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About type 1 diabetes

The release of insulin from pancreatic beta cells is triggered by a rise in blood sugar; for e.g. after eating a meal.

When the beta cells that store and release insulin are destroyed, this leads to high sugar levels in the blood. Over time, this leads to serious illness including heart attack, stroke, blindness and kidney disease.

People with type 1 diabetes mellitus (T1D) have to monitor their blood sugar levels, and take insulin injections several times a day.

Life expectancy is lower for people with T1D.  A significant proportion of people will also develop serious complications.

The causes of type 1 diabetes 

T1D develops when the beta cells that make insulin are destroyed by the body’s own immune system. Hence it’s classified as an autoimmune disease. In type 2 diabetes, the beta cells are normally preserved.

We’re not sure why this immune attack occurs, but we know it’s caused by an interaction between genes and the environment. There is a genetic risk for T1D, although 80% of people with T1D have no family history of the disease.

  • Risks
  • Symptoms
  • Diagnosis & Treatment

Unlike type 2 diabetes, T1D cannot be prevented and is not associated in any way with obesity or lifestyle. Even with insulin treatment, T1D can dramatically impact quality of life.

T1D is also associated with serious complications that can reduce life expectancy. It’s estimated that people diagnosed before the age of 30 will lose more than 10 years of life expectancy. Almost one third of people with T1D will suffer life-threatening kidney failure, thereby needing dialysis or a kidney transplant.

Long-term complications can also affect the eyes and the cardiovascular system.

One of the more worrying complications is hypoglycaemic unawareness. When your blood sugar drops, you usually feel warning symptoms like shaking and sweating.  However, someone with hypoglycaemic unawareness will not recognise these symptoms. If not treated appropriately, the results of a hypoglycaemic episode can be serious, and include loss of consciousness, brain damage, coma and death.

The symptoms of type 1 diabetes include:

  • Excessive thirst
  • Frequent urination (including through the night)
  • Hunger or loss of appetite
  • Unexplained weight loss
  • Fatigue, tiredness, nausea and vomiting
  • Itching skin, thrush or other skin infections
  • Visual disturbances, such as blurred vision.

Uncontrolled diabetes can severely damage the organs and tissues of the body.

Further complications include:

  • kidney damage
  • increased likelihood of infections
  • damage to the eyes (diabetic retinopathy and cataracts)
  • poor blood circulation in the legs and feet, sometimes requiring arterial grafts or lower limb amputation
  • damage to the nerves of the hands and feet
  • increased likelihood of heart disease and stroke
  • problems with pregnancy
  • and problems with sexual function.

Despite ongoing research, at this stage nothing can be done to prevent or completely cure type 1 diabetes, but the condition can be successfully managed.

  • Self-monitoring of blood glucose levels by regularly testing blood in a glucose meter
  • If glucose levels are high, self-testing to check for ketones in urine or blood
  • Taking regular insulin injections
  • Increasing the amount of ‘slow’ carbohydrates in the diet, such as beans and fruit, which take longer to be absorbed by the body (low GI foods)
  • Regular exercise
  • Regular medical checks, including eye checks.

There’s some indication that research into whole-genome sequencing and islet cell transplantation are offering hope in understanding and treating T1D.

This content is provided for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. If you have any concerns or questions about your health, please consult a suitably qualified healthcare professional.