you know if you have diabetes. If you’ve gotten your blood sugar tested at a health fair or pharmacy, follow up at a clinic or doctor’s office to make sure the results are accurate.
If your doctor thinks you have type 1 diabetes, your blood may also tested for autoantibodies (substances that indicate your body is attacking itself) that are often present with type 1 diabetes but not with type 2. You may have your urine tested for ketones (produced when your body burns fat for energy), which also indicate type 1 diabetes instead of type 2.
Un many health conditions, diabetes is managed mostly by you, with support from your health care team (including your primary care doctor, foot doctor, dentist, eye doctor, registered dietitian nutritionist, diabetes educator, and pharmacist), family, teachers, and other important people in your life. Managing diabetes can be challenging, but everything you do to improve your health is worth it!
If you have type 1 diabetes, you’ll need to take insulin shots (or wear an insulin pump) every day to manage your blood sugar levels and get the energy your body needs.
Insulin can’t be taken as a pill because the acid in your stomach would destroy it before it could get into your bloodstream.
Your doctor will work with you to figure out the most effective type and dosage of insulin for you.
You’ll also need to check your blood sugar regularly. Ask your doctor how often you should check it and what your target blood sugar levels should be. Keeping your blood sugar levels as close to target as possible will help you prevent or delay diabetes-related complications.
Stress is a part of life, but it can make managing diabetes harder, including controlling your blood sugar levels and dealing with daily diabetes care. Regular physical activity, getting enough sleep, and relaxation exercises can help. Talk to your doctor and diabetes educator about these and other ways you can manage stress.
Healthy lifestyle habits are really important, too:
Make regular appointments with your health care team to be sure you’re on track with your treatment plan and to get help with new ideas and strategies if needed.
Whether you just got diagnosed with type 1 diabetes or have had it for some time, meeting with a diabetes educator is a great way to get support and guidance, including how to:
- Develop and stick to a healthy eating and activity plan
- Test your blood sugar and keep a record of the results
- Recognize the signs of high or low blood sugar and what to do about it
- Give yourself insulin by syringe, pen, or pump
- Monitor your feet, skin, and eyes to catch problems early
- Buy diabetes supplies and store them properly
- Manage stress and deal with daily diabetes care
Ask your doctor about diabetes self-management education and to recommend a diabetes educator. You can also search the American Association of Diabetes Educators’ nationwide directoryexternal icon for a list of educators in your community.
Hypoglycemiaexternal icon (low blood sugar) can happen quickly and needs to be treated immediately. It’s most often caused by too much insulin, waiting too long for a meal or snack, not eating enough, or getting extra physical activity. Hypoglycemia symptoms are different from person to person; make sure you know your specific symptoms, which could include:
- Nervousness or anxiety
- Sweating, chills, or clamminess
- Irritability or impatience
- Dizziness and difficulty concentrating
- Hunger or nausea
- Blurred vision
- Weakness or fatigue
- Anger, stubbornness, or sadness
If you have hypoglycemia several times a week, talk to your doctor to see if your treatment needs to be adjusted.
Connect with Others
Tap into online diabetes communities for encouragement, insights, and support. The American Diabetes Association’s Community pageexternal icon and the American Association of Diabetes Educators’ Peer Support Resourcesexternal icon are great ways to connect with others who share your experience.
Type 1 Diabetes: What Is It?
Diabetes is a disease that affects how the body uses glucose, the main type of sugar in the blood.
What Happens in Diabetes?
Our bodies break down the foods we eat into glucose and other nutrients we need, which are then absorbed into the bloodstream from the gastrointestinal tract.
The glucose level in the blood rises after a meal and triggers the pancreas to make the hormone insulin and release it into the bloodstream.
But in people with diabetes, the body either can't make or can't respond to insulin properly.
Insulin works a key that opens the doors to cells and lets the glucose in. Without insulin, glucose can't get into the cells (the doors are “locked” and there is no key) and so it stays in the bloodstream. As a result, the level of sugar in the blood remains higher than normal. High blood sugar levels are a problem because they can cause a number of health problems.
What Is Type 1 Diabetes?
The two types of diabetes are type 1 and type 2. Both make blood sugar levels higher than normal but they do so in different ways.
In type 1 diabetes, the pancreas loses its ability to make insulin because the body's immune system attacks and destroys the cells that produce insulin.
No one knows exactly why this happens, but scientists think it has something to do with genes. But just getting the genes for diabetes isn't usually enough.
A person probably would then have to be exposed to something else — a virus — to get type 1 diabetes.
In type 2 diabetes, the pancreas still makes insulin but the body doesn't respond to it normally.
Glucose is less able to enter the cells and do its job of supplying energy (a problem called insulin resistance). This raises the blood sugar level, so the pancreas works hard to make even more insulin.
Eventually, this strain can make the pancreas unable to produce enough insulin to keep blood sugar levels normal.
Who Gets Type 1 Diabetes?
Type 1 diabetes can't be prevented, and there is no real way to predict who will get it. Nothing that either a parent or the child did caused the disease.
Once a person has type 1 diabetes, it does not go away and requires lifelong treatment. Kids and teens with type 1 diabetes depend on daily insulin injections or an insulin pump to control their blood glucose levels.
What Are the Signs & Symptoms of Type 1 Diabetes?
A person can have diabetes without knowing it because the symptoms aren't always obvious and they can take a long time to develop. Type 1 diabetes may come on gradually or suddenly.
But kids or teens who develop type 1 diabetes may:
- Need to pee a lot. The kidneys respond to high levels of glucose in the blood by flushing out the extra glucose in urine (pee). Kids with high blood sugar levels need to pee more often and make more pee.
- Drink a lot of liquids. Because they're peeing so often and losing so much fluid, they can become very thirsty and drink a lot in an attempt to keep the levels of body water normal.
- Feel tired often. This is because the body can't use glucose for energy properly.
- Lose weight (or not gain weight as they grow). Kids and teens with type 1 diabetes may have an increased appetite, but often lose weight because the body breaks down muscle and stored fat in an attempt to provide fuel to the hungry cells.
In some cases, other symptoms can be the signal that something is wrong. Sometimes the first sign of diabetes is bedwetting in a child who has been dry at night. Diabetes also should be suspected if a girl who hasn't started puberty yet gets a vaginal yeast infection.
How Is Type 1 Diabetes Diagnosed?
Doctors can say for sure if a person has diabetes by testing blood samples for glucose. When high blood sugars show that a child has diabetes, other blood tests are usually done to help doctors find out if the child has type 1 or type 2 diabetes, because management and treatment of the diabetes may differ type.
If diabetes is suspected or confirmed, the doctor may refer your child to a pediatric endocrinologist, a doctor who specializes in the diagnosis and treatment of kids with diseases of the endocrine system, such as diabetes and growth disorders.
How Is Type 1 Diabetes Treated?
Treatment means good diabetes control to minimize symptoms; prevent health problems; and help kids have normal physical, mental, emotional, and social growth and development. To do this, parents and kids should aim to keep blood sugar levels within the goal range as much as possible.
In general, kids with type 1 diabetes need to:
- take insulin as prescribed
- eat a healthy, balanced diet with accurate carbohydrate counts
- check blood sugar levels as prescribed
- get regular physical activity
Following the treatment plan helps kids stay healthy, but treating diabetes isn't the same as curing it. Right now, there's no cure for diabetes, so kids with type 1 diabetes will need treatment for the rest of their lives. But with proper care, they should look and feel healthy and go on to live long, productive lives, just other kids.
What Problems Can Happen With Type 1 Diabetes?
If early symptoms of diabetes are missed and treatment isn't started, chemicals called ketones can build up in the blood and cause stomach pain, nausea, vomiting, fruity-smelling breath, breathing problems, and even loss of consciousness. Sometimes these symptoms are mistaken for the flu or appendicitis. Doctors call this serious condition diabetic ketoacidosis, or DKA.
Diabetes also can cause long-term complications in some people, including heart disease, stroke, vision impairment, and kidney damage.
It also can cause other problems throughout the body in the blood vessels, nerves, and gums.
While these problems don't usually show up in kids or teens who've had type 1 diabetes for only a few years, they can affect them in adulthood, particularly if their diabetes isn't well controlled.
There's good news, though — proper treatment can stop or control these diabetes symptoms and reduce the risk of long-term problems.
What's New in the Treatment of Type 1 Diabetes?
Doctors and researchers are developing new equipment and treatments to help kids cope with the special problems of growing up with diabetes.
Some kids and teens are already using devices that make blood glucose testing and insulin injections easier, less painful, and more effective.
One of these is the insulin pump, a mechanical device that can deliver insulin more the pancreas does. There's also been progress toward the development of a wearable or implantable “artificial pancreas.
” This consists of an insulin pump linked to a device that measures the person's blood glucose level continuously.
Doctors and scientists are investigating a potential cure for diabetes. This involves transplanting insulin-producing cells into the body of a person with diabetes. Researchers are also testing ways to stop diabetes before it starts. For example, scientists are studying whether diabetes can be prevented in those who may have inherited an increased risk for the disease.
How Can I Help My Child?
Parents can help their kids lead happier, healthier lives by giving constant encouragement, learning what they can about diabetes, and making sure their children eat properly, exercise, and stay on top of blood sugar control every day.
Kids and teens with diabetes need to monitor and control their glucose levels. They need to:
- check blood sugar levels a few times a day by testing a small blood sample
- give themselves insulin injections, have an adult give them injections, or use an insulin pump
- eat a balanced, healthy diet and pay special attention to the amounts of sugars and starches in the food they eat and the timing of their meals
- get regular exercise to help control blood sugar levels and help avoid some of the long-term health problems that diabetes can cause, heart disease
- work closely with their doctor and diabetes health care team to get the best possible diabetes control
- be watched for signs of complications and other diabetes-related health problems
Living with diabetes is a challenge for anyone, but kids and teens often have special issues to deal with. Young kids might not understand why they need blood tests and medicines. They might be scared, angry, and uncooperative.
Teens may feel different from their peers and want a more carefree lifestyle than their diabetes allows. Even when they faithfully follow their treatment schedule, they might feel frustrated if the natural body changes of puberty make their diabetes somewhat harder to control.
Having a child with diabetes may seem overwhelming at times, but you're not alone. If you have questions or problems, reach out to the diabetes health care team — they can help with medical issues, and are there to support and help you and your child.
Reviewed by: Shara R. Bialo, MD
Date reviewed: August 2018