(Diabetes Type 1)

In this condition factsheet:

• The facts on Type 1 Diabetes


• Causes of Type 1 Diabetes


• Symptoms and Complications of Type 1 Diabetes


• Diagnosing Type 1 Diabetes


• Treating and Preventing Type 1 Diabetes

The Facts on Type 1 Diabetes

Diabetes is a condition of elevated blood sugars in which the body does not make enough insulin and/or the insulin being made cannot be used properly by the body. The body's main fuel is a form of sugar called glucose, which comes from food (after it's been broken down). Glucose enters the blood and is used by cells for energy. To use glucose, the body needs a hormone called insulin, which is made by the pancreas.

Insulin is important because it allows glucose to leave the blood and enter the body's cells. Diabetes develops when your body can't make any or enough insulin, or when it can't properly use the insulin it makes.

There are two main types of diabetes: type 1 and type 2. Type 1 diabetes develops when your body makes little or no insulin. When this happens, glucose can't get into the cells for energy and remains in the blood, causing hyperglycemia (high blood sugar).

Type 1 diabetes is an autoimmune condition. Most people develop type 1 diabetes before the age of 30, but it can also occur in older adults. In North America, 5% to 10% of people with diabetes have type 1 diabetes. It occurs equally among women and men.

Causes of Type 1 Diabetes

There is a genetic predisposition for type 1 diabetes, but the exact science behind the condition is not yet fully understood. There is also the need for certain environmental factors or "triggers" to be involved that lead to the condition.

While the exact cause of type 1 diabetes isn't known, researchers believe the disease develops when a virus or environmental toxin damages the pancreas or causes the body's immune system to attack the beta cells of the pancreas (called an autoimmune reaction). As a result, the beta cells of the pancreas can no longer produce enough insulin.

Without insulin, glucose in the blood can't enter the cells in the body and blood glucose levels rise. The body begins breaking down fat and protein for energy instead of using glucose for energy.

Symptoms and Complications of Type 1 Diabetes

Although some people have no symptoms, most people diagnosed with type 1 diabetes have the following signs and symptoms of hyperglycemia (high blood sugar):

• blurred vision
• decreased mental sharpness
• extreme thirst and hunger
• feeling tired (fatigue)
• frequent need to urinate
• frequent skin infections
• weight loss despite having an increased appetite
• slow-healing wounds

In some cases, emergency symptoms of very high blood sugar may develop. They include:

• confusion
• fast breathing
• fruity-smelling breath (a sign of diabetic ketoacidosis)
• loss of coordination
• pain in the abdomen
• shaking
• slurred speech
• unconsciousness
• nausea
• vomiting
• fast heartbeat

It's absolutely critical to get immediate emergency medical attention if any of the above emergency symptoms develop. Make sure you get to a hospital right away.

There are short- and long-term complications associated with diabetes. Short-term problems are hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). Taking too much insulin*, missing a meal, or over-exercising can make blood sugar go too low.

Symptoms of low blood sugar can come along very quickly, and they can include:

• cold sweats
• fast heartbeat
• hunger
• lightheadedness
• numbness of the tongue and lips
• shakiness
• anxiety
• nausea

In contrast, symptoms of high blood sugar (such as thirst, increased urination, or blurred vision) usually come on slowly and can be brought on by circumstances such as taking too little insulin, eating too much food, or during stressful times or illness. A serious condition called ketoacidosis can occur when blood sugar is high and there is not enough insulin circulating in the body. Diabetic ketoacidosis mainly affects people with type 1 diabetes and can be very dangerous if left untreated.

Long-term complications develop when blood sugars are high over a long period of time, such as eye, kidney, and nerve problems as well as damage to blood vessels.

Damage to the larger blood vessels can cause narrowing of large arteries (atherosclerosis), which can lead to heart attack, stroke, and poor blood flow to the legs. Damage to small blood vessels can affect the eyes (a condition called diabetic retinopathy), which is the leading cause of blindness in North America for people 20 to 74 years of age. It can affect the kidneys and lead to nephropathy, which is the leading cause of kidney failure in Canada. It can also affect the nerves that supply the extremities (legs and arms), leading to nerve damage called neuropathy.

Other long-term complications of type 1 diabetes include slowed movements of the stomach and intestines caused by nerve damage (diabetic gastroparesis), increased risk of infection, and skin problems (poor wound healing and ulcers).

Fortunately, many of the complications of type 1 diabetes can be prevented or at least delayed by keeping blood sugars under good control.