Understanding Type 1 Diabetes: A Patient Guide

Type 1 diabetes is a chronic condition where your body’s immune system attacks the cells in your pancreas that produce insulin. Insulin is a hormone that helps regulate blood sugar (glucose) levels. Without enough insulin, glucose builds up in your blood, leading to high blood sugar levels (hyperglycaemia). This guide explains the condition, its causes, symptoms, treatments, and how to manage living with it.

Background on Type 1 Diabetes

• History: Type 1 diabetes was first identified as a distinct condition in the early 20th century. The discovery of insulin in 1921 revolutionised its treatment.
• Global Impact: Type 1 diabetes accounts for about 5–10% of all diabetes cases worldwide. It requires lifelong management to prevent complications.

Causes, Incidence, and Prevalence

Causes

Type 1 diabetes is an autoimmune condition, meaning your immune system mistakenly attacks healthy cells—in this case, the insulin-producing beta cells in the pancreas. The exact cause is unknown but likely involves:

• Genetics: Certain genes increase the risk of developing type 1 diabetes.
• Environmental Triggers: Factors like viral infections or exposure to certain toxins may trigger the immune response in genetically predisposed individuals.

Incidence and Prevalence

• Incidence: Around 15–30 new cases per 100,000 people are diagnosed annually worldwide (Diabetes UK).
• Prevalence: Approximately 9 million people globally live with type 1 diabetes (International Diabetes Federation).

Who Is Affected?

1. Age of Onset: Type 1 diabetes often develops during childhood or adolescence but can occur at any age.
2. Gender: Both males and females are equally affected.
3. Ethnicity: Higher rates are seen in people of European descent compared to other ethnic groups.

Geographic Distribution

Type 1 diabetes is more common in northern Europe and North America than in Asia or Africa. Finland has one of the highest rates globally.

How Does Type 1 Diabetes Impact You?

Symptoms

The symptoms of type 1 diabetes can appear suddenly and may include:

• Excessive thirst (polydipsia).
• Frequent urination (polyuria).
• Unexplained weight loss.
• Fatigue or low energy levels.
• Blurred vision.
• Increased hunger (polyphagia).

If untreated, it can lead to diabetic ketoacidosis (DKA), a life-threatening condition where the body breaks down fat for energy, producing harmful acids called ketones.

Living With Type 1 Diabetes

Living with type 1 diabetes requires daily management of blood sugar levels through insulin therapy, monitoring devices, and lifestyle adjustments. The condition can affect your physical and emotional well-being but can be managed effectively with proper care.

Expected Life Expectancy

With advances in treatment, many people with type 1 diabetes live long and healthy lives. However, poorly managed blood sugar levels can lead to complications that may reduce life expectancy.

Managing and Treating Type 1 Diabetes

Available Treatments

There is no cure for type 1 diabetes, but treatments focus on maintaining normal blood sugar levels to prevent complications:

1. Insulin Therapy:
   1. Rapid-Acting Insulin: Taken before meals to manage spikes in blood sugar (e.g., insulin lispro).
   2. Long-Acting Insulin: Provides a steady level of insulin throughout the day (e.g., insulin glargine).
   3. Insulin is administered via injections or an insulin pump.

2. Blood Sugar Monitoring:
   1. Regular finger-prick tests or continuous glucose monitors (CGMs) help track blood sugar levels throughout the day.

3. Lifestyle Adjustments:
   1. Healthy Diet: Focus on balanced meals with controlled carbohydrate intake to stabilise blood sugar levels.
   2. Regular Exercise: Helps improve insulin sensitivity but requires careful monitoring of blood sugar to avoid hypoglycaemia (low blood sugar).

4. Education and Support:
   1. Diabetes education programmes teach you how to manage your condition effectively.
   2. Psychological support can help address emotional challenges associated with living with a chronic condition.

Ongoing Clinical Research

Research into type 1 diabetes continues to explore new treatments and potential cures:

1. Artificial Pancreas Systems: Combining continuous glucose monitors with automated insulin pumps for better blood sugar control.
2. Islet Cell Transplants: Replacing damaged beta cells with healthy ones from donors.
3. Immunotherapy: Targeting the immune system to prevent it from attacking beta cells.
4. For information on clinical trials related to type 1 diabetes, visit gov.

Support Groups and Resources

If you have been diagnosed with type 1 diabetes or are caring for someone who has it, connecting with support groups can provide valuable information and emotional support:

1. Diabetes UK (org.uk)– Offers resources for managing life with diabetes in the UK.
2. Juvenile Diabetes Research Foundation (JDRF) (org.uk)– Focuses on funding research for type 1 diabetes and providing community support.
3. International Diabetes Federation (IDF) (org)– Provides global advocacy for people living with diabetes.
4. American Diabetes Association (ADA) (org) – Offers education and support for individuals affected by all types of diabetes.