What is diabetes type 1?

Type 1 diabetes is a lifelong disease that develops when the pancreas stops making insulin. The body needs insulin to let sugar (glucose) move from the blood into the body's cells, where it can be used for energy or stored for later use.

Without insulin, the sugar cannot get into the cells to do its work. It stays in the blood instead. This can cause high blood sugar levels. A person has diabetes when the blood sugar is too high. Over time, diabetes can lead to diseases of the heart, blood vessels, nerves, kidneys, and eyes.

To treat type 1 diabetes, you need insulin. You can give yourself insulin through an insulin pump, an insulin pen, or a syringe (needle). Insulin, exercise, and a healthy diet can help prevent or delay problems from diabetes.

With education and support, you will treat diabetes as a part of your life—not your whole life. Seek support when you need it from your family, friends, and your doctor or other diabetes experts.

Over time, high blood sugar can lead to serious problems. It can:

• Harm your eyes, nerves, and kidneys.
• Damage your blood vessels, leading to heart disease and stroke.
• Reduce blood flow and cause nerve damage to parts of your body, especially your feet. This can cause slow healing and pain when you walk.

That's why it's important to keep your blood sugar within a target range.

A more sudden problem can happen when the blood sugar level gets so high that a serious chemical imbalance develops in the blood. This condition can be life-threatening and needs quick treatment.

When people hear the word "diabetes," they often think of problems like these. But daily care and treatment can help prevent or delay these problems. The goal is to keep your blood sugar in a target range. It's the best way to reduce your chance of having more problems from diabetes.

Symptoms of type 1 diabetes are caused by high blood sugar. They usually develop quickly, over a few days to weeks. At first, symptoms may be overlooked or mistaken for another illness, like the flu.

Symptoms include:

• Urinating often. This may be more noticeable at night.
• Being very thirsty. This happens if a person urinates so often that they get dehydrated.
• Losing weight without trying. This happens because the body isn't able to get energy from sugar. Instead, the body uses muscle and fat for energy.
• Increased hunger. The body isn't using all the calories that it can. Many calories leave the body through urine.
• Blurry vision. When sugar builds up in the lens of the eye, it sucks extra water into the eye. This changes the shape of the lens and blurs vision.
• Feeling very tired. The body isn't using the calories it takes in, and it isn't getting the energy it needs.

Treatment for type 1 diabetes focuses on keeping blood sugar levels within a target range. This will help prevent problems from diabetes such as eye, kidney, heart, and nerve disease.

To manage type 1 diabetes, a person will:

• Take insulin every day. This may be done through an insulin pump or a syringe (needle).
• Check blood sugar levels often.
• Make healthy food choices.
• Get regular physical activity. Exercise helps the body to use insulin in a more efficient way.
• Get routine screening tests and exams. These are done to watch for signs of problems.
• Avoid smoking.

Blood sugar levels are easier to manage when mealtimes, amount of food, and exercise are similar every day.

Medicine to treat other health problems, like high blood pressure or high cholesterol, may be needed. This may help prevent problems from diabetes.

Currently there is no way to prevent type 1 diabetes. But studies are looking into ways to prevent it in those who are most likely to get it. If you have a parent, brother, or sister with type 1 diabetes, and you're willing to take part in a study, talk to your doctor.

The doctor will ask about past health issues and do a physical exam. Blood tests are done to measure how much sugar is in the blood. The doctor will use those test results and the American Diabetes Association criteria to diagnose diabetes.

Some people are diagnosed with type 1 diabetes because they have symptoms of diabetic ketoacidosis.

It may be hard to tell what type of diabetes a person has. If so, the doctor may do a C-peptide test or test for autoantibodies to diagnose type 1 diabetes or a slowly developing form of type 1 diabetes called latent autoimmune diabetes in adults (LADA). Some rare forms of diabetes are caused by a genetic problem. Genetic testing may be done to diagnose them. This includes maturity onset diabetes of the young (MODY). There are many types of MODY, depending on the gene that is affected.

Insulin helps keep your blood sugar level within a target range. It can be taken as a shot (injection) or through an insulin pump. Rapid-acting insulin is also available as a powder that you inhale.

Most people who have type 1 diabetes take a combination of types of insulin. For instance, they may take a long-acting insulin once or twice a day and a rapid-acting insulin before each meal. The amount and type of insulin needed varies for each person.

• The amount and type of insulin you need changes over time. It depends on your age, hormones (such as during rapid growth or pregnancy), and changes in exercise routine.
• You may need higher doses during times of illness or emotional stress.

Never skip a dose of insulin without the advice of your doctor.

There's plenty you can do to care for yourself when you have diabetes. Check your blood sugar and take insulin as directed by your doctor. Get regular exercise. Follow your meal plan to know how much carbohydrate to eat. Check your feet daily for sores. Get checkups every 3 to 6 months.

Surgery may be an option for certain people who have type 1 diabetes. Choices may include:

Pancreas transplant.

When insulin isn't enough to keep blood sugar in your target range, a pancreas transplant might be an option. If it's successful, you may no longer have symptoms or need to treat diabetes. But you may still get complications from diabetes. And you must take medicine to keep your body from rejecting the new organ.

Pancreatic islet cell surgery.

This involves inserting a small group of donated pancreas cells (islet cells) through a vein in your liver. After surgery, these cells start to make insulin. If they can make enough, you may no longer need insulin injections. But you must take medicine to prevent rejection.

Risk factors are things that increase the chances of getting sick or having a problem. Risk factors for type 1 diabetes include:

• Family history. A family history of type 1 diabetes increases the chance of a person having autoantibodies such as islet cell antibodies. These antibodies attack the cells in the pancreas that produce insulin. But a family history of type 1 diabetes doesn't mean that someone will definitely have the disease.
• Presence of autoantibodies in the blood. People who have both a family history of type 1 diabetes and two or more autoantibodies in their blood are likely to get type 1 diabetes. If a person has family members with type 1 diabetes, the person can be tested to look for autoantibodies.
• Race. White people have a greater risk for type 1 diabetes than Black, Asian, or Hispanic people.

The body makes insulin in beta cells, which are in a part of the pancreas called the islet (say "EYE-let") tissue. Type 1 diabetes starts because the body's immune system destroys those beta cells. So people who have type 1 diabetes can't make their own insulin.