Type 1 Diabetes: Diagnosis, Causes, and Treatment

What is Type 1 Diabetes?

Type 1 diabetes is a chronic illness that often initially appears in childhood or adolescence, yet it can also affect adults. High blood sugar levels are caused by the body stopping to produce insulin. Managing the illness involves insulin medication and a balanced diet, among additional therapies to reduce complications.

Symptoms of Type 1 Diabetes

Type 1 diabetes symptoms often start mildly and progressively worsen over days, weeks, or months as pancreas insulin production declines. Common symptoms include:

• Excessive thirst
• Frequent urination (including bedwetting in children and frequent nappy changes in infants)
• Increased hunger
• Unexplained weight loss
• Fatigue
• Blurred vision
• Slow-healing wounds
• Vaginal yeast infections

If you or your child experience these symptoms, consult a GP as early diagnosis is crucial. Delayed treatment can lead to a serious complication called diabetic ketoacidosis (DKA), which can be life-threatening.

Emergency Symptoms Requiring Immediate Medical Attention

Seek immediate medical attention if you or your child suffers from any of these symptoms: nausea, vomiting, stomach discomfort, rapid breathing, confusion or drowsiness or loss of consciousness.

How is Type 1 Diabetes Diagnosed?

The diagnosis is simple and usually entails the following examinations:

• Blood Glucose Test: This test measures blood sugar levels randomly or during a fast. Diabetes is typically indicated by a very high result.
• The HbA1c test: calculates the mean blood sugar levels throughout the previous three months.
• The autoantibody test: finds markers of the immune system that differentiate Type 1 diabetes from Type 2 diabetes.

Causes of Type 1 Diabetes

Type 1 diabetes is caused by the body's immune system attacking insulin-producing cells in the pancreas. Although the exact cause is uncertain, infections may be a contributing factor. In rare instances, pancreatic illness or pancreatic removal surgery may be the cause.

Genetic variables are involved, although they are not directly inherited. The risk rises if a close relative has Type 1 diabetes.

Complications of Type 1 Diabetes

Uncontrolled blood sugar over time can cause serious health complications, including:

• Heart and Blood Vessel Issues – Increased risk of angina, heart attacks, strokes, and poor circulation.
• Eye Damage – Retinopathy, macular oedema, cataracts, and glaucoma.
• Kidney Damage – May lead to kidney failure.
• Nerve Damage (Neuropathy) – Can cause numbness, tingling, and pain.
• Foot Problems – Poor circulation may result in ulcers or infections, leading to gangrene.
• High Blood Pressure – Increases cardiovascular risks.
• Oral Health Issues – Periodontitis and gum disease.
• Skin Conditions – Bacterial and fungal infections, dry skin, and diabetes-related dermopathy.

Regular blood sugar management reduces the likelihood of complications.

Treatment for Type 1 Diabetes

While there is no cure, diabetes can be managed effectively. The primary goals of treatment are:

• Maintaining blood sugar levels as close to normal as possible.
• Reducing risk factors for complications.
• Detecting complications early for proper treatment.

Key Aspects of Treatment:

Insulin Therapy

People with Type 1 diabetes require insulin daily. Insulin types vary by how quickly they work and how long they last in the body. The amount needed depends on factors such as age, weight, activity levels, diet, and current blood sugar levels.

Methods of insulin administration include:

• Multiple Daily Injections (MDI) – Using syringes to inject insulin into fatty tissue.
• Insulin Pens – Pre-filled devices that are similar to injections, but more convenient than syringes.
• Insulin Pumps – Deliver insulin continuously via a small tube under the skin, mimicking natural insulin release.
• Inhaled Insulin – A fast-acting insulin alternative.

Insulin needs change over time, requiring regular GP check-ups.

Blood Sugar Monitoring

Frequent monitoring helps keep glucose levels within a safe range. Methods include:

• Blood Glucose Meters – Require finger-pricking and provide immediate results.
• Continuous Glucose Monitors (CGMs) – Sensors placed under the skin continuously track blood sugar, reducing the need for finger tests.

A GP will advise on target blood sugar levels based on age, lifestyle, and overall health.

Carbohydrate Counting

Tracking carbohydrate intake helps match insulin doses to food consumption. This involves reading nutrition labels and using an insulin-to-carb ratio tailored by a GP.

Healthy Eating

There is no need for special “diabetic” foods. A balanced diet should include:

• Plenty of vegetables, fibre, and healthy fats.
• Limited processed foods, sugar, and salt.
• Moderation with fruit due to natural sugars.

The Dose Adjustment for Normal Eating and Exercise (DAFNE) programme helps people with Type 1 diabetes manage insulin based on food intake and activity levels.

Side Effects of Diabetes Treatment

The main risk of insulin therapy is low blood sugar (hypoglycaemia), which happens when insulin intake is too high relative to food and activity levels.

Symptoms of Hypoglycaemia:

• Shaking or trembling
• Sweating and chills
• Dizziness
• Rapid heartbeat
• Headaches
• Hunger
• Nausea
• Irritability
• Pale skin
• Weakness

If untreated, hypoglycaemia can be dangerous. The 15-15 Rule helps manage it:

1. Take 15g of fast-acting carbs, such as glucose tablets or fruit juice.
2. After fifteen minutes, check your blood sugar.
3. If required, repeat until the blood sugar level reaches at least 70 mg/dL.

Children may require different carb amounts, so check with a GP.

Reducing Risk Factors

Minimising additional risk factors helps prevent complications. Steps include:

• Keeping blood pressure in check.
• Quitting smoking.
• Staying physically active.
• Maintaining a healthy weight.

Regular Health Checks

Early detection of complications improves outcomes. Routine tests include:

• Blood sugar, HbA1c, cholesterol, and blood pressure monitoring.
• Diet and lifestyle assessments.
• Eye, kidney, and foot checks.
• Urine and blood tests.

Regular screenings ensure timely intervention if needed.

Outlook for Type 1 Diabetes

Type 1 diabetes is linked to a number of problems and can be difficult to manage, especially over the course of a lifetime. Nearly half of those with Type 1 diabetes will experience a serious complication at some point. However, individuals who go 20 years post-diagnosis without complications generally have a positive outlook.

For more information or treatment options for type 1 diabetes, kindly reach out to us to book an appointment.