Type 1 Diabetes

Type I diabetes, or juvenile diabetes, occurs when your body’s immune system — which fights infection — attacks your own pancreas. When the pancreas cells that produce insulin are destroyed, your body can’t make insulin any more (insulin is a hormone that allows the glucose to enter the body’s cells). Without insulin, your body has difficulty regulating your blood sugar levels.

Children and young adults are most commonly diagnosed with type 1 diabetes, giving it the name juvenile diabetes. In fact, about 1 in every 500 children or teenagers has type 1 diabetes. However, a slow-onset version of type 1 diabetes, LADA (latent autoimmune diabetes in adults), occurs only in adults.

People with type 1 diabetes must take insulin every day — usually several times a day. Most people take insulin by injection (a shot). Others wear a small pump that delivers insulin continuously into their body. People with type 1 also need to follow a meal plan and get regular exercise to help regulate blood glucose levels. Although people with LADA may respond to oral diabetes treatments for a time, they typically need to take insulin within a few months. (Over time, the autoimmune process destroys insulin-producing cells in the pancreas.)

In people with diabetes, high blood glucose can cause two complications — both of which can result in foot problems. You may have one or both of these:

• Nerve damage (neuropathy). Nerve damage from high blood glucose usually begins in the hands and feet. It can cause painful symptoms — tingling, aching, or throbbing — but it can also reduce sensation. If you can’t really feel cold, heat, or pain in your feet, it’s easy to ignore an injury or infection. And unfortunately, in people with diabetes, even a small blister or stubbed toe can become serious.
• Poor circulation. High blood glucose can damage your blood vessels and reduce blood flow to your feet. This means that injuries take longer to heal. Over time, poor circulation in your feet can even change the shape of your feet and toes. This can cause problems with the way you walk.

If you notice these symptoms in yourself or your child, you should make an appointment to see your primary care provider. Type 1 diabetes is a chronic condition without a cure, but your doctor can help you make the lifestyle and diet changes you need to effectively manage your blood sugar.

Scientists are still studying the causes for type 1 diabetes. But, it seems that both genetics (inheritance) and environment are factors. Scientists believe that type 1 occurs when something in the environment triggers diabetes in a person who already has a genetic tendency toward the disease.

Type 1 diabetes usually appears suddenly and progresses quickly. It tends to occur in people of normal weight. It can cause a rapid weight loss before it’s detected and treated. Anyone can get type 1 diabetes. Children and young adults get it most often, especially those with a strong family history of type 1 diabetes.

To confirm a type 1 diabetes diagnosis, your doctor will ask about your symptoms and family history, as well as perform a few tests. To diagnose and monitor diabetes, healthcare providers test your plasma glucose levels. In the United States, plasma or whole blood glucose are measured in milligrams per deciliter, or mg/dL.

• HbA1C test. This test can be done any time during the day, whether or not you’ve eaten recently. It requires a small blood sample that’s then analyzed. The HbA1c test is used to monitor diabetes as well as to diagnose it. This test is unique in that it evaluates blood glucose levels over several months.
• Fasting plasma glucose (FPG) test. For the FPG test, you first need to fast (not eat or drink anything except water) for at least 8 hours. Then, a sample of your blood is drawn and analyzed at your healthcare provider’s office.
• Other blood tests. Your doctor may ask for additional blood samples to test for ketones in your urine.

People with type 1 diabetes must take insulin every day — usually several times a day. Most people take insulin by injection (a shot). Others wear a small pump that delivers insulin continuously into their body.

People with type 1 also need to follow a meal plan and get regular exercise to help regulate blood glucose levels. Although people with LADA may respond to oral diabetes treatments for a time, they typically need to take insulin within a few months. Over time, the autoimmune process destroys insulin-producing cells in the pancreas.

Because we don’t know the exact causes of type 1 diabetes, we also are unsure of how to prevent it. However, it is always a good idea to maintain a healthy weight through good nutrition and regular exercise.

• Diabetes Care Handbook

People with type 1 typically have high blood glucose levels, in addition to other symptoms:

• Ongoing fatigue
• Increased thirst and hunger
• Urinating more frequently
• Unexplained weight loss
• Mood changes
• Blurred vision
• Infections or cuts that take an abnormal amount of time to heal