Type 1 Diabetes: Causes, Symptoms, Screening and Daily Care

In type 1 diabetes, the pancreas makes no insulin or very little. Insulin lets blood sugar into the body's cells to be used for energy; without it, sugar builds up in the blood, and high blood sugar causes many of diabetes's symptoms and complications.

Once called insulin-dependent or juvenile diabetes, type 1 often starts in children, teens and young adults, but can begin at any age. It's less common than type 2 — about 5%–10% of people with diabetes have type 1.

No one knows yet how to prevent it, but it can be managed well by following your doctor's advice on a healthy lifestyle, managing blood sugar, getting regular checkups, and using diabetes self-management education and support.

Causes

Type 1 is thought to be an autoimmune reaction: the body mistakenly destroys the beta cells in the pancreas that make insulin — a process that can go on for months or years before symptoms appear.

• Some people carry genes that raise their chances, though many never develop it.
• An environmental trigger, such as a virus, may play a part.
• Diet and lifestyle don't cause type 1 diabetes.

Who's at risk

Risk factors are less clear than for type 2:

• a parent, brother or sister with type 1;
• age — it usually starts in children, teens or young adults.

In the U.S., White people are more likely to develop type 1 than African American or Hispanic/Latino people.

Symptoms

Early on there are no symptoms. As it progresses, symptoms can appear suddenly — within weeks or months — and be severe. Some resemble other conditions, so don't guess: if you think you might have type 1, get your blood sugar tested. Untreated diabetes can lead to very serious, even fatal, problems. See also: just diagnosed with type 1.

Testing and screening

• A simple blood test screens for diabetes. If you were tested at a health fair or pharmacy, confirm the result at a clinic or doctor's office.
• If type 1 is suspected, or you're at high risk, you may be screened for diabetes-related autoantibodies, which can find early stages that can be treated before symptoms and complications appear.
• Your doctor may test your urine for ketones, made when the body burns fat for energy; ketones can point to type 1 rather than type 2.

CDC's screening infographic shows who should be screened and how it works.

Living with type 1

Diabetes is managed mostly by you, with a team: primary care doctor, foot doctor, dentist, eye doctor, registered dietitian nutritionist, diabetes educator and pharmacist — plus family, teachers and others close to you.

• Insulin every day, by injection or pump. It can't be taken as a pill, because stomach acid would destroy it. Your doctor will find the right type and dose.
• Regular blood sugar checks — ask how often, and what your targets are. Staying near target helps prevent or delay complications.
• Know how to handle low blood sugar (hypoglycemia) and diabetic ketoacidosis, both common complications — ask your doctor for step-by-step instructions.
• Stress makes diabetes harder to manage; exercise, sleep and relaxation help.
• Healthy food, physical activity, and managing blood pressure and cholesterol.
• Regular appointments keep you on track.

Parents of a young child with type 1 will handle daily care — insulin and watching for and treating low blood sugar — and stay in close touch with the child's health care team.

Managing diabetes can be hard, but everything you do for your health is worth it.

Sources

Based on "Type 1 Diabetes," Centers for Disease Control and Prevention; a work of the United States government in the public domain.