A Guide To Type 1 Diabetes

A Guide To Type 1 Diabetes

Type 1 diabetes is a chronic condition in which glucose levels in the blood are too high. It affects 370,000 people in the UK, and the incidence of type 1 diabetes is increasing.  Type 1 diabetes can affect your body from top to toe, impacting your health, wellbeing and quality of life. 

 

What is type 1 diabetes?

 

Type 1 diabetes is an autoimmune disease in which your body attacks and destroys the beta cells in the pancreas that produce the hormone insulin.  

Insulin regulates glucose levels in your blood. It acts as a key, unlocking the body’s cells so that they can use glucose for energy and ensuring that excess glucose is stored for use in the future. 

With type 1 diabetes, your body can’t produce insulin. As a result, your cells can’t get the glucose energy they need to fuel their functions, and the level of glucose in your bloodstream increases.

If you have type 1 diabetes, your body will need replacement insulin to allow the cells in your organs, muscles and tissues to get the energy to work and stay alive and to control the blood glucose levels in your blood.

 

Who gets type 1 diabetes? 

 

Type 1 diabetes can affect children and adults of all ages. It used to be called juvenile diabetes because it commonly develops in children and young people. However, the name was changed because adults can also develop type 1 diabetes. The average age of diagnosis of type 1 diabetes is 13 years- but ranges from babies to the elderly. 

 

What causes type 1 diabetes?

 

Doctors and scientists don’t fully understand the causes of type 1 diabetes. However, several factors are believed to work together to increase your risk of developing the condition. Many people with type 1 diabetes have a family member that is also affected. 

Experts believe that an individual’s genes and environmental factors combine to cause type 1 diabetes. Research into the causes is ongoing, they include:

  • Genetics: Researchers have identified many different genes that can increase your risk of type 1 diabetes
  • Viral infections: Viruses including Human Enteroviruses and SARS-CoV-2 have been linked to type 1 diabetes
  • Gut microbiome
  • Environmental factors

 

Symptoms of type 1 diabetes

 

The symptoms of type 1 diabetes usually come on suddenly, especially in children. Without essential insulin, your cells will be starved of the energy they need, and the glucose levels in your blood will increase.  This is known as hyperglycaemia or a ‘hyper’ and can cause symptoms. You may notice:  

  • Feeling tired and low in energy
  • Passing more urine
  • Feeling more thirsty
  • Blurred vision
  • Feeling hungry
  • Sudden weight loss 
  • The smell of pear drops or nail varnish remover on your breath

If you think you may have type 1 diabetes, it’s important to get urgent treatment and care. Call NHS 111, make an urgent appointment with your GP or attend an accident and emergency department.

 

Diagnosis of type 1 diabetes

 

Your doctor will diagnose Type 1 diabetes based on your symptoms, an examination and tests to check glucose levels in your blood. Tests include:

  • Finger-prick blood test: A random finger-prick blood test can immediately indicate your blood glucose levels. If they are over 11.1 mmol/l, you are likely to have diabetes. However, your team should take a venous blood sample to confirm the diagnosis
  • Random venous plasma glucose concentration: A blood glucose of 11.1 mmol/l or more indicates diabetes
  • Urine dip test: When your blood glucose levels rise, glucose leaks into the urine, which can be identified using a urine dipstick

Anyone with new type 1 diabetes should be referred to a specialist hospital team for urgent assessment and treatment on the same day.

 

Treatment of type 1 diabetes

 

The treatment of type 1 diabetes should be holistic, supporting your physical and mental health. Your GP will work with your specialist hospital team to help you control and monitor blood sugar levels, maintain your health and prevent the long-term complications of diabetes. Treatment of type 1 diabetes includes:

 

Insulin replacement therapy

 

With type 1 diabetes, your body can’t produce any insulin. You will need replacement insulin to enable your body to use and store glucose from your food. 

Insulin needs to be injected because it is destroyed in the stomach. You can inject a combination of background or basal insulin, together with extra insulin at mealtimes. 

Different formulations of insulin are available, including fast, medium, slow-acting and mixed insulin. Your team will prescribe the right combination for your needs and lifestyle and teach you how to administer and balance treatment. It’s a steep learning curve, but people with type 1 diabetes quickly become experts in managing their condition. 

You can administer insulin in several ways:

  • Insulin syringe
  • Insulin pen: a slim pen-like device that you load with insulin for quick, discreet injections
  • Insulin pump: battery-powered devices that pump insulin into your system twenty-four hours a day. Pumps can help you live and eat more flexibly and are very useful if you’re struggling to control your blood glucose levels effectively 

 

Diet and nutrition

 

The carbohydrates in your food are broken down into glucose. The amount you eat will affect your blood sugar levels and the amount of insulin your body needs. A dietician or diabetes specialist nurse can help you understand nutrition and diabetes and count the carbohydrates in your diet.

 

Blood glucose monitoring

 

Measuring and understanding your blood glucose levels is crucial for good diabetes management. Your team should provide you with ways to test your blood glucose levels several times a day using finger-prick tests. 

You will be taught to recognise and treat high blood sugars (hypers) and low blood sugars (hypos).  If your glucose is regularly going too high or too low, they may suggest a continuous glucose monitor (CGM) to help improve control. 

Your team will also regularly monitor your blood glucose using your HbA1c. The HbA1c is a blood test that reflects your average blood glucose levels over the preceding two to three months. A value of less than 7.5% shows good diabetes control.

 

Health screening

 

The raised glucose levels in type 1 diabetes can damage your heart, eyes, kidneys, blood vessels, nerves and feet. Good diabetes control can reduce the risk- but you should also have regular screening to identify problems at an early stage and protect your health. Screening for type 1 diabetes should include:

  • Eye checks for diabetic retinopathy
  • Kidney screening to look for diabetic nephropathy
  • Foot examinations to check for nerve damage and circulation problems
  • Cholesterol screening
  • Regular blood pressure checks

 

To find out more about effective diabetes medications, or to speak to one of our specialists at the London Diabetes Centre about prospective treatment options, contact us today.

Sources:

https://www.nhs.uk/conditions/type-1-diabetes/

https://www.nice.org.uk/guidance/ng17

https://www.diabetes.org.uk

https://www.diabetes.co.uk/diabetes-complications/screening-for-diabetic-complications.html

https://www.diabetes.org.uk/research/our-research-projects/south-west/understanding-the-extremely-early-onset-of-type-1-diabetes

https://www.diabetes.org.uk/research/research-round-up/research-spotlight/research-spotlight-what-causes-type-1-diabetes

https://www.nice.org.uk/guidance/ta151/chapter/1-Guidance

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